Equity Beyond Entry: A Capability Approach to Understanding Widening Participation in Medical Education.
Ashley Simpson1,2, David Hope1, Jeni Harden1
1The University of Edinburgh, UK.
Perspectives on Medical Education
|December 1, 2025
Summary
Widening participation students face systemic barriers in medical education, from low expectations to financial insecurity. True equity requires transforming institutional conditions to support student success and valued outcomes.
Area of Science:
- Medical Education
- Health Equity
- Sociology of Education
Background:
- Widening participation initiatives aim to increase diversity in the healthcare workforce.
- Systemic inequities continue to impact medical students' educational trajectories.
- The capability approach offers a framework to understand factors influencing student success.
Purpose of the Study:
- To explore the experiences of widening participation students in medical education.
- To identify factors enabling or constraining student success.
- To apply the capability approach to medical education equity.
Main Methods:
- Qualitative study using semi-structured interviews.
- 16 medical students from widening participation backgrounds in Scotland were interviewed.
- Data analyzed using reflexive thematic analysis and interpreted through the capability approach.
Main Results:
- Students faced capability constraints due to discouragement and educational disadvantage.
- Financial insecurity, poor support, and limited guidance restricted capabilities.
- Individual resilience was more critical than institutional support for success.
Conclusions:
- Medical education equity needs more than access; it requires addressing systemic barriers.
- The capability approach highlights the need for institutional reform to enhance student freedoms.
- Transforming institutional conditions is crucial for enabling students to achieve valued outcomes.
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