Research article
Open Access

Make Me A Medic: A Widening Participation Course Adapted Online Due to COVID-19

Jana Kossaibati[1], Madhura Ghosh[1], Anne Boulton[2], Olivia Buckeldee[2], Natalia Cotton[1], Flora Greig[1], Oliver Mitchell[1], Rory Morrice[2], Sahaj Sethi[2], Brent Bartholomew[1], Christina Cotzias[2], Orhan Orhan[1]

Institution: 1. Chelsea and Westminster Hospital, London, UK, 2. West Middlesex University Hospital, London, UK
Corresponding Author: Dr Jana Kossaibati ([email protected])
Categories: Students/Trainees, Technology, Selection
Published Date: 09/06/2021


Introduction: The COVID-19 pandemic has had an unprecedented impact on students currently preparing to apply for medical school, including lost work experience opportunities and reduced support from schools. This study evaluated an annual widening participation course aimed at supporting Year 12 students local to Chelsea and Westminster Hospital NHS Foundation Trust, which was adapted into an online format in response to these challenges.

Methods: Participants completed application forms, pre-course, post-course and daily evaluation questionnaires. Participants’ pre- and post-course self-reported preparedness scores were analysed using a two-tailed paired t-test. Thematic analysis was performed on all free-text responses.

Results: In the pre-course questionnaire (n=48), participants reported difficulties with applications due to the COVID-19 pandemic, predominantly through lost work experience and a lack of support from schools. In the post-course questionnaire (n=42), participants gained an understanding of medical school interviews, the application process and insights from doctors. Interactive Q&A sessions and practice interviews were found to be particularly valuable, however some participants were unable to partake due to factors such as poor internet connection.

Paired responses from participants completing both pre-and post-course questionnaires (n=40) demonstrated a statistically significant increase in preparedness in all areas assessed.

Discussion: With a need for alternatives to clinical work experience and school support with applications, this virtual programme is an effective example of how widening participation activities can be sustained in the current climate and continued in the future. However, inadequate internet access can pose a barrier to participation and ways to mitigate this should be considered.

Keywords: widening participation; widening access; COVID-19


The COVID-19 pandemic has brought unprecedented challenges to medical education. Whilst medical schools and hospitals have quickly adapted to using online platforms to minimise the disruption to education (Cleland et al., 2020), it is also important to consider the impact on students preparing to apply for medical school. In the longer term, selecting the most appropriate students to become the doctors of the future is essential to maintaining the medical workforce.

The pre-existing inequalities in the UK’s higher education system have been widely recognised. A report by The Sutton Trust (2020), a UK charity supporting equal educational opportunities, has shown that state school students are less likely to be receiving A-level teaching than those from private schools, a finding echoed in a recent study of medical school applicants (Woolf, Harrison and McManus, 2021). This is critical considering that A-level examination results form part of the requirements for university entrance in the UK. Additionally, many applicants have had their work experience placements and volunteering schemes cancelled. In response to this, the Medical Schools Council (the representative body for UK medical schools) published specific guidance, reassuring students that clinical work experience is not a mandatory requirement for application to medical school (Medical Schools Council, 2020a).

Applicants are, however, still expected to demonstrate insight into a career in medicine. One innovative way of achieving this is through virtual work experience programmes, such as those provided by the Brighton and Sussex Medical School (2020) and the Royal College of General Practitioners (2020). These programmes potentially provide more equal access to work experience opportunities, particularly for those from under-represented backgrounds who may not have other means of arranging placements (Milburn, 2012). However, virtual work experience programmes do not typically give applicants the opportunity to interact with medical students and doctors to hear about their personal experiences and ask questions directly.

Given the increased disparity in support with the university application process between private and state schools (Woolf, Harrison and McManus, 2021), widening participation (WP) activities are more important than ever.

The aim of this study was to evaluate Make Me a Medic (MMAM) Online - a cross-site, virtual WP course delivered by junior doctors and medical students during the COVID-19 pandemic, with the support of the Directors of Medical Education.


