#ukmedschoolfaq

http://www.getmeintomedicalschool.com/The-Guide/UK-Medical-Schools.htmlhttps://www.themedicportal.com/application-guide/choosing-a-medical-school/comparisontool/https://www.healthcareers.nhs.uk/news/2018-entry-requirements-uk-medical-schoolshttps://www.medschools.ac.uk/media/2357/msc-entry-requirements-for-uk-medical-schools.pdfhttps://www.medschools.ac.uk/studying-medicine/medical-schoolshttps://www.thestudentroom.co.uk/university/apply/medicine/medical-school-a-level-requirement

At first it seemed complex, but soon my groups always had a clear system; we found that you could go through the steps pretty quickly once you’ve done a few PBL sessions. Even more than that, but after a while you will know exactly how you’d like to plan how to set out each case. We became very good at streamlining the process, to the point that some of the tutors complained. But I think they missed the point; the point of PBL isn’t to faff around for X number of hours arguing about how you’re going to research your theoretical case scenario patient’s condition. It’s about being able to work together to figure out what we need to know, and how we can approach it, then go off and learn it and teach each other. We were fulfilling the aims perfectly well, even if we as more experienced students didn’t have to discuss  the cases for long to work out what we needed to do. Anyhow, it’s an interesting way of studying. Reference: the Maasricht institute. Whose entire curriculum is taught via PBL

I’m not really sure, I guess it depends on the question, because there can be several kinds of ethical scenarios. One might be the ‘which person gets the liver transplant’ question, in which a good answer might briefly examine why all candidates might be appropriate or inappropriate for the transplant, before settling on one.  Ultimately, a good answer has to show that you are logical, not unduly prejudiced, and don’t seem to have plucked the answer out of thin air. They don’t necessarily expect you to have a detailed knowledge of ethics as they are applied in medical law, but it doesn’t hurt to know the basics. For example, say we’re talking about a liver transplant and whether it should be given to a 60 year old with alcoholism, a 6 year old, a 30 year old mum with 5 kids, or a  frail but much loved 90 year old scientist. Or which one should go to ITU, or receive a lifesaving drug, etc. Most people would immediately pick the child; we have a strong urge to protect children, and they are ‘innocent’. Logically, the first step would be to eliminate any candidates who are not suitable in terms of their health; can all of the candidates even withstand treatment? If a patient cannot withstand a treatment, then it is not a viable option for them. This is not necessarily about age, but about comorbidities and their general status. For example, we don’t take many 90 year olds with multiple severe comorbidities to ITU because experience has shown that they cannot withstand the treatment and are unlikely to benefit from it. Beyond that, the answer will basically boil down to ‘whoever needs it the most’; in the NHS, once we’re sure who can benefit from a treatment, if it is something we have a limited supply of (say, ITU spaces), we give it to the patient who needs it most right now, i.e. the sickest. Because the less sick may be able to hold on until the next one becomes available. So the side-stories in the scenario may well be irrelevant; it doesn’t matter if someone is loved or hated, or if they have kids or not; we don’t rule who lives or dies based on their worth to society. If you get any kind of scenario about doling out resources, you need to approach it rationally and without prejudice. Who will actually benefit? And who needs it most? And you need to demonstrate to them how you came by your conclusion. Saying you won’t give the alcoholic 60 year old the organ because you don’t feel people with self-inflicted conditions deserve treatment is one thing, but arguing that this person’s overall fitness for treatment may have been compromised by other serious health problems might be a totally different point. Reasoning is important.Now, that’s not the only kind of scenario. Quite often, they now send you a newspaper clip from a story in the news centred around medical ethics. It might be about Gillick Competence; giving teens access to contraception. Or whether children have the right to decide to refuse treatment. Or what happens when parents can’t agree whether to treat or vaccinate their kids. Or cases where the parents want a particular treatment, but the doctors think that would be futile (think Charlie Gard or along similar but technically different lines, Ashya King)Think about the kinds of cases that come up in the media. Note, these cases aren’t easy; there’s a reason these decisions have gone to court for a judge to decide what the best outcome is. The key in cases like these is again, think rationally and exclude prejudice. They want to be able to see that you’ve thought about things from both sides, before you’ve come up with a choice. Look at the two sides; On the side of the patient or parent’s wish, think about what the risks/drawbacks may be, and then what the benefits may be. And then explore it from the doctors’ side; the risks and the benefits of treatment, or not giving treatment. Extending life is often desirable. Saving life is nearly always desirable. Quality of life is always desirable. Bear in mind that doctors have a duty to do no harm, as well as a duty to do good. And that we have a duty of justice to the patient, which means, in the case of children, treating them as independent human beings whose interests may be different from their parents’ wishes. Because children are not chattels, and are not owned by their parents. We normally go along with the treatments parents choose for their children because there is not considerable risk of harm. Though there is a respect for autonomy, in cases that involve children, their right to autonomy equally means that their parent’s don’t necessarily get to have the final say.  Though note that an adult still cannot demand treatment for themselves that a doctor believes to be futile or unnecessary. Because treatment is not something purchased at the buyer’s risk, but something actively given by a clinician who puts their own reputation on the line every single time they prescribe or treat. the doctor takes the legal risks of giving patients treatment, therefore it is the doctor’s choice whether they prescribe. Remember that treatment is not without risk or harm. And bear in mind that sometimes extending life (or extending the period of existence) with no benefit, can extend suffering and therefore harm. So before you formulate an answer, consider carefully what the harms would be (of, say, treating a dying child against their will, or extending suffering when there is no reasonable chance of a cure, etc). Death is not the only bad outcome that can happen. Note that cost is, in the UK usually rarely a factor. We regularly provide incredibly expensive care to the tiny number of people who need it. there are treatments the NHS does not fund (and it doesn’t fund them for everyone!), and there are treatments that you have to apply to a special funding panel to receive, so that only patients who have a decent chance of benefiting from them can receive them. But that’s not usually what is at stake, here. In the end, I’d say that you’d want to briefly explore all sides, and then show that you understand how difficult this decision would be. There’s a real place here for empathy; all the people stuck in these scenarios are suffering horrible situations, and facing very difficult choices to which there is no clear cut answer. I put an emphasis on being rational for these answers, because they want to be able to clearly see how you’ve come to a sensible and unbiased decision, someone who won’t judge people at face value or give prejudiced care. But logic and empathy are not opposites. I think no answer for such a question is complete without a heartfelt conclusion that makes it clear you understand that it’s difficult for the people stuck in these situations. It’s OK to say that the entire scenario sucks and nobody should have to make that choice. At the end of the day, they don’t want a robot, they want a future doctor.

