Improving fairness in Scottish undergraduate medical education

Success in higher education should be determined solely by ability. While educational processes should be fair and non-discriminatory, students from some groups are less likely than others to succeed throughout their programme of study, or attain a degree with the highest merit. This is termed an awarding or attainment gap, and suggests that the educational environment is not supporting some groups of students appropriately. A fair medical education system is important for social justice, and to ensure that doctors are representative of the communities that they serve, yet awarding gaps are a particular problem for UK medical schools. The gap in award between some groups of undergraduate medical students remains evident in UK higher education, despite an increasing focus on Equality, Diversity, and Inclusion (EDI) policies and strategies. Educational inequality is a highly sensitive and complex area, and to date there is no conclusive evidence for how group membership directly affects educational awards. Research suggests that financial differences, a lack of a sense of belonging and unfair treatment might account for some instances, however, very little research has explored the medical school processes for identifying and managing concerns at an early stage. It is evident that there are barriers to successful attainment, yet, without discourse and actively identifying whether such barriers exist within a school, little action can be taken to address the issues and support students throughout their training Using qualitative methods, this research first explored the practices and views of medical education staff to query how differences in students’ awards are identified, managed and reported, and how staff engage with undertaking such work. In addition, a second study was undertaken to include the voices of undergraduate medical students who identify as belonging to one or more under-represented groups. Within this second study, students’ perspectives of seeking support within the medical school were explored. Questions devised by the researcher were used as a tool for individual, semi-structured interviews to capture these views within both studies. This research has highlighted several themes which identify concerns from both members of teaching staff and undergraduate medical students. Many of the teaching staff reported various challenges in terms of being involved within work to identify and manage unfair differences in student awards. Key aspects such as concerns of causing offense, disrepute to themselves and the establishment, and lack of guidance led to hesitancy in undertaking the work and involving oneself in discourse of the topic area. Concerningly, accounts from the second study found three primary reasons for why undergraduate medical students are less likely to seek academic support. Independence, and a preference to successfully meet the requirements of the degree without being ‘noticed’ were prevalent among the vast majority of the participants interviewed, as too was the recurrent theme that students are less likely to seek support if they are unaware that there are concerns around their performance. This has implications for educators within their practice, as when teaching staff are hesitant to identify and report on concerns, the likelihood that students will refrain from seeking feedback and support is likely to continue, limiting some groups of students from reaching their full potential. From the findings of this work, recommendations are suggested to the four Scottish medical schools included within this research. These recommendations include the need for specific training and support for staff, involving staff and students in discussions about awarding gaps, building stronger staff-student professional relationships, and finding improved ways to share knowledge about awarding gaps. If considered and addressed, these recommendations could be implemented into key areas of practice for other UK medical schools to improve fairness, and ameliorate the awarding gap.

Grantor dc:publisher

The University of Edinburgh

Year dc:date.issued

2025

Author dc:creator

• Quinn, Donna

Advisors dc:contributor.advisor

• Hope, David
• Jaap, Alan
• Kluth, David

• medical education
• medical students
• attainment gap
• staff-student professional relationships

Language dc:language.iso

en

Identifier URI

http://dx.doi.org/10.7488/era/6413

OAI identifier oai:identifier

oai:era.ed.ac.uk:1842/43882