MMAM has been running as an annual face-to-face course aimed at Year 12 students (16-17 year olds in their penultimate year of school education), for the past three years. It is organised and delivered by the Medical Education Fellows at Chelsea and Westminster NHS Foundation Trust; a group of trainees from varying specialities who have taken time out of training to develop their interests in undergraduate and postgraduate medical education, under the supervision of the Directors of Medical Education.


Recruitment of participants for the original course commenced in December 2019. In order to prioritise pupils from under-represented backgrounds, eligibility for free school meals (FSM), a means-tested statutory benefit for school-age children, was used as a measure of educational disadvantage (Crawford and Greaves, 2013). Twenty schools with the highest rate of pupils eligible for FSM were identified from a list of all secondary state schools within a three-mile radius of the Trust’s two hospital sites (Chelsea and Westminster and West Middlesex Hospitals). These schools were offered two places each. Following the first recruitment round, remaining places were offered to all the schools within three miles of each hospital site, on a first come first served basis, with a maximum capacity of 80 attendees. Pupils were asked to complete an application form, which included their motivations for attending he course.

Due to the emerging COVID-19 pandemic, the course was initially postponed and subsequently adapted to be delivered in an online format. All participants who had already been offered places for the face-to-face course were contacted and invited to attend the online course. Both participant and parental consent were obtained for attendance and involvement in this study.

Course Design and Delivery

The MMAM online course was adapted to address the dual issues created by the COVID-19 pandemic; loss of work experience and lack of support with applications. Interactive discussion sessions with medical students and doctors, as well as practical advice for the application process were made the focus. Feedback from previous iterations of the course has indicated that the opportunity to interact with medical students and health professionals was one of the most useful aspects. The aim of these sessions was not to simply promote the positive aspects of a medical career, but to give the participants an insight into the attributes and skills required of doctors, as well as the everyday challenges they face. With evidence that new graduates are unprepared for the realities of work as a doctor (Monrouxe et al., 2017), ensuring medical school applicants have an understanding of what will be expected of them in the future is a key part of the admissions process (Medical Schools Council, 2010). Participants were given an accompanying course booklet containing information about the application timeline, writing personal statements and student finance.

The course was delivered via webinar, across three consecutive afternoons, followed by individual practice multiple mini interviews (MMI) and a closing session (Table 1). Participants were invited to register for each day they wanted to attend (Figure 1).

Table 1: MMAM 2020 Online Programme

Day 1 – 27th May 2020

Welcome and Introduction to Applications

Entry Tests – UCAT and BMAT

Medical Student Discussion Panel


Day 2 – 28th May 2020

Interview Tips

Ethics Case Discussions

Appraising Medical Information in the News


Day 3 – 29th May 2020

The Patient Journey

Q+A with Junior Doctors


Practice Interviews

(1st June – 11th June 2020)


Closing Session – 12th June 2020

Practice Interview Feedback

Personal Action Plans

Final Q&A


Figure 1: Participant recruitment flow chart


Course evaluation

Online questionnaires were distributed pre- and post-course. These assessed participants’ understanding of what it is like to work as a doctor in the NHS and the impact of COVID-19 on doctors’ working lives. Participants were also asked questions about their preparedness for different aspects of their applications, including choosing medical schools, personal statements, interviews and admission tests, using 5-point Likert scales. We hypothesised that attending the course would improve participants’ self-reported understanding and preparedness scores in the aforementioned areas. Ratings of individual sessions and self-reported confidence following the practice interviews were also assessed.

Likert scores were analysed using the two-tailed paired t-test. Effect sizes were calculated using corrected Hedge’s g (Goulet-Pelletier and Cousineau, 2018). Descriptive statistics were also calculated. All data were analysed using Microsoft Excel 2010 and the Real Statistics add-in.

