The difficulties of obtaining places to study midwifery by Denise Tiran, Educational Director, Expectancy.
According to the recent report on the State of maternity services (RCM 2011), England has a shortage of 4700 midwives; problems are compounded by rapidly rising birth rates and a diminishing workforce as many approach retirement age. There is certainly no dearth of aspiring midwives, with thousands of UCAS applications, but limited funded places mean that candidates have about a 1: 40-50 chance of securing a student place (personal communications).
Prospective midwives must, therefore, do everything possible to strengthen their applications. Applicants must be in good health, but there are no national minimum requirements for midwifery training. Each university sets its own criteria, most requiring 5 GCSEs including English and mathematics, plus 2 A levels, or equivalent (www.nhscareers.nhs.uk). Interestingly, Midwifery 2020 advocates that wider entry criteria become accepted through more flexible Accreditation of Prior Experiential Learning in order to attract those previously excluded on academic grounds but who possess the broad personal attributes to become midwives (DH et al 2010).
Those without academic qualifications undertake further study, often as Access to Higher Education (HE) programmes. These claim to prepare students for teaching and learning styles adopted in HE, yet could be accused of ‘spoon feeding’ in order to boost institutional success rates. Rarely do these courses cover any subjects of direct professional relevance, nor do they adequately equip students with the academic and communication skills, or the skills to manage their own learning and to work with others, which are essential in HE and in professional practice.
In addition, most HE institutions request experience of caring. Whilst some institutions consider applicants who have undertaken any caring role, eg with the elderly or disabled, some specify maternity-related experience. Service managers frequently receive requests from prospective midwives to undertake work experience or to visit maternity units, but issues around confidentiality, Criminal Records Bureau clearance or lack of sufficient staffing to support visitors mean that requests are often declined. Some applicants work as maternity support workers – and may eventually be seconded for training. Others attend parent education classes, Sure Start Children’s Centres, breastfeeding support groups, and reflect on their own experiences of childbirth.
Further education courses may equip prospective students with required academic qualifications and – perhaps – with an awareness of the rigours of HE. Relevant activities may enhance understanding of maternity care, but the public’s perception of midwifery is such that applicants rarely appreciate the realities of the midwife’s role and responsibilities (DH et al 2010, Pollard 2008). Candidates with the necessary UCAS points to jump the first hurdle in the selection process, can fall at the next stage if their personal statements do not adequately reflect knowledge of the midwife’s role. If invited for interview, many more are unsuccessful because they are unable to verbalise their understanding of the profession they wish to enter. A desire to ’work with babies’, or any mention of midwifery as ’nursing’ are usually deemed sufficient for an automatic ’decline’).
There is an urgent need to fill the limited numbers of midwifery training places with students who not only have the appropriate academic abilities and relevant caring experience and the stamina to achieve both a professional licence to practise and an academic degree, but also the motivation to remain in the profession once qualified.
Aspiring midwives must show knowledge of the midwife’s role and responsibilities and of the huge diversity within the profession. Applicants for midwifery could also be requested to demonstrate core skills, at an appropriately adjusted academic level, which are necessary for study at HE level. These include the ability to utilise information resources, communicate verbally and in writing, reflect on and analyse their work and negotiate and adapt within group settings.
An Introduction to Midwifery programme, which focuses on these core skills, is now offered by Expectancy, designed to be taken alongside an Access to HE course, or as an additional preparatory activity. The first intake of 25 students has proved so popular that a second fast-track version was offered, and a home study pack is also available.
- Department of Health, Social Services and Public Safety, Welsh Assembly Government et al (2010). Midwifery 2020. Delivering expectations: executive summary. [Accessed 1 December 2011].
- Pollard K (2008). New midwifery students’ views of their future role. Midwives http://www.rcm.org.uk/midwives/in-depth-papers/new-midwifery-students-views-of-their-future-role [Accessed 1 December 2011].
- Royal College of Midwives (RCM) (2011). State of maternity services report 2011. London: RCM. [Accessed 30 November 2011].
Contributor: Denise Tiran, Educational Director of Expectancy, Visiting Lecturer at University of Greenwich
Photo credit: © Nikolai Sorokin – Fotolia.com