Doctors do not need top marks at A level to succeed, a project based at King's College London has shown.

It aimed to attract bright students from state schools in inner London who had A-level results that were far too poor to gain entry to medical school and show that, with the right help, they could succeed.

Students would normally require two As and a B at A level, but the scheme, called the Extended Medical Degree Programme, accepted those who had managed no better than three Cs.

The idea was to train doctors who better represented diverse social and economic backgrounds and to prevent medicine from becoming the exclusive preserve of the middle classes.

The programme began in 2001 and now has more than 200 students who are doing well, the academics behind it say in this week's British Medical Journal.

The students get an extra year of studying, with the first two years' studies being spread over three. This enables them to catch up and be given more support, but it is expensive.

Nine out of ten come from ethnic-minority communities and just under a third from middle-class families. To qualify they must have come from one of 100 state schools in the 15 most educationally deprived boroughs in inner London.

A mental agility test is used, with a 30-minute interview, to select the applicants. Most are the first in their family to go to university.

Despite their lower entry grades, those on the scheme gain degree results that are evenly spread throughout the entire year group of 360-400 students. Although they make a slower start, in the clinical years (years 4-6) pass rates are identical for both conventional and EMDP students (93 per cent).

Of those who opted to do the longer BSc degree, 12 per cent got a first, 76per cent an upper second and 12 per cent a lower second, compared with 28 per cent, 65 per cent and 7 per cent among the conventional students.

The authors, Pamela Garlick, from King's, and Gavin Brown, from the University of Leicester, conclude: “A new type of doctor is being created that, among other things, better reflects the social diversity of London's population.”

An editorial in the same issue of the British Medical Journal says that the scheme is politically correct, but costly. The extra cost is £190,000 a year.

Professor Chris McManus, of University College London, and Hugh Ip, of the journal, question whether this is justified. The scheme involves sacrificing equality of opportunity for the quest for social justice, they say.

“Is it worth our while to widen participation, particularly if this risks reducing standards?” they ask. “Political ideology says yes, but the evidence is pending and the costs are rising fast.”

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