Free-text responses from application forms and questionnaires were transcribed into Microsoft Word, and inductive thematic analysis was performed (Kiger and Varpio, 2020). Emergent themes were identified through reading and grouping of the data, and these were reviewed by all authors to ensure clarity and coherence.


77 students had registered for the original face-to-face course. Of these, 64 expressed an interest in attending the online version. Attendee numbers for each day of the online course were 39, 43 and 40 respectively (Figure 1).


48 participants (96%) completed pre-course surveys, and 42 (91%) completed post-course surveys. These were not anonymised so that paired responses could be included in the final statistical analysis (n = 40). There was a statistically significant increase in self-reported preparedness for all aspects of the medical school application process assessed (p ≤ 0.01). The largest effect size was in interview preparedness, and the smallest was on the understanding of the impact of the COVID-19 pandemic on doctors’ working lives (Table 2).

Of participants who completed practice interviews (n=30), 93% reported feeling more confident about medical school interviews and 97% found the individual feedback valuable (Table 3). Prior to the course, 44% of participants reported they had not had the chance to talk to health professionals about their working lives. The most highly rated session was the Question and Answer (Q&A) with junior doctors (4.84/5 weighted average) (Figure 2).

Table 2: Quantitative Results - Paired responses

How prepared do you feel for the following aspects of your medical school application? (n = 40)

Mean change in score from pre- to post-course (95% Confidence Interval)



Hedge's g corrected for effect size (95% Confidence Interval)*

Choosing medical schools

0.76 (0.47 - 1.08)*

0.86 (0.59- 1.59)

Personal statement

1.05 (0.71 - 1.39)*

1.21 (0.80 - 1.86)


2.1 (1.79 - 2.41)*

2.62 (2.15 - 3.73)

Admissions tests (BMAT/UCAT)

1.2 (0.78 - 1.52)*

1.16 (0.83 - 1.89)


To what extent do you feel you understand what it is like to work as a doctor in the NHS?

0.83 (0.57 - 1.08)*

1.02 (0.89 - 1.97)

To what extent do you feel you understand the impact that the COVID-19 pandemic has had on doctors' working lives?

0.3 (0.08 - 0.52)**

0.37 (0.12 - 1.04)

*confidence interval obtained from a non-central t-distribution (Goulet-Pelletier and Cousineau, 2018).


Table 3: Quantitative Results: Post-course interview attendees

Post-course questionnaire responses from interview attendees (n = 30)

Disagree/ Strongly Disagree

Neither Agree nor Disagree

Agree/ Strongly Agree

I feel more confident about going for a medical school interview




It was a good opportunity to practice answering interview questions




The sessions on Days 1-3 helped me answer questions in the practice interview




The individual interview feedback was valuable




The group interview feedback was valuable




The MMAM booklet is a valuable resource for preparing my medical school application





Figure 2: Individual session ratings (where 1 = very poor, and 5 = excellent)



Thematic analysis of the original applications forms (n = 64) identified two main motivations for attending the course: gaining first-hand insights from doctors and for guidance with applications (see Table 4). Participants sought to gain a realistic understanding of a career in medicine, with one commenting ‘I would like to gain insight into the mental well-being of doctors especially how they deal with death and other challenges in the medical field’ (participant 35).

In the pre-course questionnaire, most participants (33/48) reported difficulties in preparing their medical school applications due to the COVID-19 pandemic. Key themes were lost work experience or volunteering opportunities and a lack of support from schools such as not “having ready access to teachers to ask for advice regarding my personal statement” (participant 17).

In the post-course questionnaire, participants were asked about the most important thing they learnt from the MMAM course. One of the key themes that emerged was an understanding of the application process, as demonstrated by one participant who noted that they “…didn’t realise all the steps required and it definitely made me feel more aware and prepared” (participant 19). Interview preparation was also a key theme, with participants stating they learnt not only ‘how to answer interview questions’ (participant 3) but also ‘how to conduct myself in an interview’ (participant 6). Participants also described gaining an understanding of life as a doctor, with one commenting that ‘the life of a doctor can occasionally be very stressful – long shifts, emotional experiences with patients...’ (participant 30).

