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Friday 25th January 2013

Over the past 23 years I have had a steady stream of would-be medics (and dentists and vets) pass through my hands. And I can put my hand on my heart and say that the few who never made it in the end all did so for one reason - they simply stopped trying. As I tell all potential medics during our first session, there are dozens of ways of skinning this particular cat (although admittedly it is a bit easier if you have a bit of cash!) and you simply have to keep going. I have had students make up to three attempts before getting into medical school before now - it is frustrating and wearisome, but those who persisted invariably got their reward.

The whole process of selection by UK medical schools has become extremely refined in recent years - after many decades of recruiting ‘medical morons’, with high brainpower and little natural empathy with sick people, the whole process is now aimed at looking at candidates ‘in the round’. And with so many people applying to be medics nowadays, every single aspect of the application (academics, UCAS statement, references, interview skills, BMAT/UKCAT) has to be trained-for and done professionally. A substantial industry has developed simply around the whole process of making an application to medical school. The day of the average obstinate 18-year-old just blundering in and doing their own thing and hoping to get a place are rapidly nearing an end.

I have over 40 students now with whom I am still in contact who are either at medical school, have recently graduated, are working as medics or (in more than a few cases) become disillusioned and given-up medicine altogether, even after qualifying. Barely a handful of those 40 or so students walked straight into medical school from good A-levels: most had to take the ‘long way ‘round’ as already mentioned. And a damned good thing too, in my opinion- the UK is one of the few countries in the world to take such youths straight into medical school and a bit of worldly experience is no bad thing in someone making life-and-death decisions.

It IS still possible to get into a British medical school straight from A-levels, but your chances are considerably improved by taking a few basic precautions. The most obvious one is to make sure that you get three grade As in three academic subject. It is vital that you check in advance with your proposed UK medical schools which A-levels are and are not acceptable (details are on the web or you can ‘phone admissions tutors directly - preferably at a quiet time of year - and they can be very helpful). The requirements can vary considerably from place to place and year to year. It would be a waste of an application applying without A-level chemistry to a medical school that requires this, for instance - and the vast majority (but not all) still do. Similarly, if you are a ‘retake’ candidate it would be pointless applying to one of the schools that says specifically that it will not accept retakers.

Early research into these matters is vital - if you haven’t got anyone locally who can advise you I can point you in the right direction. Doing ‘odd’ A-levels is not necessarily an automatic bar, by the way - say you started off doing arts A-level subjects at school but suddenly conceived a massive desire to do medicine. There are actually a few British medical schools which offer ‘foundation years’ for those with arts A-levels in which you effectively do a compressed science A-level course in a year before being admitted to the medical school proper. Similarly doing two sciences or a science and math s plus an arts subject is not at all a bar to medical school entry in most cases - in fact many medical schools favour this degree of academic ‘rounding’ rather than the old ‘Biology, Chemistry, Maths’ or (now coming back into favour thanks to Brian Cox) ’Biology, Chemistry, Physics’ A-levels.

One common mistake often made by over-conscientious students is to take four, five or even six A-levels in an attempt to ‘impress’ medical selectors. I am sure that there is a tiny fraction of students who can carry this feat off, but in every case in which I have been involved (against my express advice) it has invariably led to disappointment. All that medical schools want is three good A-levels in the ‘right’ subjects (which, by the way, is highly unlikely to include Media Studies, Sociology or Drama). Or, rather, they want that PLUS excellent references, a brilliant personal statement, a plethora of extra-curricular activities, a good BMAT/UKCAT score and a whizz of an interview. Oh, and bags of relevant (and preferably menial) medical experience - of which more later.

Daunted by all of this? Well, you want to be a medic dealing with life and death situations so you’d better get used to it sooner rather than later!

The personal statement is possibly the most daunting aspect (after the interview) of an application to medical school. I have helped to edit hundreds of statements, of massively varying quality, over the years and I feel that this topic is best left to another blog.

