Selecting a representative student population for healthcare provision in a diverse society: An investigation of the Leaky Pipeline in Health Professions Education

Inequality of opportunity in the selection for health professions education and the implications for diversity Diversity among students and staff in healthcare is important to provide good healthcare. But in the Netherlands, health professions education (HPE) programs (such as medicine and dentistry) are not as diverse as society. This study looked at the role of admission procedures in the lack of diversity. The study shows that selection candidates with a migration background, men and candidates without wealthy parents are less likely to get into HPE programmes. In particular, the switch from lottery to selection has increased this inequality. In addition, their social circle plays a role: students with parents in healthcare are more likely to get in. Furthermore, the study shows that not only entry to medical studies is unequal. The chances of becoming a doctor or medical specialist (e.g. cardiologist or surgeon) are not equal either. In particular, doctors with a migrant background are less likely to become specialists. As a solution, it is proposed to use fairer, equitable admission procedures. This could take into account the different backgrounds of candidates. This kind of approach is already used in other countries. Most experts and stakeholders who participated in the study support this idea. The study concludes that selection is a major cause of the loss of diversity. Adjustments in the way students are admitted could help to better reflect different groups of people from different backgrounds in healthcare. This is important to provide the best possible care to everyone in the Netherlands.