Several participants did not attend a practice interview. Reasons given included feeling unprepared, lack of a suitable environment in which do the interview and logistical factors such as poor internet connection on the day.

Table 4: Selected themes and quotes

Application Form: What would you most like to get out of MMAM?



First-hand insights from doctors

“I am most interested in having conversations with current junior doctors… learn more about the career, and confirm my enthusiasm for it.”(Student 28)

First-hand insights from medical students

“I would love to have the chance to speak with some students” (Student 30)

Support with applications

“I think the mock interviews will be very beneficial because I have little experience in a formal interview setting and understand this is essential for applications.”(Student 28)

Support with entrance exams

“…session for the entry exams would definitely allow me to have more of an understanding as to what it would be like to sit those exams and how to prepare for them as they are a key aspect when applying to medical school” (Student 8)


Pre-course Questionnaire: Have you had any difficulties in preparing your application for medical school as a result of the COVID-19 pandemic? If so, what have they been?



Lost opportunities for work experience 

“My work experience that would have been very beneficial towards my application was cancelled” (Student 15)

Lack of support while not at school

“Having ready access to teachers to ask for advice regarding my personal statement” (Student 17)

Volume of remote school work

“it’s already difficult enough to keep up with schoolwork during the pandemic, having to prepare for entrance tests/wider reading, etc.. is even more difficult on top of that” (Student 9)

University open day cancellations

“I am struggling with which universities to pick as I was planning on attending their open days which are now cancelled” (Student 12)


Post-course Questionnaire: What is the most important thing you have learnt from the MMAM course?



Interview skills and practice 

“developing interview skills and how to improve what to say in interview” (Student 20)

Preparing applications

“I didn’t realise all the steps required and it definitely made me feel more aware and prepared” (Student 19)

Medical ethics

“I think the brief presentation on the 4 pillars of medical ethics and the 3 C's was invaluable…; this really helped me navigate the ethics section of the mock interview.” (Student 26)

First-hand insights from doctors

“The most important thing that I have learnt from this course was the talk with junior doctors…as it helped me understand more of what it’s like to work on the frontline” (Student 10)

Post-course Questionnaire: Did you have a MMAM practice interview? If no, please state reason why.



Feeling unprepared

“I felt like I wasn’t prepared to respond to the questions properly or how I would in the actual interview…” (Student 11)

Environmental factors

“I don't have an environment where I could do the interview” (Student 2)

“My WiFi was not working” (Student 7)


Our results indicate that an online widening participation course for prospective medical students was effective at both giving an insight into the realities of working in the NHS, as well as improving feelings of preparedness for the medical school application process. 

Demonstrating an understanding of the realities of working as a doctor is a key requirement of medical school applicants (Medical Schools Council, 2020b), and analysis of the MMAM application forms showed that this was one of the main priorities of our course participants. Notably, a large proportion of them had not yet had the opportunity to speak to any health professionals, and cancelled work experience placements would make such opportunities even rarer. Our course was designed specifically with this in mind. We provided participants with the opportunity to interact with doctors and hear about their experiences of working in the NHS. The benefit of utilising such a platform for WP activities extends beyond the COVID-19 pandemic, as it can help reduce the disparities between students able to organise work experience and those without the appropriate contacts to do so (Milburn, 2012).

The course was particularly effective at increasing self-reported preparedness for medical school interviews. Whilst not all participants attended a practice interview, the majority of those who did highly rated the experience. This is significant as the opportunity to undertake a practice interview and receive personalised feedback is often only available through paid private courses, disadvantaging those without the financial means to attend.

COVID-19 has accelerated the integration of technology in medical education (Cleland et al., 2020), and this is also affecting WP activities. However, the shift to online learning risks exacerbating some of the inequalities that WP programmes are trying to address. This is demonstrated in The Sutton Trust report, which found that working class students were less likely to have adequate internet and device access, compared to those from middle class backgrounds (The Sutton Trust, 2020).

