The Essential Guide to Becoming a Doctor

By Adrian Blundell, Richard Harrison and Benjamin W. Turney

All you need to know about becoming a doctor in the UK

This book contains all the help you need to become a doctor. From applying to medical school through to choosing your specialty, you can find out: 

• How to choose a medical school
• How to get into medical school
• How to survive as a medical student
• All about electives
• What life is like as a doctor

As well as easy to follow information on choosing, getting into - and surviving - medical school, junior doctors in different specialties provide unique insight with firsthand accounts of what the job is like in real life, to help you plan and decide your future career path. 

Included in this fully updated third edition is the latest information on admission tests, an admission table with practical details about each medical school (as well as greater coverage of graduate medical schools), making this now even more comprehensive for everyone planning a career in medicine.

• Language: English
• Publisher: Wiley
• Release date: Jan 6, 2011
• ISBN: 9781444329766

Book preview

Chapter 1 A challenging career

1.1 Medicine or not

The decision to study medicine at university should not be made without a great deal of thought and research into the reality of life as a doctor. At the age of 17 it can be difficult to know whether you want to go to university at all, let alone study for at least 5 years. Your future career ideas should be discussed with family and friends but the final decision needs to be an individual one. Those around you are likely to have differing views; parents and teachers may feel that medicine is a respected profession and possibly encourage you to take this path but some doctors may try to dissuade you. Speak to as many students, doctors and other healthcare professionals as possible in order to gain as many opinions as possible. Ask individuals to justify their reasoning for choosing medicine as a career and to explain why they would or would not recommend it; without experiencing life as a doctor, it is difficult to know what it will really be like. We all know friends who have avoided medicine following their personal experience with one or both parents as doctors. In comparison many students, after experiencing their own family life, do decide to follow in their parents’ footsteps. Although relatively common, try not to be persuaded or coerced into studying medicine by your family – it is YOUR decision and YOUR career for the rest of your life.

For older candidates, the decision is even more difficult. A mature student needs to be certain that the decision to study medicine is the right one as often there is more at stake; each applicant will have their own personal circumstances but returning to student life may involve leaving paid employment and moving a family around the country.

1.2 Career planning portfolio

A useful starting point on the application pathway is to buy a scrapbook or folder for developing into a useful resource full of ideas and information. Early pages should be dedicated to listing your possible career or degree choices. For each decision produce a table with two columns headed ‘Advantages’ and ‘Disadvantages’.

Possible advantages of a career in medicine

Five years at university

Interesting

Virtual guarantee of job following graduation

Reasonable salary

Respected profession

Diverse range of specialties

Option to use both intellectual and technical abilities

Continual advances in the profession

Sociable work environment

Good team-working opportunities

Managerial and leadership opportunities

Structured career

Transferable skills

Opportunities for working abroad

If you find the disadvantages column dominating at any point, then think carefully whether this decision is correct. Portfolios are used extensively in the medical profession, from medical students to senior doctors, as a record of training that can be used as evidence of competence (i.e. the ability to carry out one’s job). Your portfolio can be divided into different sections: academic; work experience diary; extracurricular activities; employment; managerial, leadership and organizational skills; university choices; commitment to medicine (or other degree); newspaper/journal articles; curriculum vitae. Rather than just listing achievements, it is sensible to reflect on your experiences, for example what were the good and bad bits and how they have helped towards your future career choice. This will develop into an essential resource that will aid your future career choice decision and will be useful to look through prior to interviews.

Possible disadvantages of a career in medicine

Five years at university

Long hours

Lots of exams

Risk of mistakes

Stressful periods

Dealing with death/suffering

Patient expectations

Media bashing

Paperwork

Lack of NHS funding

Possible job insecurity

Lack of flexibility in training

Litigation (being sued)

1.3 The decision

University is only the tip of the medical career iceberg; the remaining 40 years of medicine can be quite different. There is no doubt that a career as a doctor can be challenging, rewarding and exciting, but remember that it is also hard work, stressful, tiring and, at times, mundane. Have you the right personality, not just for the university course but also in the longer term? The majority of sixth form students have no idea what university and a career in medicine will be like, and embark on this journey blinkered by this lack of insight. However, knowledge can be gained by talking to current medical students, career advisors, general practitioners, hospital doctors, and by reading books on the topic of studying medicine and perusing the medical journals. It is also necessary to spend time in and around a hospital or GP surgery, known as work experience or voluntary work. This is an essential prerequisite for obtaining a place at medical school as it shows your commitment, but it is also necessary for gaining more insight into your future career choice.

