12-03, 12:30–12:45 (Australia/Sydney), Zoom Breakout Room 2
Introduction:
Globally young people with the academic and personal attributes to successfully study medicine experience disadvantage associated with sociodemographic factors. Governments have attempted to address this issue via macro-level policies aimed at widening access (WA) to medicine. These policies differ by country, suggesting much can be learned from examining and comparing international policy discourses of WA. Our question was: how are discourses of WA to higher and medical education positioned in the UK and Australia?
Methods:
A systematic search strategy was guided by five a priori themes inspired by United Nations Sustainability Goals (2015). Seventeen policy documents (UK n=9, Australia n=8) published between 2008 - 2018 were identified. Analysis involved two over-arching, iterative stages: a document analysis then a Foucauldian critical discourse analysis.
Results:
Discourses of social mobility and individual responsibility within a meritocracy are still paramount in the UK. In contrast, the dominant discourse in Australia is social accountability in achieving equity and workforce diversity, prioritising affirmative action and community values. Similarities between the two countries in terms of WA policy and policy levers have changed over time, linked to the divergence of internal drivers for societal change. In both countries socially privileged stakeholders dominate policy and practice development, with implications for addressing inequities, differences and hidden disadvantage.
Discussion:
Widening access policies and hence WA practices are situated and contextual. Conceptualising equity and diversity should explicitly consider the historical disempowerment of marginalised groups and put their perspectives at the core of the design and development of policy and policy-related texts.
This work utilises a Foucauldian approach to critical discourse analysis. It is situated within the paradigmatic framework of criticalism, where the goal is to unveil power dynamics within studied phenomena and foster empowerment via description and analysis of these dynamics. Our aim was to challenge the current rhetoric of widening access to higher education and medicine via a comparison of related policy produced by organisations within the UK and Australia. The ultimate objective of this study was to identify and seek explication of the assumptions and underpinnings of widening access discourses, and how these discourses could be potentially refined, reframed or even dismantled.
Maeve is a final year doctoral student in medical education with a background in public health, psychology and mental health advocacy. Her PhD programme is part of an alliance between the University of Aberdeen in Scotland and Curtin University in Perth, Australia. Her research uses qualitative methods to explore widening access to medical education in both the UK and Australia.