SO… YOU WANT TO BE A DOCTOR?
THE ROYAL GRAMMAR SCHOOL GUIDE FOR MEDICAL SCHOOL APPLICANTS
So you want to be a doctor?
Do you mean a doctor of medicine who is able to prescribe drugs, diagnose disease and effect cures or a person who has spent three or more years doing unique research on a topic, writing a thesis and being awarded a PhD?
Having established that you are talking about the former, this booklet should be read carefully by you and your parents so that you can decide whether -
• Medicine is the right career for you
• You are the right person to undertake the long and arduous pathway through medical school and beyond
• You are selecting a suitable university
• The course you apply for will suit your style of learning
• You still have options if you don’t make the grade
Medicine – Is it The Career for You?
If the idea of becoming a medical practitioner appeals then you must have good reasons. However, there are some things to consider to ensure that you are not going to make the wrong choice of career.
Being doctor sounds glamorous. Doctors are well-respected members of the community, earn healthy salaries and are usually guaranteed employment even in the worse economic conditions. The openings and career opportunities are vast and you can climb the promotional ladder almost as far as heaven. However….
• The training is long and arduous – do not underestimate this statement. If you receive an offer from a medical school and attain the necessary grades, you are the bottom of a very high, steep and slippery mountain which you (and your parents) will scale inch by inch, stopping en route to sit exams and maybe slithering back down if you fail.
• If you don’t like old people, reconsider your choice. Hospitals are 90% full of old folk.
• If you don’t like illness or are a raging hypochondriac, then this may not be the path you wish to take. Most medical students imagine they have a plethora of rare and lethal conditions as they learn more about pathology but they usually learn to live with these.
• Doctors see the worst side of people. Most casualties in A&E late at night are drunks and drug addicts, some of whom are less than respectful and not too friendly.
• If you aren’t keen on blood, vomit or bodily fluids, perhaps you should be a teacher or a florist.
• If you have a tendency to be impatient, irritable or have a dislike of human-kind, veterinary medicine may be an option.
• If you are visually or aurally challenged and cannot communicate with patients, then it is unlikely that medicine is a suitable choice. Some mental disorders like Asperger’s will also preclude a student from applying to medical school.
• If you are not academically able with a good crop of A* grades at GCSE (Birmingham University will not consider anyone with less than 7 A*s) and predicted A grades in all three A level subjects (including Biology and Chemistry), you need to skip to the section on Graduate Entry Medicine (GEM) because your application will not be considered.
• If you have not done substantial work experience or voluntary work (at this stage you are not expected to have carried out major brain surgery) or demonstrated your talents as a caring individual with excellent communication skills, re-consider your choice.
• If you have any criminal convictions or have undertaken dodgy dealings – or if you have been shown in a non-flattering light on Facebook – your application will not be considered.
• Finally – it costs £250,00 to train a doctor (the NHS pays £200,000) but only £25,000 to get someone through a BSc. The investment by the state is huge and thus the selection procedure has to be rigorous.
The last point to make is that you should never, never be pushed into a medical career by your parents. You need to be passionate and self-motivated or you will end up in a career that you hate.
Before you embark on your application, be aware there is only one course that is more competitive for places than medicine and that veterinary medicine.
The table below shows how medical applications have risen over the past nine years.
Year No. trained No. of applicants
2000 5000 9000
2002 6500 11000
2004 7200 17000
2006 7400 20000
2008* 7500 20000
As an aside, the 2008 intake consisted of 5500 school leavers, 1500 graduates, 350 mature entrants and 150 who were from other courses.
Pre 1999, 5000 new doctors were trained every year in the UK to fill 7500 places (the rest having been poached from abroad). After 1999 the number of medical school places was increased by the Chancellor to 7000. This was done by increasing the size of the existing schools and six new schools were created.
All Universities have different entry requirements and selection procedures and these are outlined in their prospectuses. All courses differ slightly and it is absolutely vital as the first step up that mountain to contact the admissions officers and order an up to date prospectus for all the medical schools and read these through thoroughly.
There are 31 medical schools in Great Britain: 23 in England, 2 in Wales, 1 in Northern Ireland and 4 ½ in Scotland. (The ½ is St Andrews which offers a three year course then turfs its students out to complete their clinical skills elsewhere – usually in Manchester).
If you look at the map it will show that there are five schools in London, (Imperial, UCL, St Georges, Queen Mary and Kings), 10 in big cities, 6 new schools plus Oxford and Cambridge.
All the medical schools are governed by the GMC (General Medical Council).
Map to Show the Location of the Medical Schools in the UK
How Do Medical Schools Differ?