The decision to study medicine at university should not be made without a great deal of thought

Students have differing motivations for choosing a medical career: family tradition has been discussed, others have experienced medicine as a patient, some have an interest in science, a minority have wanted to become a doctor since the dawn of time, and many just feel that they want to help people. Having experienced medicine from the point of view of being a patient or relative is useful and these experiences can be shared on application forms or at interview. Some of your friends may well know that it is their destiny to become a brain surgeon but the odds are that these people will change their minds over the forthcoming years. The idea of a specialty is different to the reality. It is not necessary for you to decide on your future career prior to applying to medical school, but if you do have some thoughts then these can be mentioned, although remember to have reasons to justify your decision. For many the final decision to study medicine will be made shortly before sending off the UCAS form. Whatever your reason for thinking medicine is your future, it is important to realize that there are other jobs and university courses that would fulfil these reasons and a life following one of these different paths could be just as rewarding. Remember that there are a number of wrong reasons for pursuing medicine as a career.

While deciding on a medical career, it is important not to be disillusioned by the negative media publicity or the drama depicted in television programmes; these are two ends of an extensive spectrum and the majority of the work of a doctor is different. In terms of adverse publicity, remember that doctors have not just started to make mistakes, that doctors probably make fewer mistakes now than ever before, and that the difference is due to the expectation and knowledge of the general public. Mistakes are now less tolerated, and with the advent of the internet patients are more aware of their diseases and also of treatment options.

If you are serious about studying to become a doctor, in addition to researching about life as a doctor (including quality work experience), it is necessary to determine that you have the right attributes and qualities. Although academic excellence does not always equate to good clinical skills as a doctor, there are minimum requirements for entry into medical school. If you have performed badly in your GCSEs or are not likely to get high grades at A level, it is unlikely that you will be offered a place to study medicine, as there is great competition. A useful starting point is to look at the UCAS website for the minimum requirements for entry to each university. Apart from academic pursuits, it is important that applicants demonstrate other interests and abilities and most candidates will have a history of sporting or musical interests and be able to demonstrate leadership and team-working experiences. All these attributes are important for a future healthcare professional, and universities are looking for well-rounded individuals.

There may be other options available if exam results are disappointing at AS level and predicted A-level grades lower than required, and some of these options are discussed in later chapters. Possibilities to consider include resitting A levels and studying a different degree at university and then applying for graduate-entry medicine at a later date. The key is getting excellent A-level grades – if you have the academic requirements for a university place, and the suitable attributes and qualities of a future doctor, then you should be able to get an interview offer, even if this means taking a year off to reapply.

The job of a doctor can be challenging, rewarding, exciting . . .

. . . but also hard work, stressful, boring and routine

The decision to study medicine is just the beginning. Now it is necessary to decide which university and, for some students, which country. It is likely you will have a great time at whichever institution you find yourself. Remember that not all universities are the same and at some the workload could be greater and the social life less. This is why research before applying could save heartache later. Once at medical school, the majority of those students who wish to become doctors do eventually make it through. Some decide that medicine is not the career for them and either leave or convert to another degree. Likewise, some students embark on other science degrees and find that medicine would be more suitable, so make the change then. If you are unsure about your future career, then a possible option might be to study at a medical school offering intercalated degrees as part of the course. For example, at Nottingham the preclinical work includes a research project in the third year that leads to the degree of Bachelor of Medical Science (BMedSci); after this a student could leave the medical school and pursue an alternative career with a degree under his or her belt.