I did! It’s a bit like that saying that ‘successful people have failed many times’. To be brutally honest, the first time I wasn’t an ideal candidate. I knew I wasn’t doing quite as well at school as I would have liked. I wasn’t doing terribly, by any means (trust the med school applications process to make perfectly legitimate grades feel like the end of the world), but logically, I knew I might not be the best candidate out there. Now, knowing this logically, and being happy about it are two different things. It didn’t make me happy, knowing logically that my chances were not as good as I wished. All I could do was try my best, and consider how I could improve next time if I didn’t succeed.  I wanted to be a doctor for the rest of my life; one year is a very short space of time if it helps me get the rest of my life in order. Sometimes remembering that life is long, and that medicine is a lifelong path can really help us to put it into perspective. And this really hurt; I’m not going to lie. Knowing that you’re not able to show your best side, and that people might not be able to realise your potential because you haven’t shown it, is really painful. It’s important for you to use that time to reflect that you are more than your grades, and more than what you appear to be on paper. For example, I’m a doc, now. So I clearly had what it takes to make itt. But I’m also the same person who didn’t succeed the first time around. Who didn’t quite reach the grades the first time around. But But it’s life. And all you can do is try harder next time. It helps to realise that no state is permanent, that ‘this too shall pass’. You can turn your grades around. You can do better, you can try harder, and you can apply again with more experience, and a better understanding of your weaknesses. The second time I was better prepared, and in a better position, but it was still risky. Med school is so ridiculously competitive, they don’t really need much of a reason to say “sorry, no.” And it’s scary because you want this so badly, and you’ve worked so hard, and you’ve done so much, but at the end, no matter how hard you try, the decision is out of your control. I feel an immense sympathy for anyone going through it, because I’ve been there so many times, sometimes as a good candidate, and sometimes as the problem child who doesn’t look as good on paper as they really are. Applying to med schools is the scariest; far more scary than applying for doctor jobs. The last time I applied, I was in a much better position. I’d gone from slightly subpar A levels to acing a degree, and I felt more confident the last time around. But I also knew that I didn’t want to keep applying forever. So I thought hard about what else I might do if I never got into medicine. I explored other things that might make me happy. I thought about being a researcher, or working in a biomedical lab, or being a science teacher; and I think all of those things would have fulfilled many (if not all) the things that made/make me happy. And I do think that thinking about plan Bs is an important part of dealing with the uncertainty of applications. I’m quite an anxious person, so making contingency plans is inherently soothing for me; knowing that I could do other things and still be happy makes the idea of not getting the thing I want the most feel a lot less scary and horrible. Knowing that life will still go on can make all the difference.  Sometimes you have to take it one step at a time and hope for the best. Remember that whatever happens, it doesn’t define your worth as a person. You’re far more than what your application profile is like. Good luck, and let me know how you get on :)

