Our recent research, Unequal Treatment?, conducted by academics at UCL, highlighted that only a small fraction of medical school entrants in the UK are from the lowest socio-economic background. Since its publication, the Medical Schools Council has issued a response and published a letter in the Guardian, arguing that the use of ‘NS-SEC’ method, in which an applicant’s class is determined by the occupation of their parents, is misleading.

Our research measured socio-economic background using a wide variety of measures, including parental occupation (as measured by NS-SEC). Parental occupation is a widely used and accepted measure to examine someone’s class background. Indeed, it is widely regarded by a number of major social mobility organisations as one of the best measures of an individual’s socio-economic background.

It is useful because it gets at two parts of a person’s socio-economic background: their likely family income level (or their economic background), and their likely education level and wider connections (their social background). While not perfect, it gives us a useful perspective on the socio-economic environment an individual grew up in.

The highest socio-economic backgrounds by this measure will include those with parents who are doctors themselves, or roles like CEOs, lawyers, teachers, lecturers, police officers (sergeant or above) or senior managers. Those from the lowest socio-economic backgrounds, and who research has found are the most likely to be disadvantaged in education and access to the workplace, will include those with parents who are cleaners, labourers, receptionists or caretakers. Young people from these lower socio-economic families make up just 5% of medical school entrants, compared to 75% from the highest. That is clearly a disparity the medical profession needs to address.

The Medical Schools Council advocates for the use of area-based measures such as the indices of multiple deprivation (IMD), which the MSC argues is a more accurate tool for looking at socio-economic background. Although IMD does provide useful context, it doesn’t give information on an individual’s own personal circumstances, instead it gives information about the neighbourhood in which they live. Indeed, our research has shown that IMD is only moderately related to household income. It’s also biased against those who are from minority ethnic backgrounds, live in a single parent household and who rent.

Our research suggests that while improvements in access to medical school have been observed using IMD, similar progress has not been made when socio-economic background is measured via parental occupation. This raises concerns that current initiatives might be primarily benefiting better-off students within deprived areas.

That’s why it’s so important that access efforts look at a range of measures – and indeed our research looked at a range of different measures, including parental occupation, parental education level, school type, and IMD.

The main measure we recommend for higher education institutions to use, both for assessing their progress and for contextual admissions, is the one most closely associated to family income, free school meal (FSM) eligibility. FSM eligibility also has fewer biases than other measures, particularly for single parent families and renters who are more often missed by other measures. It can still however miss students just outside of eligibility, but whose families will still be on lower incomes. FSM was unfortunately not available in the dataset used for this report, but it is now available to universities.

Alongside FSM, we recommend medical schools use area-based measures such as ACORN and IMD to monitor their progress. But these measures should be used alongside individual level data, to ensure access efforts to target less advantaged areas are not primarily benefitting better-off students within them.