1.4 A changing profession

Medical training and the health service have undergone radical changes in the last 5 years. It is unusual for a day to go by without some mention in the press about changes in doctor training and cuts having to be made due to financial problems. The main push is for a quality health service at an affordable price. Morale has been low due to hospital closures and job uncertainty for many healthcare professionals. It is essential as potential future doctors that even at this early stage you stay up to date with the proposed alterations to career structure, training and NHS reforms. Although it may seem irrelevant at your stage in life, the changes may well alter your decision to study medicine. One interesting aspect is that with the increased number of places at medical school and the reduction in the number of training posts, we may see unemployed doctors for the first time. Employment following graduation is virtually guaranteed but greater competition during later training may mean limited possibilities, especially in smaller specialties and popular locations. Modernizing Medical Careers (MMC) is a government-led initiative that was introduced in 2007 to make training at all levels more formalized. Following medical school, newly qualified doctors now join a 2-year Foundation programme rather than the traditional 1-year Pre-registration House Officer (previously known as the Junior House Officer year). More information about current and future training can be found in later chapters.

1.5 Planning

Planning and research are the key components in deciding and then ultimately applying for medicine. Try to prepare well in advance. Here is a checklist to help formulate a few ideas, although it is by no means exhaustive.

Choosing a medical career: a planning checklist

Keep a scrapbook or folder: develop a plan for a medical career, divided into sections as described earlier. Remember to keep informative newspaper cuttings or journal articles and to write about your experiences rather than just listing achievements.

Academia: at an early stage determine which subjects you need at AS and A2 level. Work hard to obtain the required marks! As well as your A-level work, consider some general reading around medical topics. Nature and the British Medical Journal are good starting points; the BMJ is one of the most widely read journals in medicine and the student version has useful articles on career planning and changes in training and also presents interesting medical cases. At a minimum you should be aware of medical advances and developments that have made the lay press and look at these in more detail.

Requirements: a good starting point is the UCAS website (www.ucas.org); this has information on the necessary requirements for every course at UK universities. It also has a careers advice questionnaire program that can map your interests and abilities to potential careers and also lots of other general information for potential students. If you are required to pass an extra exam prior to applying (e.g. UKCAT), then make sure you submit applications for these (see Chapter 3).

General Medical Council (www.gmc-uk.org): the GMC is the regulatory body for doctors. It produces multiple publications with information for doctors. A useful start would be to look through the booklets Good Medical Practice and Tomorrows Doctors.

Department of Health (www.dh.gov.uk): keep abreast of developments in the health service by looking at the Department of Health website. Find summary documents on important governmental papers and legislation.

Modernizing Medical Careers (www.mmc.nhs.uk): look through the recent developments in medical training.

Research your future career: speak to as many doctors (community and hospital), medical students and other healthcare professionals as you can.

Work experience: you need to be organized to sort this in good time. The quality is more important than the quantity and consider a variety of experiences.

Medical school research: request the prospectus from the universities you are considering applying to and look at their websites. Make sure you attend the university open days and take the opportunity to speak to as many students as possible and look around the town or surrounding areas (see Chapter 5).

Extracurricular activities: as with work experience, it is about the skills and attributes you have gained from your interests outside academia rather than merely the number of hobbies you have.

‘Premedics’ groups: rather than isolating yourself from your peers, why not start a small group of students interested in doing medicine to share ideas, knowledge and experiences.

Referee: start planning in advance who your referee will be. Ensure that he or she has been aware of your commitment to medicine and also that they are fully supportive of your application.

Interview practice: once you have offers, or even earlier if possible, organize mock interviews with several teachers. Practice asking and answering interview questions in your ‘premedic’ group.

1.6 Summary

There is no one good or bad reason for studying (or not) to become a doctor. It should be a decision that a student is completely happy with and should not be made lightly. For many, a career as a doctor is usually enjoyable and rewarding, but there are times when it can interfere with personal and family life and this can be seen in the higher rate of divorce, depression, alcohol problems and suicide among medical practitioners. With the changes in working practice and the reduction in hours, the impact on personal life should reduce. To help make your chosen career less stressful, it is important not to bottle up emotions but to talk through any problems with friends and colleagues and to have other interests outside medicine in order to relax.