Hello! I’ll let you in on what I studied, as long as you remember that your A level choices are you own ones to make. I don’t like the idea of people basing their choices on mine, because we’re all different people with different skills and interests. I took biology, chemistry and English at A level, and classical civilisation and phyics at AS level. I loved art and DT, but there was no way that I’d have had the time to acutally do well in such an intensely time-consuming subject at A level. I enjoyed the subjects I did take, though it was still a challenge. The good news is that with your spread of subjects, most med schools would probably be prefectly happy. Theatre studies is quite unusual, but that needn’t be a bad thing; you an probalby think of some really interesting things to say about it in interviews or in your personal statement. Every med school is slightly different; some prefer 3 science subjects (like some Oxbridge colleges), others like UCL explicitly prefer 2 sciences and at least 1 non-science subject. Some require biology. Others require chemisty. Some ask for no specific subjects but vaguely want ‘2 sciences’. Biology and chemistry are good standard subjects that are well-liked for medical applicants. If you drop down to 3 sbjects at A level, that’s when your choice of either 2 sciences 1 art, or 3 sciences might affect which med schools are more likely to accept you. It’s not a big issue; I know plenty of people with 3 sciences, and plenty with 2 sciences and 1 art subject. The only thing it might mean is picking your choices carefully. The trick is to read around. Perhaps you an even email any universities you are particularly interested in, and ask them directly. Useful links:Med schools.ac.ukEntry requirements for UK med schools. The Student Room applying to med school using your strenghts. Medic Portal How to choose a med schoolMedic Portal  picking a med school to suit your strengths

