Understanding gateway to medicine programmes

Background Supporting underrepresented groups in pursuing, applying and matriculating into medical education is a key issue in the field. In the United Kingdom, Gateway to Medicine programmes were created as a specific form of entry to medical education, to support diversification goals. Whilst well-established, how these programmes are broadly designed and implemented, and how their functioning links to conceptual views of diversity, is not well described in the literature. Methods This article explores relevant diversity-related literature, including a specific review of all Gateway programmes. Findings Key facets of diversity-related work in medicine, including the distinction between 'widening participation' and 'widening access' are discussed. These distinctions frame the presentation of Gateway years; their selection process, structure and function are described. The purpose of these years is then discussed, with the lens of different discourses around diversity in medicine, to provide theoretical and practical considerations. Recommendations for how faculty can better explore diversity-related issues are also provided. Conclusion Gateway programmes may be effective, to some extent, in widening access to medical education, but require considerable resourcing to operate. Though heterogenous in nature, these programmes share common elements. However, discourses around the goals and purpose of this diversification vary based on individuals and institutions. These varied perspectives, as well as the societal and historical implications of diversity-related work, are important for all clinical educators to understand with depth, and address directly, in order to reduce inequalities both within medical education and society at large.