• They have a different balance of priorities between academic ability and personal qualities
• They assess academic achievements by different criteria
• Personal qualities are assessed in a variety of different ways
• Class sizes differ
• Geographical location – obviously
• All have different teaching and learning approaches
Types of Course and Teaching Styles
You need to investigate the type of course offered by the different medical schools and consider which one would suit your learning style.
Those on offer are:-
Traditional courses – where candidates spend three years learning theory and then do their 3 years of clinical training. Oxbridge tend to follow these.
Integrated courses – where learning and clinical skills are done together and start from Year 1.
Systems based courses – students learn everything about a particular body system. E.g. when studying the cardiac system students will cover all aspects of the theory, practice, pathology and clinical skills associated with cardiology.
(BSMS offers integrated systems based approach)
PBL (problem based learning) - where students work in a team and are expected to study a set of clinical cases, finding all the information out for themselves.
Every medical school except Southampton will interview potential applicants. You are advised to look through the prospectuses to get an idea of the success rate of the interviews and to have some idea of what to expect. The majority of interviews take 20 minutes and consist of a panel of two or three comprising a member of the medical school (professor, sub dean etc), a local GP or hospital specialist and a Year 5 student or lay person.
If you are invited for an interview, you are usually in with a chance so research the sort of topics that you may be asked – in particular have some opinions on ethical topics. Interviewers usually lean heavily on the personal statement as their source of question so never write anything that you cannot explain or justify. Never tell lies!
Timeline - Once You Get your Place
• 5 or 6 years at medical school (6 if you intercalate)
• Graduate – not registered with GMC
• 2 year Foundation programme* (paid a salary and registered with GMC after year 1)
• 4 – 7 year postgraduate specialist training (salaried) in either General Practice or as a Consultant
*the foundation programme can be taken anywhere in the country.
The vast majority of medical schools require Biology and Chemistry at A level. Manchester and Cardiff do not demand Biology but this can be a big disadvantage as statistics infer that those students without an A level in this subject are twice as likely to drop out and those that stay the course feel that their first year was a nightmare.
Grade Requirements for School Leavers
The grade requirements will vary according to the medical school and these should be checked with the relevant prospectus, but as a rough guide…
Oxford and Cambridge AAA
Imperial and UCL AAA
Others AAB or ABB.
The majority of students are finding it increasingly difficult to get work experience in a medical environment unless they have a contact. With the data protection act and patient confidentiality, together with health and safety risks, school students are seen as a liability. There are however, many opportunities for potential medics, which will count in your favour and enhance your chances of getting an interview. These include any voluntary work in the community (charity shops, hospice visiting, epilepsy centre, working in care homes, Millenium Volunteers). Any experience which shows that you are a good communicator and are an empathetic person will be positive.
Medical applicants also need to be able to demonstrate their ability to work as part of a team (could be a sports team or as a member of the Young Enterprise Organisation) and show leadership skills (D of E , World Challenge).
Talk to as many people as possible in a medical environment to find out what it is really like. The main thing is to get experience and learn from it.
If you do not undertake some sort of work experience, there is no point in applying for medicine.
Medical School Admissions Tests
Graduate entrants to medical schools are a known quantity and are usually looked upon more favourably as they are mature, serious, well qualified and will not sign up for another 4 – 5 study on a whim. The number of graduate entrants is increasing year on year and in some countries (US and Canada) only graduates are taken into medical school. This means that the competition for places is even more cut-throat for school leavers, the vast majority of whom are predicted A grades. In order to try and differentiate these candidates, Universities have introduced admissions tests. These vary according to the institution and need to be researched carefully.
At present, there are four tests.
GAMSAT* for details see section on graduate admissions
NMSAT (No Medical School Admissions Test)
Birmingham, Bristol, Liverpool and Queens Belfast are the only medical schools where there is no requirement to sit an admissions test.
Admissions tests are mandatory at all other universities.
BMAT (Biomedical Admissions Test)
This test is used by Oxford, Cambridge, Imperial, UCL and the Royal Veterinary College.
It is used to differentiate between the best of the best and acts as a predictive guide as to how a student will perform at degree level.
It is used in conjunction with the results at GCSE and A level, together with the personal information on the UCAS form and an interview.
The marks for BMAT run from 1 – 9 and a typical candidate would achieve 5 (very few achieve more than 7).
The grade achieved can be used as a selection criterion for an interview but in certain circumstances, a high score may help if a candidate slips a grade.
.The BMAT tests scientific aptitude, understanding and ability to interpret and analyse rather than factual knowledge: it does not assess a person’s fitness to be a doctor.
The test is taken at school in the first week in November (on a Wednesday) and the results are published online during early December.
BMAT is a paper and pencil test which has 3 parts all of which are given equal weighting.
1. A 60 minute test of aptitude and thinking skills (problem solving, data analysis, argument and inferences). There are 35 questions to complete in the allocated time testing skills which are essential to a doctor when making diagnoses.
