Perceptions, barriers, and career priorities among prospective medical school applicants in Scotland

Total medical school applicant numbers in the UK are steadily declining. This is a particular problem in the devolved nations including Scotland, where the number of local applicants has not increased in line with the expansion of medical school places. This study aims to understand how prospective Scottish-domiciled medical school applicants perceive medical careers and the NHS, the potential barriers to medical school and which factors are most important when making careers decisions, including whether these factors differ depending on demographic background. An online cross-sectional survey was delivered to prospective medical school applicants in S5 and S6 (the last two years of secondary education) Scotland during the 2024–2025 UCAS application cycle. Students were invited to participate if they were considering or have considered medicine as a career in the past. Chi-squared analysis was performed to identify differences in responses by demographics. There were 416 respondents, representing a quarter of the Scottish-domiciled students who applied to medicine during the 2024-25 cycle. There are demonstrable differences in career priorities and perceptions of working as a doctor by ethnicity, sex and widening participation (WP) status. Respondents held generally negative views about the demanding and inflexible nature of working within the NHS, although identified positives such as being able to give back to the community and the variety of work. The majority of respondents had been discouraged from applying to medicine by at least one person, usually due to difficulties in the working lives of doctors, rather than barriers in the application process. Prospective applicants have concerns about working conditions and careers after graduation which may be impacting their decision on whether to apply for medicine. This necessitates coordinated efforts from medical schools, NHS trusts and other stakeholders to improve the perceptions of doctors and NHS careers generally. The survey will be delivered UK-wide in the 2025-26 application round, to shed light on whether these patterns are seen across the four nations.