Analysis of data on school leavers in Scotland points towards considerable inequality in access to higher education. This is highlighted in terms of participation in higher education by young people from lower-income households or identifying as first in their families to consider going to university. The situation is more acute in terms of access to the most competitive courses leading to careers in medicine, veterinary medicine, dentistry and law. This paper draws on data from an ongoing research and development project in the area of mentoring to present a case study of a young woman progressing an application to study medicine. Drawing on the concept of Academic Capital Formation it illuminates the ways in which institutional practices advance or impede access to higher education and particularly, to those courses which facilitate entry into high status professional occupations. The findings in this research problematise current thinking about how to widen participation in higher education and the most competitive professions.