2. A 30 minute multiple choice test of scientific knowledge (GCSE level science). There are 27 questions which require a true, false or cannot tell response.
3. A 30 minute writing test. (This is an essay which has to be handwritten on one side of A4 paper only). The BMAT essay is a test of speed. If a candidate writes more than one side of A4 the second side is ignored and the advice to all students is to write small, legible and fast!
Candidates select one essay title from a choice of three on topics which may be general, medical or of scientific interest. The skills being tested in here are the ability to read formal written English and to follow instructions. Students need to READ the statements and understand what they mean, express a view (which could be to agree, disagree or be undecided) and argue the case for their viewpoint.
Please note that examiners will not interpret illegible writing – if they cannot read something it gets ignored.
The essence of the BMAT test is speed. Every question needs to be answered but there are no penalties for incorrect responses.
Further information can be obtained from the website www.bmat.org.uk or from the only official guidebook published by Heinemann at a cost of £14.50.
UKCAT (United Kingdom Clinical Aptitude Test)
This exam must also be taken if applying to a non BMAT University. BMAT and UKCAT do not share student’s results.
This is a test of aptitude and skills. It has no science base and there is no specification from which to learn.
Aims of the test are to:
• Assist universities in choosing applicants
• help identify successful clinicians
• explore the cognitive powers and other attributes which would be valuable in a healthcare professional
All medical schools in the UK require students to have taken this test prior to applying apart from the BMAT universities and NMSAT universities.
Registration for this test starts on 1st May and closes on 25th September.
Testing starts on 7th July and ends on 9th October.
The time to do it is in the summer before you apply to medical school. It is far better to take this test early rather than later as you will have more choice of venue and date. If you enter too late, you may not get a booking. If you do not take the UKCAT, there is no point in making an application.
Remember also that the results may help your application or make you reconsider.
The test itself is taken at driving test centres, which are dotted around the country. All questions are multiple choice and are randomly selected from huge questions banks. (The chances of two tests in the same centre being the same are negligible!)
Structure of the test
• There are five sections to do in 120 minutes
• The five subtests are all multiple choice and are divided into 2 parts.
Part 1 – cognitive skills
• Verbal reasoning max 900 points
• Numerical skills max 900 points
• Abstract reasoning max 900 points
• Decision analysis max 900 points
Part 2 – non-cognitive analysis (a new part this year).
• No score is given to this part just a couple of statements.
Detail of the subtests
• Verbal reasoning – 11 passages of text and 4 statements associated with each which require a true, false or cant tell.
• Numerical skills – 10 charts, graphs or tables each with 4 test items and 5 options per question
• Abstract reasoning – looking at patterns. A 16-minute speed test where pairs of shapes (A and B) are presented together with 5 test shapes which have to put into an A or B category. There are 13 of these tests to do.
• Decision analysis - deciphering codes. One scenario is given with 26 test items each of which has 4 or 5 possible responses. This is allocated 30 minutes.
• Non-cognitive skills – a test which is designed to evaluate empathy, conscientiousness, emotional stability, psychological robustness, extroversion and learning techniques.
The results for the UKCAT are given immediately and the mark is sent automatically to all UKCAT universities even those that have not been applied to.
A good score would be to attain 600+ in each of the four sections. Usually marks of 2600 and above will guarantee an interview (as long as candidates fulfil all other criteria.)
There is only one test per year and no re-takes for this test. No commercial preparation has been endorsed by UKCAT but online information and practice scenarios are available from www.ukcat.ac.uk.
What To Do If You Don’t Get In?
if you have achieved the right grades (AAB or better) then you should
• Get a job as an HCA and try again
• Enrol for a BSc and apply as a graduate
if you have not achieved the right grades then
• Re-sit the key A levels (Do note that the number of medical schools who are accepting re-sit candidates is dropping every year, unless there are extenuating circumstances
• Enrol on a BSc and head for GEM
• Train as a healthcare professional (nurse, physio) and head for Access to Medicine (the latter have the greatest number of successful applicants)
• Train abroad in Eastern Europe (note that you will have to learn the mother tongue of your patients) or, if your parents are awash with dosh, a private medical school (e.g. St Georges Grenada).
Graduate Entry Programme (GEM)
The Graduate Entry Programme is becoming more and more popular in the UK. In the US and Canada, these are the only routes into medicine and it is likely that this is the model that will become the norm in the UK (particularly as A levels are dumbing down).
There are 16 programmes in the UK and are funded in Year 1 by a student loan but in Years 2 – 4, by NHS bursaries.
Currently there are 4000 applicants per year for the GEM courses but only 840 places.
GEM programmes are run in many of Universities but some like Swansea and Warwick only offer the graduate course.
