Evidence map›Paper›PMID 40778559›Full record

ReviewMedical education2026

Widening access to medicine: A realist review.

Emma Bartle, Sandra E Carr, Rebecca Olson, Lise Mogensen, Sarah Hyde, Nicole Shepherd, Wendy Hu, Alexia Pena, Philip Roberts, Natalie Downes and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Emma BartleHealth Professions Education, School of Health and Clinical Sciences, The University of Western Australia, Crawley, WA, Australia.ORCID 0000-0002-8840-9753
Sandra E CarrHealth Professions Education, School of Health and Clinical Sciences, The University of Western Australia, Crawley, WA, Australia.ORCID 0000-0003-0043-4362
Rebecca OlsonSchool of Social Science, The University of Queensland, St Lucia, QLD, Australia.
Lise MogensenSchool of Medicine, Western Sydney University, Sydney, NSW, Australia.
Sarah HydeHealth Professions Education, School of Health and Clinical Sciences, The University of Western Australia, Crawley, WA, Australia.
Nicole ShepherdSchool of Medicine, The University of Queensland, Herston, QLD, Australia.ORCID 0000-0002-6361-4005
Wendy HuSchool of Medicine, Western Sydney University, Sydney, NSW, Australia.ORCID 0000-0002-1711-3808
Alexia PenaThe University of Adelaide, Robinson Research Institute, Women's and Children's Hospital, North Adelaide, SA, Australia.
Philip RobertsUniversity of Canberra, Canberra, ACT, Australia.
Natalie DownesUniversity of Canberra, Canberra, ACT, Australia.
Scott McCoombeSchool of Medicine, The University of Western Australia, Crawley, WA, Australia.
Jennifer ClelandLee Kong Chian School of Medicine, Nanyang Technological University Singapore and National Healthcare Group, Singapore.ORCID 0000-0003-1433-9323

Funding

UCAT Australia and New Zealand (ANZ) Research Grant
6 · The paper itself

Abstract

introductionDespite policy drivers and "on-the-ground" activity to encourage applicants from under-represented minority groups (URMs) into medicine, their representation remains limited because of the challenge of overcoming complex societal and systemic barriers. This realist review sought to review the existing literature to identify underlying CIMOs with respect to widening access (WA) to medical school.

methodWe conducted a realist literature review informed by Pawson's five iterative strategies and consistent with RAMESES standards. We searched eight electronic databases (MEDLINE, EMBASE, CINAHL Plus, PsycInfo, JBI EBP, ERIC, Scopus, Proquest Public Health) to identify studies published from 1990 to April 2023 on WA pathways into medical school. We used a realist logic of analysis to examine how the mechanisms of action (M) identified for each WA intervention (I) triggered outcomes (O) related to widening access, and thus increasing cohort diversity, in different contexts (C).

resultsThirty-two of 6300 studies identified and screened met the inclusion criteria. Most papers were from Global North countries (31/32). They reported five types of WA interventions: Minimising Bias; Modifying selection criteria; Community Collaboration; Preparing applicants for selection and studying medicine; Combining College with Medical School. Mechanisms were categorised as addressing institutional, situational, or dispositional barriers to studying medicine. Interventions were classified as addressing WA at a system-level or individual-level. There were four outcomes of interest: established widened selection pathways; an increased number of pathway applications for medical school; a change in offers for medical school, and increased cohort diversity.

conclusionsThis review highlights that issues with access to medical education are still being seen as individual not systemic, with most reported WA interventions focussing predominantly on addressing situational and dispositional 'barriers' to medical education. The dominant implicit positioning of the applicant as the only aspect in the WA process in need of change reinforces the status quo.

Indexed as

Minority GroupsSchool Admission CriteriaSchools, MedicalStudents, MedicalHumans

Identifiers

PMID40778559
PMCPMC12805216

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.