Exploring the Potentials and Pitfalls of Work Experience and Widening Participation through Narrative Interviews

Background Applicant work experience (WE) is a non-academic criteria considered by many medical schools in their admissions processes. Concerns have been raised within the literature that access to some WE opportunities may be more elusive for students from less advantaged socioeconomic backgrounds (LA-SDBs). Few qualitative studies exist which explore applicant experiences of WE, and its contribution to the widening access agenda. Our qualitative research explores the WE of applicants from a variety of socio-demographic backgrounds, and draws on Bourdieu’s concepts of ‘capital’ and ‘habitus’ as tools which enable critical analysis of the role work experience may play in the reproduction of inequality. Methods Narrative telephone interviews were undertaken with 23 applicants to a large United Kingdom medical school in the 2017-18 admissions cycle, purposively sampled backed on school background, age, gender and widening participation experience. Framework analysis was applied to interview data, and themes and subthemes identified. Results WE remains a key step in the preparation process for applicants when applying to medical school. Participants suggested WE has the potential to confirm career choice and deepen understanding about the realities of a career in medicine. At times, applications from LA-SDB’s were provided with application support from healthcare professionals through WE which may have otherwise been inaccessible. Access to WE opportunities depended on access to information networks or school support, typically a barrier for those from LA-SDB’s, and myths and misinformation about WE were more commonly evident in this group. Conclusion Meaningful and equitable engagement in WE requires a consideration of more than just access to WE opportunities. Our results suggest that applicants require timely and transparent information on how best to engage with WE opportunities. Additionally, communication with under-represented schools, directed at dispelling myths and fostering meaningful reflection, may go some way to mitigate the risk of social and cultural disadvantage in applicants from LA-SDBs. .