Peter Chiodini, clinical parasitologist and clinician, talks about his working-class childhood, his pathway into medicine and the importance of social mobility.
According to the Sutton Trust, 6% of doctors are from a working-class background compared with 33% of the general population. I am very proud to have come from a working-class background and yet to have succeeded in medicine and gained an international reputation. I am writing about this important topic, not because I want to stoke a class war or foster the ‘politics of envy’, but in the interests of opportunity and fairness. We need the best possible students to train as doctors and we are missing many who would contribute at least as much as I have.
When I was a child, my parents did not have much money, indeed at one stage we had a prepayment electricity meter that took shilling coins. I remember it running out one evening and going to the local off licence with some small change to get shilling coins, then resuming my homework when the lights came back on.
I loved school, did lots of homework and had strong parental encouragement, so I did extremely well, got very good grades and went to university.
I had no idea what to expect when arriving at college as no one else in the family had ever been. On a day-to-day basis I still remember how warm it was living in halls. Hot water on tap 24/7 and no limit to the number of baths one could take!
While they had very little idea of what university life was like, my parents, like everyone else, interacted with doctors from time to time, either via their GP or the hospital, pronounced ‘ors-pittle’ in their London accent, which I remember fondly.
They had great respect for doctors, for example if the GP was due to make a home visit to one of us, my mother would wash the bedroom floor with Dettol so it was spotless for the doctor’s arrival. So it is hard to overestimate the effect on a working-class family of one of their members qualifying as a doctor. If you want an idea of what I mean, watch ‘Billy Elliot’, a film that stirs strong emotions in me every time I see it.
There was, therefore, enormous parental pride in my achievement. My father hugged me only twice in my adult life: the day I got married and the day I qualified as a doctor.
So far, so good, but being upwardly mobile does bring challenges. A medical degree gives gold card entry to the middle class, but it takes time to get used to that new world, so I owe a huge debt of gratitude to Jane, my wife of 41 years. Her father was a solicitor and Town Clerk of Exeter in the days when that post was a really big deal. In the time of Jane Austen, they would have said that my Jane had married beneath herself! I’m so glad she did, and she helped my adjustment to the process of social mobility enormously.
My background gave me one big advantage in medicine: I could understand and communicate well with working-class people who represent most of our patients, and my mission is essentially to help give more working-class students the chance to have a career like mine.
I have worked with a charity, the Social Mobility Foundation (SMF) for some years now. It has been a privilege to host their students at UCL hospitals as they prepare to apply to medical school. They join our ward rounds, attend clinics and multidisciplinary team meetings and crucially, get to hang out with our trainees and medical students.
SMF students are truly impressive, but entry to medical school is highly competitive and for them, their background means the process is like starting a grand prix from well behind the back of the starting grid. Furthermore, for those who do win a place, the effects of deprivation do not disappear at the end of freshers’ week.
How does the current situation differ from my time as a medical student?
By far the biggest issue is finance. Thanks to my local education authority grant, I graduated with £40 in the bank and no student debt, nigh on impossible now.
Food, rent, clothes, books, stethoscope and travel to college were core items then and still are, but would I have read medicine if I also had to cover tuition fees and take out student loans for such a long course? I hope so, but it would have been very difficult to do so on top of the demanding academic regimen to be followed.
Going through medical school, coming from a different background than most of my peers, it would have been valuable to speak to a mentor with similar working-class origins, to share experiences and see the way through more clearly. The SMF mentoring programme is an excellent model designed to help that adjustment.
The late Queen Elizabeth II gave me my OBE in 2018 and I use that honour to encourage other working-class students to pursue their dreams of a medical career with determination and optimism.
Medicine remains a great profession and a working-class background should not prevent those with the necessary ability and aspiration to join it from doing so.