I commend Curtis-Lopez et al. for their recent commentary piece highlighting the lack of
racial diversity in medical academia and the barriers minority-ethnic medical students face.However, strikingly absent from their piece is the role of class in determining who can
succeed in academic medicine. People from an ethnic minority in the UK are disproportionately
working class,
so it is likely they will face an additional class barrier to becoming involved in
academic medicine.Evidence is clear that students who attend medical schools with mandatory intercalation are
far more likely to apply to the Academic Foundation Programme.
This is the main entry point for medical students interested in a career as a clinical
academic. It is cheaper to attend a school with a five-year programme and therefore plausible
that more students from a lower socioeconomic background attend these schools.Many medical students, particularly those from a working-class background, have a part-time
job to support themselves. Often, you need to be able to afford to do unpaid research to get a
foot in the door of academic research. Time ‘volunteered’ that is spent trawling datasets or
conducting qualitative interviews is time away from valuable employment. A PubMed-indexed
publication might look impressive during interviews for posts in the future but cannot cover
today’s rent.While some medical schools offer paid opportunities to get involved in research, these are
limited and competitive. This means for unsuccessful applicants – who depend on the funds to
be able to pursue their research interests – there is little other option. Their wealthier,
whiter counterparts do not need to compete to take up kind offers from professors encountered
on placement.How might we tackle the material barriers that prevent medical academia from being more
diverse? Routinely recognising the research work medical students routinely perform as
work – that is, labour entitled to a corresponding wage – might be a good
start.