When I’ve talked to Brits graduating in Europe who want to come back to the UK to work, they’ve often been quite keen to apply for an FY1 to start with, rather than going in at FY2 like they could. Which, once I thought about it, seemed quite sensible. Firstly, there are much fewer unpaired solitary FY2 placements available; you’ll probably be stuck applying to places where an FY1 has dropped out of training. Whereas there are lots of FY1 jobs by comparison. So you might get more choice in terms of where you can apply. FY1 jobs also tend to be a bit more protected; they expect new docs to need more supervision. FY1 jobs in high-pressure specialities like paeds or obs and gynae tend to be supernumerary (no on-calls, and always with SHO supervision), and in many hospitals FY1s don’t work nights, or do less clerking, and usually have SHOs to ask for support. Whereas FY2 can see you seeing sick patients in A&E, paeds, gynae, GP or psych and you may be the only SHO around, with only a stretched registrar for advice. On top of that, you might have FY1s coming to you for advice! You might not have any of those specialities in your FY2 placement, but I personally feel they are stressful enough as an FY2 when you have experience; I certainly wouldn’t have volunteered myself to do them straight out of med school, no matter if I had one more year of theory under my belt. In general, FY2 jobs tend to be more isolated; you’re often either working a busy rota or else on a more specialised placement where you may be the only FY or SHO doctor, so there’s generally less support or community. Fy1s tend to be more social and there’s a cameraderie amongst FY1s bonding over the terror of hitting the wards for the first time that you just don’t get at any other time. FY1 jobs tend to either have another FY1 on your ward, or an SHO who can support you. More importantly, if you start as an FY1, you’ll be treated on par with everyone else who is a new doctor; people might not know that you’re actually a new doc, because they’ll expect someone who’s already got a year of experience. Most people are nice, but people can be impatient if they don’t understand the level you are working at, so if you go for the FY2 route, you should be honest that you’re only just starting out as a doc, despite your grade. Make sure people know what you feel comfortable doing, and don’t let people pressure you into doing something you don’t feel competent to do. The main drawbacks are that your first year will be paid less as an FY1 than FY2, though I believe that’s probably less pronounced now on the new contract.  And of course, it would mean one more year of training. But that can sometimes be a good thing; you actually apply for core or specality training a few months into FY2, which would be really soon if you only just started working as a doctor a few months ago! The best thing about FY1 and FY2 for me were doing lots of rotations in different specialities, so that I could get a better idea of which ones I liked, and I think a lot of people would benefit from having that opportunity before picking for good. Though I can understand the draw in skipping a year and going for FY2, particularly when it’s better paid. I’m sure that starting straight as an FY2 might be the best option for some people, and since there are a lot of different med schools out there, perhaps some people from across the continent feel adequately prepared  to follow that path. So I’m not about to judge anyone who decides this is the best option for them, given that they are technically entitled to make that choice. (albeit, allowed by a system that cares relatively little for our welfare or training) But having talked to people who’ve studied in a few places, if it were me, unless my med school had quite a big emphasis on seeing patients and doing simple procedures, I’d still start at FY1 if I had the choice. LAS and LAT jobs are basically similar to trust grade jobs or clinical fellowships, which can sometimes be used to count towards your training time, however they are basically long-term locum jobs in a department where there is a vacancy because they haven’t managed to get a training doctor to fill the gap. Many departments offer non-training jobs (trust grade SHO jobs), LAT or LAS jobs tend to be fewer, because departments probably prefer to get by with less responsibility for their employees. Training people is more difficult and requires more supervision, after all. Always remember that hospitals are employers: whilst they are not out to get you, they also aren’t there to do you any more favours than they have to. So look out for yourself and your wellbeing, and think hard about whether any jobs you apply to are suited for you. Hospitals just want someone to fill their job vacancies and get on with service provision. Look after yourself, and make the choice that you feel would be best for you, because the system isn’t set up to put us first. So you have to do that. Whatever and wherever you choose, do it because you feel it’s right for you, not because the opportunity exists; not every job and not every opportunity we have in medicine is in our favour. For example, some FY1 or FY2 jobs have 2 relatively low stress jobs and 1 high stress job. Whereas some offer jobs that have 3 stressful jobs in a row with a high number of on-calls. The fact that the burnout rates for those placements are higher doesn’t seem to matter to the deaneries that keep offering those rotations. So my ranking, in terms of how protected/supported jobs are is FY1 > FY2 > LAS/LAT > Trust grade or clinical fellow > Locum. If you don’t want to do an FY1 year, then starting from FY2 is more supported than going fora LAS/LAT which is mroe supported than trust grade or short term locums. My advice would be, if you have an opportunity for work experience or electives, try to do an elective in the UK to get a feel for what it’s like, and how ready you feel you’d be. Even if it’s just a few weeks over the summer, it might be worth it if it could put you mind at ease. No matter what you choose, I hope it makes you happy, and good luck for the coming years. I look forward to you joining the team :)

I hope that helps.

I’ve actually finished my night shifts for the time being (YAY), though I’m back on long-day oncalls on Thursday and Friday, so at least I got a little bit of a break. I’ve just been trying to reset my body clock with mixed  esults. I’ve been on-call a lot recently because my current rota separates our timetables into ‘ward blocks’ and ‘on-call blocks’, but even so, it’s miles better than my paeds rota. Still, soon I shall be back on my regular ward workin’ 9-5, and having time to actually do things!