LAUSR

Dear Editor, We were pleased with the WATCCH 16–18 year old’s programme and its aim to increase diversity in healthcare careers through multiple avenues including mentoring, work experience, workshops and coaching [1]. However, in our experience as mature undergraduate medical students from the 32nd most deprived local authority in England, ethnic minorities, and parents who were not degree-level educated, widening diversity includes improving access to programmes such as WATCCH for mature students. The Higher Education Statistics Agency demonstrated an increasing trend of mature students in all undergraduate programmes since 2017 [2]. The proportion of undergraduate mature students increases with deprivation at every quintile, whilst the proportion of non-mature students is highest for the least deprived. This makes the case for mature students from disadvantaged backgrounds being a target of widening participation [3]. In our experience as mature students, barriers cited in the study were also barriers we encountered; difficulty gaining work experience due to a limited network of healthcare professionals and a lack of confidence and self-belief in particular. The latter two are echoed by other mature students in qualitative analysis [4]. Practically, work experience offered by the NHS for adult learners is limited, with typical careers services and the formal network at schools being generally inaccessible to mature students. This further limits opportunities for work experience as well as experiential and expert knowledge of various healthcare careers. Barriers that are more unique to mature students are also present. These include non-traditional qualifications, a potential need to gain further qualifications (e.g. an Access course), consideration to family life (e.g. children), marital status, employment, ‘reorientation of lifestyle’, and financial matters [4]. The decision-making process is therefore lengthy and incorporates a different cohort of potential students. Considering these barriers in addition, coaching mature students prior to application is an important consideration as a potential part of an extended WATCCH programme. In particular, widening focus onto multiple healthcare careers may similarly impact decision-making with increased awareness of potential careers. For example, community-based healthcare careers may match with single parents. In fact, single parents report aims such as obtaining a job to ‘support family’ and being a ‘role model’ as positive drivers [4]. Further, early contact with mature ‘aspirant’ students may reduce anxiety about Higher Education (HE), which may improve self-confidence and perceived ability to cope with HE level study which is cited as a common concern [4]. This may increase retention, which is lower relative to non-mature students [3]. As finance is a substantial barrier, workshops on sources of financial support at universities and government incentives may further increase applications and retention. An inclusive approach to WATCCH has the potential to expand the growing trend of mature students in HE and may reduce the time taken to transition from ‘aspirant’ to student [4]. This may prove to be a welcomed and novel approach with a plethora of benefits.