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Favourable prognosis

An outreach group at a London training hospital is working to help local working-class students enter a profession they might have felt was barred to them, Mark Gould writes

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An outreach group at a London training hospital is working to help local working-class students enter a profession they might have felt was barred to them, Mark Gould writes

At a comprehensive school in East London, 40 sixth-formers are listening to two fourth-year medical students explaining how those from a working-class background can get into medical school.

"How many of you have relatives in the medical profession?" they ask. No one raises a hand.

The sixth-formers, from St Angela's Ursuline School in Forest Gate, Newham - one of Britain's poorest boroughs - are interested but shy. As the medics talk, only a few ask questions or make observations.

The sixth-formers are here because they are interested in a career in medicine, but the statistics show that it will be tough for them: just one in seven students at medical school is from a working-class family.

Having doctors in the family can help, they are told, not necessarily just through nepotism but because they offer aspiring medics advice and insights into their world. It also makes it easier for students to gain work experience, giving them a head start on the competition.

There are other factors, too. Working-class students may have three A- grade A levels, but may lose out to middle-class, often public-school, students who offer a more polished application, suggesting well-rounded characters with wide interests.

Middle-class students also tend to do better in the problem-solving and reasoning tests set by medical schools, often because they have received extra coaching.

The two medical students talking at the school, Rupali Bhatnagar and Amal Hashi, want to help those from working-class families break through those barriers. They are members - and Bhatnagar is president - of the Student Assisted Medical and Dental Applicants Society (Samda).

It was set up in 2000 at Barts and The London School of Medicine and Dentistry - which is part of Queen Mary, University of London - to help would-be medics in the surrounding boroughs of Tower Hamlets, Hackney and Newham get into medical school. Only 14 per cent of the university's medicine and dentistry students are locally born.

The society was founded by Dr Abdul Kamali, a Tower Hamlets schoolboy who felt he did not receive much support and guidance with his medical school application, and believed that students in London's East End were disadvantaged by their social background.

The society runs a programme of talks by senior doctors, events and mentoring sessions to improve understanding of the courses, add lustre to applications, sharpen interview techniques and overcome parental concerns about the cost of a medical education - pound;45,000 tuition fees for a five- year course.

Each year, medical and dental students from the society organise six sessions at 12 schools and sixth-form colleges. They explain what life is like for a GP, a colorectal surgeon or a dentist, for example.

The school students attend medical taster days - which cost the society pound;2,000 per day - at the Barts and The London Medical Simulation Centre. They take blood, stitch wounds, take blood pressure and listen to hearts. Thankfully, the "patients" are life-like automata.

In the session at St Angela's Ursuline School, Bhatnagar tells the sixth- formers that competition for places at medical school is stiff. "There are 24 medical schools in England, but there are six people applying for every place, all with good exam grades, so you have to do that bit extra to make your application stand out. You need to show you are well rounded, you should be aware of the news - read newspapers, look at the BBC News website."

Bhatnagar asks the group for their thoughts on what being a doctor is all about. "Being able to take tough decisions under pressure - being able to cope when lots of things are thrown at you," Sebastian Osei-Asibey, 16, says. He's not wrong.

The teenager has already made a good start, having done a week's work experience shadowing doctors at Newham General Hospital. "It was good to get experience of what it is like in hospitals," he says. "I didn't know that doctors are part of such a big team and it is about teamwork."

The medical students emphasise that relevant work experience is vital and that it is worth applying to hospices, charity shops, pharmacists or local GPs. They also urge the sixth-formers, mostly from South Asian or Afro- Caribbean backgrounds, to exploit family connections.

Those of South Asian origin could enhance their application by doing voluntary work when going home to visit relatives, Hashi suggests. Bhatnagar had relatives in India and managed to get work with doctors in a village just outside Delhi. "You need to think of any family connection that can help your application," she says.

The Samda president stresses that students need to achieve top-class exam grades and be fully committed. "This is a lifelong job - you are learning and updating your skills all your life - therefore you need to be sure you are making the right decision," she says. "There is a lot of hard work but there is also light at the end of the tunnel."

Some students enter medicine after completing another degree and the number of mature students is rising, so another option is entry via a relevant biomedical science degree, she says.

Healthy competition

But with more graduates applying for medicine, East End students are in competition with adults with more rounded characters, wider interests in community and volunteer work, and other extracurricular activities. Having that extra edge is more important than ever, the medics say.

Mark Wade, a senior tutor at St Angela's and its sister school St Bonaventure's Sixth Form Centre, asks if personal statements should include phrases "bordering on the cheesy or corny" such as "I like people" or "I really want to help people". Bhatnagar replies: "If it's something sincere then you should say it, but I would say that you can recognise those who are sincere during interviews."

Mohammed Hussain, a former St Angela's student who was helped by Samda and is now a second-year student at Barts, says that a series of mock interviews he did proved particularly useful. "They helped me to think clearly about my responses to questions and eased my nerves about the real thing."

The mock interviews are carried out by medical students who offer students feedback on technique, things to mention and things to leave out. The written feedback is "a bargain", as they receive it for free, Hussain says, adding that professional companies charge "between pound;100 and pound;200" for mock interviews.

Follow-up interviews also try to replicate the real thing - they are carried out by senior doctors and held in the Harry Potter-esque surroundings of the medical school library where the actual selection interviews take place.

Hussain cringes with embarrassment when he recalls that his mock interview was carried out by the daunting figure of Dr Nigel Yeatman, a senior clinical lecturer at the medical school. "He asked me if I knew what TB was and I said it was something to do with arteries and he started laughing."

Learn to self-promote

Part of the Samda philosophy is getting students to open up, Bhatnagar says. "We have seen loads of students who do great things but are reluctant to blow their own trumpets or think that people would be interested in what they did. It's a question of teasing it out and saying: `That's great, get it on your application or mention it in the interview'."

Anne Setright, head of widening participation at Queen Mary, University of London, says Samda's work complements the university's own inclusion work in local schools, with summer schools and taster days.

She refutes the idea that East End schools lack ambition and says there is no feeling that their students could not or should not study medicine, despite reports from the British Medical Association saying that fewer working-class students are applying because they are put off by the cost.

Wade ends the session with a message to the sixth-formers. "We (teachers) can tell you a lot but you are never going to get the knowledge and experience from us that you will from these medical students. These people give you the hands-on practical stuff so listen to what they are saying."

In the current economic climate, however, students are keenly aware that, even if they make it as doctors or dentists, a long career may not be guaranteed. But as the group begins to disperse, Osei-Asibey asks: "What is the likelihood of being made redundant as a doctor?"

Photo credit: Hang Kei Ho

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