Medicine Needs Diversity and Equal Opportunity

Dr. Gröne, what barriers do students most commonly face on their path to studying medicine?
 

For many students, the path to medical school is associated with considerable obstacles—particularly for those from educationally disadvantaged or low-income backgrounds. Three major barriers can be identified.

Financial barriers play a crucial role. Medicine is one of the longest degree programmes, with a standard duration of at least six years, followed by the Practical Year and often additional stages of professional qualification. This lengthy period of training places a significant financial burden on many families. Living expenses, study materials, and the delayed opportunity to earn a regular income accumulate over many years. Although Germany has no or only very low tuition fees compared with countries such as the United Kingdom or the United States, the financial pressure created by the sheer length of medical training remains a genuine barrier that discourages many young people from even considering this career path.

Low expectations on the part of teachers and a lack of support at school represent another, often underestimated, barrier. Children and young people are highly sensitive to the messages they receive from their educational environment. When teachers—consciously or unconsciously—expect less of certain students, this can have lasting consequences for those students’ self-image and educational aspirations. A teacher’s words can have a profound impact for years to come, both positively and negatively. In the absence of a culture of recognition and empowerment, many students internalise the message that certain professions are “not for people like them” long before they have the opportunity to make an informed decision about their future.

Limited social networks constitute the third major barrier. Access to internships in hospitals or medical practices sometimes depends on whom you know or how well informed you are. Students who grow up in social environments where doctors, academics, or well-connected professionals are part of their network simply have more opportunities. A conversation at the dinner table can open doors that remain closed to others. For students without these informal networks, access is limited not only to information but also to practical experiences that play an important role in university applications and career decisions.

Which findings from the workshops have surprised you most?

The workshops have both confirmed and challenged our expectations—and in both cases, the experience has been highly valuable.

Perhaps the most striking finding was how universal the barriers to studying medicine are. What we identified in the international research literature is reflected directly in the experiences of the students. The obstacles encountered on the path to medical school are not unique to Germany but represent a structural phenomenon that can be observed internationally, albeit with different characteristics depending on the national context.

What became particularly clear was how greatly the empowering role of teachers and career advisers is underestimated. In our conversations with students, it became evident time and again how influential individual encounters with committed educators had been—and how deeply the absence of such support was felt. What surprised us most was that empowerment is hardly embedded structurally within educational practice. Instead, it depends largely on the personal commitment of individual teachers—an individual solution where a systemic approach is needed.

This is not about creating unrealistic expectations. Rather, it is about establishing a culture in which every student experiences that their talents, strengths, and potential are recognised and valued. This stands in stark contrast to the deficit-oriented culture that still characterises much of the education system. Empowerment and a culture of positive feedback need to become much more firmly embedded in teacher education.

We were also surprised by how quickly and intuitively students recognised and articulated inequalities within the healthcare system. As soon as we introduced the topic, discussions became lively, thoughtful, and nuanced. It was particularly encouraging to see that social justice in healthcare has now become part of upper secondary education within the subject Politics, Society and Economics (PGW), signalling that the issue has gained broader societal recognition.

Finally, we were pleased to observe that many students—even those with no intention of studying medicine—left the workshops better informed and able to leave behind common misconceptions. In particular, the widespread belief that admission to medical school requires a perfect grade point average equivalent to a 1.0 Abitur could be corrected. For many participants, this alone was visibly liberating.

What Will Be Piloted in Schools Next?

The project has now entered an exciting implementation phase. We are currently introducing the teaching units developed within the project at all three partner schools, and the feedback has been extremely encouraging.

The teaching units are embedded within the schools’ career guidance programmes and each lasts 90 minutes. They focus on helping students reflect on their own strengths, using the study of medicine as a practical example. This approach makes careers in healthcare more accessible while simultaneously strengthening students’ confidence in their own abilities.

At the same time, we are actively participating in regional and local careers fairs, including school-based events. Medical students involved in the DiMe project introduce medical studies in an accessible way and engage students in practical activities such as measuring blood pressure or suturing a wound. These hands-on experiences not only provide knowledge but also create direct connections between students and the possibility of studying medicine.

Our mentoring programme is still under development and currently supports four mentees. We are working to increase its visibility, for example by introducing it at the beginning of the teaching units so that students become aware of this support structure at an early stage and can benefit from it.

This autumn, two important professional development programmes will take place: one on diversity awareness for career guidance professionals and another for teachers. We are very much looking forward to this interactive exchange, as the lived experiences of everyone involved will enrich the process.

The implementation is still ongoing. We have already achieved a great deal, but another year of work lies ahead. We are excited about the opportunities this will create for scaling up the project.