MedEdPublish (Dec 2018)
Diversifying the medical workforce requires a step change in widening participation - Putting the cat amongst the pigeons!
Abstract
Worldwide there is a call for diversifying the healthcare workforce through widening participation (WP) necessitating a significant change in current recruitment and selection policies and practices. However this is advocated without a well understood conceptualisation of WP or consensus between stakeholders about its purposes. Employers, and patients, require a medical workforce that is both caring and competent but also accessible. This presents a significant challenge for most countries, especially in some areas of healthcare, for both common and varying reasons. For example Australia and NZ have long struggled to recruit healthcare workers to remote and rural parts of their countries, whilst currently general practice within the UK, is in crisis due to under recruitment and low morale. Higher Education institutions wish to recruit the best students but it is not clear who the "best students" are and who will progress to fulfil future workforce requirements. Globally universities are concerned by market forces and face significant financial constraints often directly competing with WP policies. Furthermore an established culture of meritocracy, schemes to "top-up" perceived deficits within certain student groups, and fears surrounding the performance of non-traditional students once at university, deter both would be students and the institutions themselves from increasing diversity. Whilst medical schools may aspire to the aims of social justice and fair opportunities such a trajectory is plagued with difficulties, such as university tariff leagues tables, and concerns with student attrition and differential attainment. However considering the aforementioned workforce issues it is timely to look afresh at what our priorities are in selecting for the future medical workforce. Better understanding the available evidence and the inherent tensions within WP would help us make the required step change that facilitates selecting a more appropriate medical workforce.