Entry requirements vary depending upon the university and degree standard ranges from a 1st to a 2.2. Entry tests also vary as do the Biology and Chemistry A level requirements.
The teaching and learning approach on graduate courses varies but the cohort size is usually much smaller than on the undergraduate courses.
Detail of GEM requirements
• 1st class honours – Birmingham
• 2.1 – all other except
o Kings 2.2 plus masters
o Nottingham and St Georges, London 2.2 plus GAMSAT
• Any degree –Cambridge, Kings, Keele, Newcastle, Nottingham, Southampton, St Georges, Swansea
• Biology specific degree – Birmingham, Liverpool, Bristol, Imperial
• Science degree – Oxford, QMW, Warwick
• Health degree – Leicester
A level grades may be specified and vary according to the institution.
Additional tests required
GAMSAT UKCAT NO TEST
This is essential for entry to the graduate programme. Candidates need to have found out about the work of a doctor and to have experience in caring.
These are longer and more structured that for the undergraduate courses. They last between 20 and 45 minutes.
Applicants apply through UCAS. They can select 4 choices and the deadline for applications is mid October.
After the medical degree, students apply for F1 posts as junior doctors and after 2 years they undertake specialist training (either as GP or consultant).
GAMSAT (Graduate Australian Medical School Admissions Test)
This test is one of the most rigorous tests that can be taken by university applicants. It is mandatory for applicants on the graduate entry programme to St Georges, Nottingham, Swansea, Peninsular and Keele.
The test is 330 minutes and has three sections.
1. Reasoning with Humanities and Social Sciences.
This is a multiple choice test where candidates choose responses 1 – 4. There are 75 questions to complete in 100 minutes and it tests high level thinking skills.
2. Written communication
There are 2 writing tasks to complete in 60 minutes. The first task is a socio-cultural issue, the second is more personal and social issues.
3. Reasoning in Biological and Physical Sciences
These are multiple choice questions, with responses being chosen from 1 – 4. There are 110 questions to do in 170 minutes and the content weighting is Chemistry 40%, Biology 40% and Physics 20%. The level and knowledge required is that for an undergraduate (apart from the Physics which is A level standard).
Students need to prepare thoroughly for this test and the score achieved is valid for two years.
I hope this booklet will be a valuable source of information for any student who is seriously considering a career in medicine – it is aimed at doctors rather than dentists or vets but much of the information is useful to all three disciplines.
There is no point in building up your hopes and planning your life round a medical career if you are not a realistic candidate, so the information in this booklet needs to be read carefully by you. Sections that are highlighted or words in bold are particularly important and need to be fully understood. The rewards at the end of a long, hard academic grind will be worth it but unless you are absolutely dedicated, it may not be the right choice for you
I have used information from a variety of sources to ensure a fair and balanced document. The statistics and data (which will change every year) have been provided mainly from the admissions tutor for Brighton and Sussex Medical School and Medlink in Nottingham. Students need to ensure that they carry out their own research and it is absolutely vital that they obtain and read the current prospectus for the different medical schools.
The RGS Medical Society is there to help you with understanding the nature of medicine as a career and thereafter to support you with the application process. Please ensure that you attend our meetings and ask us for help.
We are not experts but have a wealth of experience which has been invaluable to students who have successfully secured places at medical school and, over the years, the realistic candidates have been happily positioned on a course that suits their nature and academic ability.
As an interviewer of potential medical applicants at UCL, I am able to give valuable feedback to students who are preparing for their own interviews and as a parent with two children at two different medical schools, I can empathise with parents who are going to be backing you every step of the way.
Finally, the Medical Society could not be quite as successful without the support of Mrs Jill McDavitt (Chemistry and Careers) and Dr Janet Philpott (Head of Careers).
I would also like to acknowledge the various guest speakers who have given up their time to make excellent presentations and finally to you fantastic students of RGS who will be the doctors of our future.
Good luck and don’t give up!
Suggested Reading List for Medical Applicants
SPECIFIC TO A MEDICAL APPLICATION
1. Medical School Prospectuses (make sure it is the current one for your year of application)
2. So You Want To Be A Brain Surgeon?
Ed Ward & Eccles ISBN 0192630962 (everything you wanted to know about medical careers but were afraid to ask.)
3 A Career In Medicine, Do You Have What It Takes?
4 The Insiders Guide To Medical School
5 Bedtime Stories, Confessions of A Junior Doctor
6 Learning Medicine by Peter Richards
7 The Essential Guide To Becoming A Doctor A Blundell and R Harrison
8 Getting Into Medical School J. Ruston & J. Burnett
9 Doctors To Be Spindler
1. St Johns First Aid Manual
2. Blood and Guts: A Short History of Medicine
3. How The Brain Works J.McCrone
4. Bodies Jed Mercurio
5. The Student BMJ (order online from the BMJ)