There was a high attrition rate, with only half of the applicants to the face-to-face course attending MMAM online, and even fewer attending a practice interview (Figure 1). This was related in part to problems with internet access, as several practice interviews had to be rescheduled due to this. It is also possible that an online course was perceived as less valuable than a face-to-face course, although course feedback was very favourable, indicating that online platforms can provide an acceptable alternative. In future, the attendance rate could also be addressed by having a longer lead time between the planning and delivery of the course.

Despite these issues, attending virtual courses avoids transport and accommodation costs, reducing a possible financial barrier to participation. They can also provide significant benefits to attendees. Notably, medical school interviews are now likely to take place online (Medical Schools Council, 2020c). Therefore, virtual practice interviews such as those provided by MMAM, give participants an opportunity to familiarise themselves with the format and processes, as per recommendations made by the National Medical Schools WP Forum (2020).

Even with the advantages of the online format, we were required to scale down the original face-to-face course, which usually includes a greater number of sessions and participation from allied healthcare professionals. This was because both the organisers and faculty on the course had increased clinical responsibilities during the COVID-19 pandemic. However, the ability to participate remotely improved the availability of some individuals, particularly as they work from two hospital sites. If restrictions on face-to-face educational activities remain, the flexibility of online platforms may improve access to faculty for future courses, providing opportunities to expand the course to cover other sessions, which we were not included this year, such as discussions with allied health professionals.

Hosting the course online can also significantly increase the organiser’s workload, as it requires proficiency with the chosen technological platform, a barrier frequently cited by medical educators to adopting online learning approaches (O’Doherty et al., 2018). Encouraging interactivity within the limitations of the virtual environment is also challenging. In future, further work to increase the interactivity of the virtual programme should focus on developing the skills and confidence of the faculty, in order to create an engaging experience within the current constraints.

A limitation of this study is that we evaluated the course at the reaction level (Kirkpatrick 1) (Kirkpatrick and Kirkpatrick, 2006). It is not yet possible to say if the course helped participants secure a place at medical school, nor in how prepared they actually are once there. We plan to follow up all participants, to determine if they go on to apply for medical school and gain a place.


The COVID-19 pandemic has posed significant challenges to medical school applicants, particularly for those from under-represented backgrounds. Given restrictions on face-to-face educational activities and the move towards conducting medical school interviews online, this virtual course is an effective example of how WP activities can be supported during the pandemic and beyond. Nonetheless, careful consideration must be given to avoid introducing new inequalities through the reliance on technology.

Take Home Messages

  • The COVID-19 pandemic has had an unprecedented impact on students currently preparing to apply for medical school, particularly those from under-represented backgrounds.
  • Virtual Widening Participation activities can be effective at supporting these students with their applications, including the opportunity to practice for online interviews.
  • The shift to online learning risks exacerbating some of the inequalities that Widening Participation programmes are trying to address, and further work is needed to identify solutions to the lack of adequate internet access.

Notes On Contributors

Dr Jana Kossaibati is a Paediatric trainee working in London, UK. She obtained her MBBS degree from Imperial College London, and is currently working towards an MSc in Medical Education. ORCiD:

Dr Madhura Ione Ghosh is a Neurology Specialist Registar with an interest in Medical Education. After graduating from Imperial College London, she completed her PGCert in Medical Education at the University of Bristol.

Dr Anne Boulton is a Speciality Trainee in Immunology with an interest in Medical Education. She earned her MB BChir from the University of Cambridge.

Dr Olivia Buckeldee is an associate Clinical Teaching Fellow at Imperial College London and is completing her Internal Medical training in London, UK. She gained her primary medical qualification from the University of Bristol in 2017.

Dr Natalia Cotton is a Psychiatry trainee working in Oxford, UK. She obtained her BMBCh in Medical Sciences from Oxford University in 2017.

