Totally changed. It was a doddle back in the old days. A consultant friend told me he got into Med school (now morphed into Imperial) with hardly any effort (he was the laziest person he knew, by his own admission) and A-level grades of BBC!! UCAT and BMAT not required then either. Really makes you feel sorry for the sixth formers jumping through hoops, doing months, if not years, of volunteering, job shadowing and work experience to even have a fighting chance.