Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012.

Aim To compare trends in the volume, socio-demography and academic experience of UK applicants and entrants to medicine and dentistry in the UK with university in general, before and after the major increase in university fees in England in 2012.Methods Descriptive trend analyses of University and College Admissions Services (UCAS) data for focused (preferred subject was medicine or dentistry) and accepted applicants, 2010-14, compared with university in general in relation to socio-demography (age, sex, ethnicity, POLAR 2, region) and academic experience (school type). POLAR2 data provide an indication of the likelihood of young people in the area participating in further or higher education.Results In 2012 the volume of applicants to medicine and dentistry fell by 2.4% and 7.8% respectively, compared with 6.6% for university overall. Medical applications remained buoyant and by 2014 had risen by 10.2% from 2010 to 23,365. While dental applications fell in both 2012 and 2013, they had increased by 15.6% to 3,410 in 2014, above 2010 levels. Females formed the majority of applicants, and admissions, with the proportion gaining admission to dentistry in 2014 reaching an all-time high (64%), exceeding medicine (56%), and university in general (56%). Mature admissions to dentistry were at their highest in 2010 (29%) falling to 21% in 2014, compared with 22-24% in medicine. Black and minority ethnic group admissions to university, although rising (24% in 2014), are still less than for medicine (34%) and dentistry (48%). In 2013, just over half of the students admitted to dentistry were from BME groups (51%) for dentistry. Among UK applicants <19 years, over 60% of applicants, and 70% of accepted applicants, to medicine and dentistry are from the top two POLAR2 quintiles representing areas of high participation in education; however, in 2014 there was a notable increase in the proportion of applications from the lower two quintiles to dentistry (19%) and medicine (20%), with a very modest increase in those gaining admission over 2012 (14% of both; cf 10% and 12% respectively).Discussion The findings suggest that the short-term impact of the 2012 rise in fees had a greater influence on the volume and nature of applicants to dentistry than medicine, and that both programmes are gaining in popularity, despite high fees and reduced places. Dentistry remains particularly attractive to Asians, and females, the latter forming an increasing majority of students. While there is some recovery, social inequalities exist and present a challenge for widening participation in the professions.

Widening participation - a comparison of the characteristics of successful UK applicants to the five-year and four-year dental programmes in 2007 and 2008.

AIM: To compare the demographics (age, sex, ethnicity, social status, disability, country/region) and academic experience (school type) of accepted UK applicants to the five-year and four-year dental programmes in 2007 and 2008. METHODS: Retrospective descriptive analysis was carried out on the University and College Admissions Services (UCAS) data for accepted UK applicants to the five- and four-year dental programmes at UK dental schools in the years 2007 and 2008. Logistic regression was used to model the outcome of dental admission to programmes (four-year vs five-year), controlling for the other explanatory variables. Data were analysed using SPSS v19. RESULTS: In the years 2007 and 2008 over 2,000 UK applicants were accepted on to a dental course (n = 2,274) within the UK. Of these accepted applicants, 84% (n = 1,903) were accepted onto a five-year and 14% (n = 322) onto a four-year, programme. Over half were female for both the five- and four-year programmes (58% cf 59% respectively). One tenth of students accepted to the five-year programme were 'mature' (n = 173) and nearly all of the students to the four-year programme (n = 321). Similar proportions of accepted applicants to both programmes were from minority ethnic groups (46%), with the majority of students being of White or Asian background; however, the four-year programmes accepted a higher proportion of black (4% cf 1%) and 'other' minority ethnic students (8% cf 3%) when compared with the five-year programme. A higher proportion of accepted students to the four-year programmes came from the lowest 'higher/further education participation areas' (POLAR2 groups 1-3) than the five-year programmes (38% cf 28%). Proportionally more accepted applicants to the four-year programmes came from London than the five-year programmes (30%, cf 20%). In contrast, a greater proportion of accepted applicants to the five-year programmes came from Scotland (13% cf 6%), Northern Ireland (9% cf 0%) and Wales (4% cf 2%). When all other factors were controlled, the odds of being accepted to the four-year rather than the five-year programme were higher if the applicants were mature and from Greater London. CONCLUSION: There is little definitive evidence that graduate entry programmes widen access to dentistry when compared with the traditional five-year programme; however, the findings do highlight geographic disparities in access to graduate entry programmes, which are important for policy makers and schools to consider.

