Abstract
Aims:The aims of this research were first, to examine trends in the application and admission to dentistry and medicine by socio-demographic status (age, gender, ethnicity, social status), geography (country/region), academic experience (school type) and attainment (tariff scores) of focused and successful applicants in the UK, 1996-2011; and, second, to explore the attitudes of young people towards dentistry as a possible degree course, identifying barriers and facilitators that may affect this choice.
Methods:
Retrospective descriptive and multivariate analyses of the characteristics of focused applicants and successful applicants to dentistry and medicine from 1996 to 2011, was conducted using anonymised UCAS data, together with analysis of accepted applicants to different dental programmes 2007-11. Exploration of academically able, science-minded young people’s (aged 14-18 years) perceptions of dentistry as a potential career was achieved through a series of focus groups conducted at various types of school in the Greater London region (13 focus groups and 91 participants), identifying barriers and facilitating factors perceived by these pupils and their careers teachers to studying dentistry at university. Data were analysed using SPSS v21.0&22.0 and Framework methodology.
Results:
Between 1996 and 2011, nearly three hundred thousand (n=286,354) focused students applied to UK dental and medical schools (n=37,948 to dental schools and n=248,406 to medical schools). A total of 126,847 were successful in this time period in gaining admission (n=16,555 to dental schools and n=110,292 to medical schools). The proportion of mature applicants to UK dental schools trebled from 11% (n=267) in 1997 to 32% (n=1,023) by 2011, while for medical school it doubled from 17% (n=2,017) to 33% (n=7,228). The proportion of female applicants remained relatively unchanged for both courses (on average, 55.6% for medicine and 52.6% for dentistry). A greater proportion of UK applicants to dentistry were from State schools compared with medicine (on average 34.7% and 31.8% ci), which increased over the time period to 40% (n=800) of applicants to dentistry in 2010, and 42% (n=6,749) to medicine. Dentistry attracted a greater proportion of UK students from ethnic minorities (on average, 56.9%) than medicine (on average, 37.1%), with the majority being from Asian groups (on average, 45.8%). A greater proportion of UK applicants to dentistry came from lower socio-economic groups (on average, 11%) than medicine (8.5%), increasing for both courses 1996-2011; however, both courses attracted (40.2% to medicine and 40.8% to dentistry) and accepted UK students from the highest Higher Education participation areas (POLAR2), this remaining unchanged 2007-2011. The UK regions where students applied from varied little over time, however, dentistry attracted a greater proportion of students from Northern Ireland (5%) and Scotland (7%) than medicine (4% and 6% ci). A significantly greater proportion of accepted students to the graduate-entry programme were mature (with an older age profile), of Black ethnicity, had a residential address in England and were from lower ‘Higher Education participation areas’ than the standard-entry dental programme, 2007-2011. Overall males, White and Black students, and those from lower participation areas and State schools were under-represented amongst applicants to both courses. Accepted applicants to dentistry, when compared with applicants, were more likely to be White, from regions of high participation, Scotland and selective schools. Accepted applicants to medicine, when compared with applicants, were more likely to be White, female, under 21 years of age, from regions of high participation, from areas other than Greater London and from selective schools. There is clear evidence that tariff scores are an important predicator of dental admission. Multiple factors were identified by London secondary school pupils that would attract them to dentistry – motivational factors – (1) Science-based; (2) Status and security – extrinsic rewards; (3) Structure of service provision; (4) Career opportunities; (5) Social interactions; (6) Personal skills and care – intrinsic rewards; and (7) as a Vocational degree. Demotivating features of the career dentistry included lack of diversity within the job, and the ‘negative image’ of dentists, with medicine having greater social status and more varied career options. Wider influences on pupils’ decision-making included ‘social and community networks’, ‘experience’ both personal and work, the school environment, as well as wider socio-economic, cultural, political and environmental conditions. A lack of ‘marketing’ of dentistry was identified by students as a reason for not considering it as a career option. Barriers to studying dentistry, supported by careers staff perceptions, included failing to achieve the required A-level grades, deficiency of information and a lack of work experience opportunities.
Conclusions:
The findings suggest that although there is evidence of an increase in some under-represented groups in UK dental schools, and to a lesser degree UK medical schools, both professions largely remain the preserve of the social elite. Pupils in London schools report similar features of dentistry as being attractive as dental students, as well as its importance as a vocational degree, and although dentistry appears to lack status, and profile, when compared with medicine, it may be more acceptable in relation to its lifestyle. Further initiatives to increase the profile of dentistry may help to achieve widening participation ambitions, particularly for under-represented groups.
| Date of Award | 1 Jun 2019 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Jenny Gallagher (Supervisor) & Lyndon Cabot (Supervisor) |