Dr Flora Greig is a Psychiatry higher trainee currently working in The South London & Maudsley NHS Foundation Trust, specialising in General Adult and Old Age Psychiatry. She obtained her MBBS from University College London in 2010.

Dr Oliver Mitchell is a junior clinical fellow in Acute Medicine at Chelsea and Westminster Hospital in London, UK. He graduated from the University of Nottingham in 2017 with a Batchelors of Medicine and Surgery with Honours.

Dr Rory Morrice is currently a Physician Trainee at Royal North Shore Hospital, Sydney, Australia. He has an interest in medical education having previously worked as a Clinical Teaching Fellow at West Middlesex Hospital in London, UK. He earned his MBChB at the University of Edinburgh medical school. 

Dr Sahaj Sethi is a trainee in Emergency Medicine working in London, UK. He obtained his medical degree from King's College London.

Dr Brent Bartholomew is a Consultant in Acute Internal Medicine and the Director of Clinical Studies at Chelsea and Westminster Hospital in London, UK.

Miss Christina Cotzias is a Consultant in Obstetrics and Gynaecology and the Director of Medical Education at West Middlesex University Hospital in London, UK.

Dr Orhan Orhan is a Consultant in Respiratory and General Medicine and the Director of Medical Education at Chelsea and Westminster Hospital in London, UK. He obtained his MSc in Medical Education from University College London.


The authors would like to acknowledge Sundhiya Mandalia for her advice and assistance with the quantitiave data analysis.

All tables and figures source: the authors.


Brighton and Sussex Medical School (2020) BSMS Virtual Work Experience. Available at: (Accessed: 7 July 2020).

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Crawford, C. and Greaves, E. (2013) A comparison of commonly used socio-economic indicators: their relationship to educational disadvantage and relevance to Teach First. Available at: (Accessed: 20 July 2020).

Goulet-Pelletier, J.-C. and Cousineau, D. (2018) ‘A review of effect sizes and their confidence intervals, Part I: The Cohen’s d family’, The Quantitative Methods for Psychology, 14(4), pp. 242–265.

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O’Doherty, D., Dromey, M., Lougheed, J., Hannigan, A., et al. (2018) ‘Barriers and solutions to online learning in medical education – an integrative review’, BMC Medical Education. BioMed Central Ltd., 18(1), p. 130.

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There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (

Ethics Statement

The Research and Development Team at Chelsea and Westminster Hospital NHS Foundation Trust have advised that this study is considered is a service evaluation and therefore does not require formal ethical approval. The study was conducted in accordance with the Declaration of Helsinki.

External Funding

This article has not had any External Funding


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Enam Haque - (18/06/2021) Panel Member Icon
Excellent approach to service evaluation of this important intervention, especially in the time of a pandemic. It provides a workable blueprint for similar initiatives to address the current issues.

However, the approach is similar to other projects that I have come across. The key aspect that is lacking is the longitudinal relationship with aspiring medical students, as the lasting impact of any intervention is most the valuable thing for me. It would have been helpful to follow up the aspiring medical students, and measure the same areas, to ensure the positivity remains at the same level. Also, I would have considered utilising the HEAT data process, to enable a method by which to measure how many students successfully entered medical school.

In terms of selection of participants, the free school meal flag is fine. However, it looks like schools with high numbers of pupils receiving free school meals could freely select two pupils of their choice to attend. Is there a risk that a non WP student could have been selected to attend, thereby depriving a student who really needs to attend, the chance to take part? The work we have done with the National Forum and MSC Selection Alliance has placed an emphasis on getting the contextual data right for individual students. I would consider a more robust inclusion criteria in future.

Overall, well done on making a positive difference to those students from WP backgrounds, who aspire to enter medical schools.
Jennifer Cleland - (11/06/2021) Panel Member Icon
Interesting to see participants' views of the online prep course and how they think it helped. The obvious follow up is to see how many of the participants a) applied for medicine, and b) obtained a place. That kind of hard outcome data continues to be lacking in research looking at the impact of inreach and outreach programmes.