PERSONAL VIEW

Adrian Blundell

I do not remember when I decided to become a doctor; my first career ambition was to become a pilot, but my early enthusiasm was not shared by my parents. They felt being a pilot would not allow a favourable work/life balance due to the long hours and the frequent trips abroad. My parents are not from a medical background and so possibly didn’t realize the long hours involved in being a doctor. Nevertheless, the idea of being a fast jet pilot was then out of my head. At school, I was fairly good at science and reasonable at the arts. The headache initially was deciding my A levels: science and study medicine, or arts and study law. (This limitation in my choice reflected my naivety about the possible careers available and also a rather disappointing lack of careers advice at school.) Science it was and medicine followed.

My teachers were not particularly generous when predicting my A-level grades (BBC). This was actually fair, as my results in the lower sixth form exams were quite poor. The most common offer in 1990 when I was applying to medical school was BBB, and for this reason I ended up obtaining only one offer from a London college. Other universities I applied to wrote back with offers for other degree courses but I had decided on medicine and turned these down. I actually contacted the medical schools to ask why they had not offered me a place – one response was that I had not done any voluntary work. This might have been true at the time of applying but I spent a large majority of my upper sixth helping at the local hospital.

Results day arrived; I had achieved BBB. A difficult decision ensued as I had obtained the necessary grades to take my medical school place, but I was uncertain as to whether I wanted to spend the next 5 years in London. I really wanted to go to a university rather than a medical school so I declined the London offer, and took a gap year. I then had to commence the application procedure once more.

I was unsure exactly what to do with this year. I had no guarantees of getting an offer and would not find out for several months. An advert appeared in the local paper for a school-leaver with science A levels to work in the field of cancer research at a local pharmaceutical company. I successfully applied for this position and then began the process of reapplication to medical school. Many of my friends spent their year jet-setting around the world. Although a little envious, I still had the problem of finding a place at medical school and this prevented me from leaving the country for long stretches. On this occasion I applied to the University of Nottingham, as I had studied the prospectus and liked the idea of a more modern course. I had never even visited the city before, but on the day of my interview I had a gut feeling that this was the place I really wanted to spend my university days. Fortunately, an offer appeared through my door 2 weeks later. The rest, as they say, is history.

During a gap year, the choices include work, travel, or stay around your home town living off your parents’ generosity. The latter is to be avoided and universities will not look favourably at this. Work or travel is the main question. Most students undertake a bit of both. From personal experience this is probably the best advice, although working for the whole year did mean that I had some beer money when I left for university and also a car in which to carry it. The decision is yours! Good luck.

Chapter 2 The application procedure

2.1 General advice

All applications to university or college courses have to be directed through the University and Colleges Admission Service (UCAS). All applications are now completed online as paper forms no longer exist.

Initially, the task of completing the UCAS application can be quite daunting; after all, this will essentially determine whether you obtain an interview offer and subsequently a university place to study medicine. Do not lose heart: everything in this book is designed to allow you to make an informed decision about your future career, and this chapter guides you stepwise through the application procedure. We will give you hints and tips as to how to complete the form, tell you exactly how the UCAS application system works, and guide you through the application step by step.

Medicine is one of the most popular subjects chosen by undergraduates, and is also one of the most competitive. To be accepted to study medicine, candidates need high grades at A level (or equivalent qualifications), a strong interest in the medical profession and good ‘people skills’. Medicine is a profession that combines an intellectual challenge with a strong sense of vocation and contact with a wide range of people.

2.2 Timing your application

Application dates

Application dates differ according to your chosen course and, in the case of medicine, are earlier. For the majority of subjects, your UCAS application must be submitted before mid-January of the year in which you wish to enter university. For medicine, however, you must apply 3 months before this, by mid-October (usually 15 October). Candidates applying for medicine are not entirely alone in having to apply early; those wishing to apply for any course at Oxford or Cambridge, and those applying for dentistry or veterinary medicine, must also apply early.