Widening access? Characteristics of applicants to medical and dental schools, compared with UCAS.

AIM: The aim of this paper is to compare the demography (age, sex, ethnicity, social status) and academic experience (school type, tariff scores) of focused and successful applicants to preclinical dentistry with preclinical medicine, and with higher education in general in the UK. METHOD: Retrospective analyses of anonymised University and College Admissions Services (UCAS) data for focused applicants whose preferred subject was preclinical dentistry or medicine, and accepted (successful) applicants to the same programmes in 2006. These data were compared with publicly available data on applicants and accepted applicants through UCAS. Information for each medical, dental and general UCAS applicant included age, sex, ethnicity, socio-economic group, region, school type and tariff score. Logistic regression was used to model the probability of being accepted in relation to all explanatory variables and interactions. RESULTS: In total there were 2,577 focused applicants to dentistry; 1,114 applicants were accepted, 4% (n = 46) of whom did not have it as their preferred subject choice. There were seven times as many focused applicants for medicine (18,943) when compared with dentistry; 8,011 applicants were accepted, 2.7% of whom did not have medicine as their preferred subject choice (n = 218). Just over half of the applicants to dentistry were from minority ethnic backgrounds (50.5%), exceeding medicine (29.5%), and higher education in general (19%). The proportion of female applicants was similar across all three groups at around 55%. Only one fifth (21%) of focused applicants to dentistry were mature compared with one third (33%) to medicine and one quarter (25.5%) of all UCAS applicants. Greater proportions of applicants to medicine (25.8%) and dentistry (23.5%) were from upper socio-economic backgrounds, compared with higher education in general (15.5%). When all other factors are controlled, the odds of being accepted for medicine, and for dentistry, are lower if mature, male, from a lower social class, from a minority ethnic group and have attended a further/higher education college. CONCLUSIONS: Focused and successful applicants for preclinical medicine and dentistry are more likely to be from higher social classes and a minority ethnic background than applicants to higher education in general. Dentistry attracts twice the level of Asian applicants as medicine and four times that of universities in general. Controlling for other factors, there is evidence that gender, ethnicity, maturity, and school type are associated with probability of acceptance for medicine and dentistry. Higher social status is particularly associated with acceptance for medicine. The implications of these findings are discussed in terms of widening access and social justice.

Monensin-dependent and -independent mechanisms of cell-matrix adhesion.

Attachment and spreading of human FL cells on a subcellular matrix (SCM) preparation made by treating confluent cell monolayers with deoxycholate are insensitive to the presence of monensin. However, if the cell suspension is surface-iodinated prior to adhesion using the LPO/H2O2 system, cell spreading on SCM is inhibited by 1 microM monensin. The suggested interpretation is that cell surface components required for cell spreading on SCM are inactivated by iodination and need replacement from intracellular reserves by a monensin-sensitive pathway. This pathway is not required in the absence of iodination when sufficient surface components (or a monensin-independent pathway of surface expression) are available. Support for this interpretation is obtained by means of double-iodination experiments in which surface-labelled cells adhere and spread, are detached and labelled a second time and then allowed to adhere again to SCM. Cell spreading in the second case is inhibited by approximately 80%, suggesting that both previously expressed and newly recruited receptors are inactivated.

Kinetic analysis of cell spreading. II. Substratum adhesion requirements of amniotic epithelial (FL) cells.

The kinetics of spreading of trypsinized FL cells on plastic or glass substrata covalently or passively coated with various proteins to make simplified model extracellular matrices have been measured. Kinetics have also been obtained in the presence and absence of serum and amniotic fluid. Data from such experiments are shown to be sigmoid and have been computer-fitted with great accuracy to 12 mathematical models discussed in the accompanying paper. A log normal distribution function is shown to give the best fit over 18 different types of experiment. For the first time, therefore, such data can be characterized quantitatively and compared. We obtain the simple parameters mu (mean time to spread) and sigma (standard error of the mean) and show that the cells spread most rapidly in amniotic fluid or on fibronectin 'carpets'. They also spread rapidly on a fibronectin-fibrinogen complex extracted from placenta. Spreading is slower in serum, in amniotic fluid lacking fibronectin and on type I collagen or cellular microexudate from FL cells or fibroblasts. On concanavalin A, spreading is rapid but the distribution of times to spread (as expressed by sigma) is relatively wide.