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Friday 25th January 2013

Okay, so you’ve done everything ‘right’...the statement has been honed to perfection; your teachers have been cajoled into giving a good reference; you have scored highly in BMAT/UKCAT (if applicable); your interview went well, you are on track to get four grade ‘A’s...and you’ve still failed to get an offer. What next?

Well, at this point I have to be dishearteningly honest. My sample is only a small one in terms of national statistics, but my experience has been that if you don’t get an offer at this stage you are never going to get one on the basis of only A-levels. Conversely I have found on several occasions that students HAVE been given offers and failed to make them it has been quite usual for the medical school to allow the candidate to keep retaking until they meet the offer (though some schools may increase the offered grades for a retaker). Several of my students such as Shantanu have got into medical school this way. But getting the offer is the main thing - without it it is unlikely in MY experience that A-level retakes will help.

At this point several of my students have given up (against my strongest advice) and presumably accepted a life of ‘what might have been’. I do not encourage this! Medicine is not a job - it is way of life and if it is what you want to do then there is no ‘second best’. Okay, so you may become disillusioned with it later, but at least you got the chance to be so!

If you have cash (or can borrow it - medics are always seen as a good investment) then there are quite a few ways of skinning this cat. If you look up ‘offshore medical schools’ on the web you will see that this is a massive industry. Most are based in the West Indies, and have varying degrees of respectability. The oldest and most respected appears to be St. George’s Medical School in Grenada. I’ve been there and it is very sound, if rather Americanised! I’ve had three students go there to my knowledge. One, Danny ,was a 40-something business executive who had always hankered to be a doctor. He mortgaged the house (with his wife’s support) and took himself off to me and my old friend Mac (now, alas, no longer with us) to do A-levels in Biology and Chemistry in-between working full-time. He got his two grade ‘A’s (although I am fairly sure that ‘B’s would have sufficed) and went off to the sunny West Indies. Another, Ben, was an entrepreneur who had a degree in business from one of the old Polytechnics many years before and similarly hankered to be a medic. Like Danny he came to Mac and myself, got his two grade A’s and actively chose to go to Grenada as he ‘fancied a couple of years in the West Indies’ - although he could have walked into any British medical school. He did his pre-clinical years in Grenada, came back to Bucks to do his clinical training and is now a successful orthopod.

The third person who trod the Grenada route was Emilia, the girl who qualified as an auxiliary nurse while reading biochemistry. She was particularly interesting as she got a major scholarship from St. George’s, which is definitely something worth investigating. Sadly, after three attempts at getting into medical school and a year at St. George’s she actually decided that medicine wasn’t for her and dropped out.

I have also has a more recent student, Fabiha, who got excellent A-levels last year and did all the right things but still got no offer from British medical schools. I have heard that she is now at the Charles Medical School in Prague (Czech Republic) and doing well. She may come back to the UK to do her ‘clinical’ examinations or she may stay in the Czech Republic.

These offshore schools (and there are many others as a quick search of the web will show) tend to be quite expensive, but if you go to a reputable one like the Charles School or St. George’s the qualification is taken seriously and ‘converting’ to UK qualifications is quite possible. Do bear in mind that under EU law any continental qualification must be accepted in the UK. Teaching at the Charles School is in English, by the way - there are also offshore medical schools in the Middle East and elsewhere where instruction is in English.

I have had two potential vets who trod the offshore path. One, Sam, did a business degree at the University of The West of England and decided to become a vet. He came to Mac and myself to do Biology and Chemistry A-levels and got grade ‘A’s. He was offered places at most of the UK veterinary schools but preferred to go to the veterinary school in Budapest in Hungary.

The other veterinary Sam (this time a female version) came to me to do A-levels twice after an awful time at school, and dropped-out twice. She drifted in and out of various veterinary nursing jobs and finally fetched-up in business for many years before taking herself off to the University of Nova Scotia (Canada) to do a two-year pre-veterinary degree. She loved it there and - unlike the UK system which she hated - got high grades in all courses. A-levels are not for everybody! On the basis of this she got a place at Bristol veterinary school - and good for her!

