Monitoring the widening participation initiative for access to medical school: are present measures sufficient?

CONTEXT: Widening access to higher education is a political priority. Social trends among medical school applicants are presently monitored using information on parental occupation. However, not all students now provide this information on their university application forms. OBJECTIVES: To compare the demographic characteristics of applicants who do and do not provide information about parental occupation, and to consider the utility of an alternative measure based on area of residence (Townsend score). METHODS: We surveyed the application forms of all individuals domiciled in England who made applications to English medical schools in 1996-2003. RESULTS: During 1996-2003, the proportion of applicants who did not declare parental occupation rose from 4.6% to 18.2%. Younger applicants were more likely to state that their parents were employed in professional/managerial occupations than mature applicants. White applicants were more likely to be from professional/managerial classes (72%) than were Black (60%) or Asian (60%) applicants. Although an association between socioeconomic class based on parental occupation and Townsend score was noted, this masked substantial variation between demographic groups. Applicants who did not disclose their parents' occupations were more likely to be non-White and to live in deprived areas. However, White applicants who did not state parental occupation were equally distributed by Townsend score. CONCLUSIONS: The sole use of parental occupation or area-based measures to monitor widening participation programmes requires caution given the proportion of applicants who do not provide this information and the age and ethnic group differences noted.