Answer to "What is meant by widening participation and widening access?"
There is clear evidence of significant under-representation of some social, cultural and ethnic groups in medical schools and medicine worldwide. Widening participation (WP) or medical student diversity refers to the policies that under-represented minorities (URMs) such as those coming from disadvantaged backgrounds, mature students, students from certain ethnic and cultural groups and disabled students should be encouraged to take part, and be represented proportionately, within medical education. Widening access, on the other hand, focuses on the equality or fairness of the selection tools/processes that act as a gateway to medicine.
Nicholson S, Cleland JA. Reframing research on widening participation in medical education: using theory to inform practice. In Cleland JA and Durning S. 2015. Researching Medical Education. Wiley: Oxford, p.231-243.
Many countries have a political mandate to increase the diversity of the medical school intake (i.e., widen participation), and hence the diversity of the medical workforce further down the pipeline. Enacting this mandate falls to medical schools. Achieving government targets (such as quotas of people from certain groups) can be challenging as selecting from under-represented groups depends on people from those groups considering medicine as an option, and applying to medical school.
The references below provide Canadian and American policy approaches to medical student diversity as examples – many other countries have equivalent documents.
Knowing whether or not WP and/or WA have worked depends on monitoring the progression of graduates.
Interestingly, there is a counter issue to widening access in some countries – the situations where alumni children are privileged in the admission processes either explicitly (e.g., extra points, knowing assessors personally) or more indirectly via gaining ‘insider knowledge’ from family and/or family friends with medical backgrounds and/or who are involved in the admissions process. Given this, medical schools must consider how their policies and practices may actually narrow access. Simple actions such as asking raters to declare potential conflicts (such as knowing or being related to someone currently applying to medical school) and using this information to, for example, ensure individual raters do not assess those applicants with whom they may have the potential conflict of interest, are now in place in some medical schools. As mentioned earlier, ensuring your admissions selectors are themselves diverse can help.