Historically, members of the medical and dental profession belonged exclusively to the upper classes of society. Whilst progress has been made, the majority of current dental and medical students belong to the most affluent groups. The Scottish Dental Workforce report of 2016 highlighted the differences in the demographics of students within Scottish dental schools. Whilst the gender balance of BDS cohorts are relatively equal, individuals from the most deprived backgrounds represent just 8.9% of the cohorts. This is not just a Scottish issue but one that extends across the United Kingdom.
As a first-generation (future) dentist from a working-class background, and first-generation university student, this is something that means a great deal to me. I believe more needs to be done to identify the specific barriers and encourage individuals from working-class and deprived backgrounds to enter the dental and medical profession. The issues and barriers to access are multifactorial and there isn't just a quick fix. Some of these barriers that impact aspirations of young people are defined by Scottish parliament as; parents income and occupation, social background and socioeconomic environments of upbringing.
I wanted to share a little on my journey to dental school. I grew up in the Burnley and Pendle area, a post-industrial region in East Lancashire which is now a pocket of deprivation. I knew in my mid-teen years that I wanted to work within healthcare. My parents were hugely supportive but having not attended university they did not how to help me in the process. My sixth form was a little more equipped in helping me in the process, providing help with the UKCAT exam and mock interviews. I was the only student in my year who applied for dentistry (of a year of ~200), with no other students applying for medicine or veterinary sciences. It felt quite isolating, but I was extremely determined to get into dentistry. I had a huge amount of advice from a former student from my sixth form who had applied to medicine the year prior. I would say without his tips and advice I probably wouldn’t be at the position that I now am.
There are issues regarding the inequalities in education, this is a systemic problem that needs to be addressed (far too much to discuss today). However, I believe part of the problem can be the attitudes of the teachers themselves. I had such a varied experience of support during my education. When I had my interview for sixth form, I drew attention to the fact that I wanted to study dentistry. Due to the area I was from and school I attended my predicted grades were quite low, much lower than what I was expecting to achieve. The teacher who interviewed me basically laughed at the prospect and said I would have to be more realistic about what I wanted to do. At 16, I found this incredibly defeating. In contrast, a teacher I had during high school went above and beyond to help another student and I do an additional science GCSE in our own time, which was to be essential to my application to dental school (Fun fact - the other student I studied with is now studying medicine as a postgraduate!).
The teachers that had confidence in me and wanted me to succeed went the extra mile to help and gave me the self-belief that it was something I could achieve, and I cannot thank them enough for that. I also believe there is a culture of internalised disbelief within students from these backgrounds that medicine and dentistry are feasible career choices. Students with an interest need to be feel empowered, and this is something I am hoping to bring forward. I am hoping to develop a short programme for A-level students at my former sixth form, with an interest in dentistry and medicine, to develop a comprehensive curriculum consolidating the application process, entrance exams, interview techniques and extracurricular support. If successful, I would love to extend this to a wider range of students.
I think that members of the profession also need to provide support where available for individuals interested, regardless of their background, particularly in regard to access to experience/shadowing within the dental practice. When I was applying, I contacted over 50 dental practices, to which one agreed to give me some shadowing experience. This exposure allows young people to gauge their interest in joining the profession, as well as being an essential aspect to university application.
The Scottish Government Report concerning access to higher education provided targets that by 2021, 10% of all university places should be held by individuals from the 20% most deprived backgrounds, with the target increasing to 20% of students by 2030. Most universities in the UK are now participating in widening participation schemes for individuals from lower socioeconomic backgrounds. An initiative, REACH, has been adopted by the top Scottish universities, and provides support to secondary school students who are interested in professional degree programmes such as dentistry, medicine, law and veterinary sciences. Teachers need to interact with these programmes for the benefit of their students. These initiatives are vital in tackling the inequalities in access to professional qualifications. Representation and access in the profession is so important.
Olliver
*An update on my first blog on the documentary 'Root Cause'. The doc has now been removed from Netflix. Hallelujah!*
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