The single biggest thing that lets most candidates down seems to be lack of good predicted grades (a ridiculous system but one we have to live with for now) and/or a poor reference from teachers. Making sure that you get on the good side of your teachers at an early stage and making it clear that you are keen and hard-working is a major help in this whole process. However, do not despair if you are a ‘square peg’ in permanent trouble with HQ - I have known one or two particularly pig-headed students who have got on the wrong side of their teachers due to a personality clash simply bulldoze the latter into writing the statement they want. Under the ludicrous laws foisted on us by the doubtless well-intentioned EU there is no such thing as a ‘confidential' personal statement nowadays and only a complete fool would allow a potentially damning personal statement to be released by a school to UCAS without asking to see it. In this day and age of AS-levels the medical schools seem to pay more attention to them than to ‘predicted grades’, but presumably this situation will no longer pertain after 2014 when old style AS-levels become extinct. Getting good marks in routine school tests (a bit of concrete evidence that CAN be waved at an obstinate teacher refusing to give a good prediction) can provide useful leverage. If you’re afraid of hard, consistent work then medical school really isn’t the place for you!

The second thing that lets many candidates down is lack of massive anounts of relevant personal medical experience - preferably in as menial and humiliating a capacity as possible. Sadly, even in the early 21st century there is a small proportion of would-be medics who have stars in their eyes as a result of the numerous medical soap operas. Being a Doctor in the white coat, worshipped by hordes of admiring minions who obey your every wise command in raptures of worshipful delight does have a certain appeal, I suppose...although, regrettably, I am told that it is far from the truth! In the days following the Harold Shipman case and other recent medical fiascos medical school selectors are rapidly moving away from the notion of ‘Doctors as God’ and looking for a high degree of commitment and humility in candidates.

If your idea of ‘relevant experience’ is a week of following at the elbow of your consultant orthopaedic surgeon godfather as he does his ward rounds (how often have I been told this tale with a straight face by some young hopeful as evidence of their ‘commitment’?) then I am afraid that you are in for a shock at many levels. One is that you will be in competition with people who have volunteered in care homes every weekend for years. The other is that when you hit the real wards it may frankly terrify and disgust you.

It is very difficult for the under-18s to get a lot of relevant medical experience due to NHS ‘elf and safety’ measures. But many of my students have shown this high degree of commitment over a prolonged period of time and have reaped the rewards in the form of a justly-deserved place at medical school. Two particularly outstanding students come to mind - one volunteered as a nurse every weekend while studying biochemistry at University (having been turned-down twice by medical schools) and duly won her place third time around. Another volunteered as a care home worker every weekend while at University studying history AND cycled down to the local college of Further education regularly to take his science GCSE, in the company of a load of 16-year olds. Such commitment does not go un-noticed by selectors!

The other point to getting a job that involves cleaning up the pee and puke is that if you don’t enjoy it now what hope will you have when you are training to be a qualified medic? Sometimes I pack off would-be medics (and particularly vets) to do some work experience and they can’t stand it - this is a good result as far as I am concerned as they now know for sure it’s not the life for them!

It may seem an obvious point (although sometimes we have to point out the obvious) but if you are asked to do a BMAT or UKCAT test then for heaven’s sake make sure that you have done the necessary practice! At the very least pick up a load of past papers and work through them...failing that sign up for a course, of which there are many now available (at a cost). Also make sure that you have prepared for the interview - a complete ‘mock interview’ course (preferably taped and played back to you in a debrief) is desirable or at the very least make sure you have discussed likely questions with someone ‘in the know’. The book on getting into medical school by Joe Ruston (a lovely chap - or at least he was when he interviewed me for a job at Mander Portman and Weoodward in the 80s) is very helpful. I am sure that there are others. Get one and read it and act upon it. It would be insanity to walk into a medical interview, be asked the old chestnut “why do you want to become a doctor?” and blurt out “because I want to help people” because the interviewer will look witheringly at you and reply “So why not become a nurse then? Next!” Similarly if you have not boned-up on the latest advances in medicine, the politics of the health service, the latest controversies in medical ethics and preferably been reading the newspapers for a few months before the interview you are likely to come badly unstuck.

Although I’ll be dwelling upon them at more length when I discuss UCAS statements in a later blog do remember that the selectors are looking for eight key qualities in every aspect of the application which may be summarised as: 1) Academic ability; 2) Ability to work in a team; 3) Leadership; 4) Stamina; 5) Ability to empathise with people; 6) Ability to communicate clearly; 7) Knowledge of what you are getting into, and 8) Ability to relax! A lot of this is about ‘CV building’ so if your principal leisure activities are ‘hanging out with your friends and shopping’ I suggest that you start expanding your leisure horizons may even find that enjoy it!

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