Late applications

UCAS state that ‘the universities and colleges guarantee to consider your application if we receive your application by the appropriate deadline’; in other words, if your application is received after the deadline date, they may consider it but there is no obligation for them to do so. Our advice would be to never apply after this deadline without extenuating circumstances. The competition for places is high, so any reason to reject your application will be taken, and a late application is certainly high up on this list. Give yourself the best chance – apply as early as possible.

Deferred entry to university

The subject of deferred entry, also known as a gap year, is considered in more detail in Chapter 4. If you are considering taking deferred entry, you must first check that the university or college will actually accept a deferred entry application. When applying for deferred entry, you must obviously meet the same conditions of offer as those not taking a year out. If you accept a place for deferred entry, you cannot reapply through UCAS in the subsequent year unless you withdraw your original application.

If you do want to defer entry to university for a year, it is not compulsory to apply to UCAS during your A-level year, as you can apply during the gap year. This can be useful if you are unsure of what you really want to study, or if your exam results do not meet expectations. However, if considering a delayed application, we recommend that you talk this over with your teachers and career advisers.

2.3 The application process

There are those who seem to know they were born to enter the medical profession, but many doctors, most of them excellent and dedicated, were not sure which career to follow until the night before the UCAS application deadline! The best advice is to find out as much as you can about medicine and the different medical schools before you complete your application. You can do this by reading university prospectuses, speaking to your careers adviser and visiting the university or college. Talk to your family and friends, particularly those who have been to the universities or colleges that you are considering. It might also be wise to attend one of the available conferences held for 16–18 year olds interested in a career as a doctor. These are held in various locations around the country several times a year and usually involve presentations by medical students and doctors of all levels from junior to professor. Many of them hold practical sessions and small group tutorials. The main aim is to give advice on the application process and to give a feel for what a future career as a doctor may be like. Although attending one of these courses does not guarantee an offer of a place at medical school, it does show a commitment to finding out about your possible career choice. You should be happy with your choice of course and university before you make your final decision. Remember, you will be spending the next 5 or 6 years there!

All applications need to be made using the UCAS secure online application system, APPLY. More detailed information can be found at www.ucas.ac.uk. APPLY can be accessed from any computer with an internet connection. Most students will make their application through a school or college and in these cases it is necessary to obtain the individual school’s log in. It is also possible for individuals to apply. The application can be changed at any time (until submitted) and we would advise printing it out to check before sending. Once complete and you are satisfied with the content, the application is submitted to UCAS through a school staff member who will add your reference. Individual applicants will need to register themselves for APPLY and also sort out their own references and include these before submitting the form. Applicants can pay online or the school can be invoiced.

When you do apply, remember to print out or save copies of the whole application for your own records and check thoroughly before submitting. Always review a copy before any university interviews.

2.4 Completing the UCAS application step by step

Registration

You need to register to use APPLY; you enter personal details, such as your name, address and date of birth. The registration process generates your username and you create your own password, which you use to log in to APPLY.

Personal details

This section is populated from the registration section above. Most of this information is used to uniquely identify you and to help in the carefully maintained UCAS demographics. You are also asked about any disabilities you may have.

Additional information

You are then asked for information about any non-examination-based activities you have undertaken in preparation for higher education (e.g. summer schools), together with other information designed to help the universities and colleges to monitor applications in terms of equal opportunities, such as your national identity and ethnic origin.

Choices

In this section you enter the courses, universities and colleges that you are applying to. You can choose up to five courses, which APPLY will arrange into alphabetical order. The order of your choices does not indicate any preference – your application will be sent to all chosen universities and colleges at the same time. Each university and college will only see details of the particular course or courses for which you have applied. They will not see your other choices until you have received your final decision.

You can apply to a maximum of:

four courses in any one of medicine, dentistry, veterinary medicine or veterinary science;

one course at either the University of Oxford or the University of Cambridge.

You can use your remaining choice for any other subject. For example, if you have made four choices for medicine, you could still make one choice for dentistry or another subject if you wished. However, you should bear in mind that your personal statement, which often contains course-biased information, will be sent to all the universities and colleges you have chosen.

Another important point when applying for medicine is that when you start your