Editor—Seyan et al use the standardised admissions ratio to measure widening participation in medical schools.1 This ratio is difficult to interpret, although it is an interesting concept. The validity of the measure of social class as used by the University and Colleges Admissions Service (UCAS) is poor.
UCAS uses brief, typically one word, students' descriptions of parental occupation to assign social class (www.ucas.ac.uk/figures/enq/index.html). This process is unlikely to be an unbiased, reliable, or valid indicator of the subtleties of class,2 particularly for 17 year olds with little idea of parental jobs and for ambiguous terms such as “manager”—of a small rural petrol station or a multinational oil company? The uninterpretable numerator of standardised admissions ratios is exacerbated by a denominator derived from entirely different data (www.statistics.gov.uk).
Standardised admission ratios cannot reach a value of unity. Post-1945 Britain has very much been meritocratic, with interclass mobility driven by intelligence,3,4 which predicts examination results (and hence university entrance), making it unsurprising that higher classes predominate in universities. Standardised admission ratios are unlikely ever to reach a utopian value of unity. Selection entirely based on intelligence would mean that 14%, 35%, 41%, 8%, and 2% of medical students would be from classes I to V with standardised admission ratios of 2.25, 1.18, 0.97, 0.48, and 0.30; social class I is still 7.7 times that of class V.5
A longer view shows little systematic change in social class of UK medical students over half a century (figure). The standardised admission ratios for social class I dropped from 12.3 in 1956 to 6.76 in 2001, but only because social class I is now twice as common in the population.
Figure 1.
Proportions of UK medical students in social classes I, II, III, and IV and V, from 1956 to 2001 compared with population proportions for 1961 and 2001 (see http://bmj.bmjjournals.com/cgi/eletters/328/7455/1545#64772 for data sources)
References
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