If you have overseas connections then other avenues open up. My lovely Guyanese student, George, did A-levels with us in the UK but, sadly, did not get a place ast a British medical school. I urged him to go to the University of The West Indies (the only non-EU school whose degrees are accepted by the UK) in Trinidad where he had five great years before coming back to the cold and snow of Glasgow to take his Fellowship exams. He is now a successful physician.

My student Arman did all the right things, got excellent A-levels and BMAT and a load of relevant experience and still got no place at a British medical school. Happily his father had a business in Belgium and so he was able to take himself off to the University of Louvain where he is now studying medicine happily. Similarly my old student Sonja (who is German) was unable to get a place at a British medical school but went back home with her okay-ish A-levels, waited a year and got a place there. She is now Dr. Sonja and happily in practice in Germany.

So, if you have some foreign contacts, maybe some cash (although scholarships are available) and a lot of imagination and guts it is QUITE possible to take the overseas route. I’m sure that any of the chaps or chapesses I’ve mentioned would be happy to talk to anyone contemplating this move.

The less dramatic (though possibly just as expensive in the long-run) move is to do some form of degree in the UK (preferably a relevant one, but not necessarily) and then apply to medical school as a graduate student. A number of universities offer ‘accelerated graduate courses’ even for non-science graduates. These change considerably from year to year so again you will need to check them out online. My delightful and capable student Edwina failed to get into medical twice from both first and second time of taking A-levels, so she took herself off to Exeter University to read Biomedicinal Chemistry. She got a perfectly respectable degree and applied to the accelerated graduate medical course at Warwick University and got in. Sadly her attempts to progress in surgery were thwarted by the macho elements still, sadly, prevalent in much of this profession (how it is possible for a load of men to talk above and around a six-foot tall gal is utterly beyond me!) and she has now moved into pathology, which she does not enjoy at all. I am saddened that after all that effort she is still not realising her dreams.

Talking of ultimatedisappointment, my student Luke abandoned a History degree at Edinburgh, re-mustered to do science A-levels with myself and Mac in a year and got a place at Southampton University to read medicine. He went through the whole system, worked for several years in a hospital and then chucked it all in to become a management consultant as he was so sickened of the politics and poor management of the health service. Several more of my old students now in the medical profession say that the health service makes what was once a dream into ‘just a job’. Something to bear in mind at all stages.

A quite popular path that several of my old students have taken when turned-down after A-levels is to accept a place on a ‘Biomedical Science’ (or ‘Bioveterinary Science’) course. This is a three-year degree course with the possibility of the top ten (or twenty) percent of the class then being able to go onto a full-blown medical course (in most cases with some sort of ‘exemption’ from having to do all five years of a traditional medical course). When these courses first appeared I was deeply sceptical as I got the impression that they were a sort of ‘consolation prize’ for would-be medics who would then go on to rather boring jobs as medical reps and the like. Actually they are mostly rather good courses, very interesting and highly ‘medical’ and with good a good track record for then getting people into medical school if they still want to. I hear more and more from old students on these courses who are now being offered places at medical school. One of them, Aamna, was one of those frustrating students who was determined to do it ‘her way’. I’m glad that she got in eventually but I can’t help feeling that she would have saved herself a couple of years if she had listened to our advice at the outset... Another lesson for potential medics to take on board!

The interesting thing is also quite how many students who go the ‘graduate’ route and then get a place on a medical or veterinary course then subsequently decide to drop out after all that effort. My old student Annie ploughed through three years of a pre-veterinary couse, got a place at veterinary school and then decided she’d had enough. The same thing happened to Emilia out in Grenada. In a similar vein my old studen Edwina (like so many of my students) had terrible problems with A-levels and had to apply after a first degree - but then she romped through her ‘Fellowship’ examinations (which have a pass rate of 40%!) The fact of the matter is that we all change as we go through life and what seems like a disaster at one stage may well turn out to have been the right thing after all. And, of course, vice-versa.

Selection for anything, including medical school, is very much a matter of personal opinion and the frailties and idiocies of human beings are well known. So if you are feeling rejected and hurt having been turned down for your ‘dream course’ despite doing everything ‘right’ I hope that these various personal stories will re-fill you with enthusiasm to keep going - tempered with the knowledge that sometimes, just very occasionally sometimes, it’s all for the best!

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