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Mile End Institute

Diversity and social mobility in the medical profession - working with NHS England and the Social Mobility Foundation

Hands at a keyboard with a stethoscope beside
Image credit: National Cancer Institute on Unsplash
Headshot of Louise Ashley wearing a black suit jacket and white top

Dr Louise Ashley

Associate Professor and IHSS Fellow

Dr Louise Ashley's research focuses on the implementation of diversity programmes in different industries.

Research linked to policy engagement work

Louise’s recently published book, Highly Discriminating Why the City Isn’t Fair and Diversity Doesn’t Work, explores the intersection of diversity, social mobility, and underlying inequalities. Her work critically examines how the emphasis on diversity and social mobility in the City is both a positive force for some individuals and functioning as a smokescreen, diverting attention away from more profound systemic inequalities. 

Engagement with policymakers and policymaking organisations

Louise has forged connections within organisations dedicated to fostering social mobility and equality, including the Social Mobility Foundation (SMF) and the Bridge Group. With the SMF she conducted research to help develop the support they offered to individuals from less advantaged backgrounds hoping to access the professions. Her research identified challenges faced by these individuals and offered actionable recommendations for improvement. Her efforts led to tangible outcomes, with for example the SMF implementing her suggestions to enhance support mechanisms for aspiring medical professionals.

Successes 

Louise explores barriers to access to elite professions for people from less advantaged backgrounds, but does so from what she acknowledges is a privileged position herself. It has been important to her that she accurately reflects the experiences of research participants and she has found it particularly rewarding when young people from less privileged backgrounds who have seen her work confirm this is the case. Their appreciation fueled her passion; knowing that her work made a real impact on their lives.

Challenges

Navigating the intricate policymaking landscape and organisational dynamics has been challenging at times. For example, with financial support from NHS England, she is currently exploring the subject of social stratification in the UK medical profession, whereby doctors from less advantaged backgrounds appear to have more limited access to the most remunerated and competitive jobs. This is a sensitive subject with certain political undercurrents, requiring that she takes care to share and socialise key findings in an appropriate way. This is made more important as the UK medical profession is currently subject to difficult working conditions and policymakers and practitioners are subject to many competing demands.

Louise's tips for getting started with policy engagement

When it comes to engaging with policy, Louise emphasises the importance of approaching challenges with a solutions-oriented mindset. Despite the initial intimidation of proposing alternative viewpoints, she thinks there is value in offering fresh perspectives that resonate with a broader audience. In her experience, audiences often crave authenticity and honesty, especially when established narratives around diversity and inclusion fail to align with their own experiences. By presenting a more critical yet accurate analysis, she found that people appreciated the departure from conventional scripts and welcomed the opportunity for deeper engagement. Louise also shared insights for researchers venturing into publishing outside of academic journal articles, highlighting the need to find a balance between academic rigour and journalistic appeal. While acknowledging the pressure to generate attention-grabbing headlines, she encouraged researchers to maintain confidence in their perspectives and push back when necessary, ensuring their work remains true to their convictions.

What's next?

Louise’s current research is exploring social stratification in the UK medical profession, focusing on understanding how socioeconomic backgrounds influence medical career paths. Highlighting a gap in existing research, she emphasises the importance of looking beyond entry to medical school and examining what happens afterwards. Her research has uncovered concerning trends, showing that medical careers are often socially stratified. Those from privileged backgrounds tend to specialise in competitive fields like surgery, while those from less advantaged backgrounds usually gravitate towards general practice. With her latest report launching soon, Louise is keen to spark conversations and drive meaningful change within the medical community.

This case study was supported by Audrey Tan (Policy Partnerships Manager, Mile End Institute) and Maja Wawrzynowicz (Policy Associate, Mile End Institute). If you’re interested in learning more about how you can build policy engagement into your own work, check out the Queen Mary Policy Hub’s Learning Resources and Policy Engagement How-To Guides.

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