Medicine 2022 entry - How difficult is it really? *title edited by MNHQ at OP's request*

[notmedicmum]

I couldn't find a thread for 2022 entrants to medicine - maybe I didn't look hard enough! DD is in Year 12 and has wanted to do medicine since Year 10. It's only this year that we realise the enormity of actually getting a place. Not only do you have to have brilliant grades, you must also have done work experience, volunteered (both difficult in the current situation), got excellent BMAT/UCAT scores. Oh, and you also must have cycled from Land's End to John O'Groats to raise money for charity or climbed Kilimanjaro or won the Nobel Peace prize or found a cure for cancer (joking about the last two). How competitive is it REALLY? I'm not sure about the value of the last apart from being used as a selection tool as the unis get so many qualified applicants - and showing enterprise and drive. Apparently this sort of thing is even more important this year as getting work experience is very hard this year. How does climbing a mountain make you a better doctor anyway? And what can normal students do to improve their chances of success??

@Needmoresleep the trouble is that at the moment there are just too many people wanting to do medicine and not enough places for all of them. It is a sad consequence that many applicants who would make good doctors won't make it into a course.

I would like to see a system which let more people in, but then if you can only train 8,000 doctors, alternative pathways would be offered after a year for those who did not do well enough to stay on the medicine course. Of course that would mean a lot of people disappointed at the end of a year, although if well managed most could be encouraged onto suitable pathways, but it would mean that many more people would have the opportunity to prove themselves over a first year of a course.

One of the weird things about medicine is that you are guaranteed a job for life on the basis of an MMI when you are 17!

Re Exeter use of A levels, in normal times I think it is completely appropriate to be more impressed by 3xA achieved than 3xA predicted - if you look at the correlation of predicted to achieved grades, the majority of applicants don't actually get grades as good as their predicted grades. They have changed it this year, acknowledging that for many applicants 2021 grades were more like predictions than normal grades. The really stupid bit of the Exeter policy is that the offers are still AAA, so students who can get their schools to predict generously have an unfair advantage.

Yes but my example was historic. Contrary to MN belief any DC has to work hard to achieve 4 or more top grade A levels. Private school kids may have advantages in terms of better teaching etc, but they still have to work very hard.

The idea that a child should be disadvantaged because they are not good at, effectively speed tests, perhaps through no fault of their own (like having non English speaking parents, being taught in the Welsh medium, or having slow processing speeds but compensatory coping skills like a strong memory) should be a less good doctor is straight silly.

My DD was the first for a decade to get a place at Bristol, despite the private school sending up to 30 a year to med school, often to Oxbridge. Bristol's priorities seemed to be widening participating including links with local schools and contextualisation. Curiously the heavy use of UCAT seems to have had a big impact on their recruitment. Lots more from backgrounds where application advice and UCAT preparation are easy to obtain. (I ended up posting my DDs many interview etc prep books to a MNetter who was mentoring a very disadvantaged student who got really poor scores on UCAT, because he had not understood its important, but a summer interview and place.) Very few, if any or my daughter's Bristol friends think they would get in now. But equally few think they are less good than the newer recruits - if anything the opposite. I don't care how good my doctor is at UCAT, or indeed what school they went to. I just want them to be good doctors.

I agree UCAT is a v blunt tool but I'm not sure what else Unis can use. Predicted grades are pointless really as a school can predict what they want with no evidence. I'd rarely turn a student down who requested an A star for an application if I know the Uni will except an A & the students is likely to get an A, because I know everyone else is doing the same for their students. I'd not predict an A star for a B student though.
Using the PS is v unfair as lots of private schools have access to professional writing help (why the GMC recommended it carrier less weight). Same with vast work experience as it's much easier to get this if a parent is a doctor, much less easy if they work in a supermarket.
I don't have the answer and I hate UCAT ! My own DD did ok on it, not stellar at all, but applied strategically which resulted in interviews as she checked her stats v carefully against the interview selection criteria. How I learned about it all.
Training places will always be the limiting factor on how many doctors we can train. Getting their skills signed off means they need access to lots of patients and too many students would dilute this.
Not sure what the solutions are. And doubt my DD would get into Notts now as her VR score was not good.

@Needmoresleep

MidlifeCrisis, and others that are baffled, I am sure that medschools would love to be able to rely on an aptitude test. However data suggests that none, apart from STEP for maths, are particularly good at predicting future performance.

UCAT and BMAT are filters as are A levels. Needed because too many qualified applicants are applying. Medical schools will know that some very good applicants will underperform at UCAT, perhaps because of a bad day, perhaps because they speak another language at home, perhaps because they are less good at speed tests, perhaps because they went to Welsh medium schools. Putting different weight on different filters allows medical schools to fish good applicants from slightly different pools, and perhaps identify applicants who are better suited to their teaching styles. And also encourage the more suitable applicants in their direction.

In practice a medicine degree is not that demanding for a science-y child. The academic bar is normally As, including chemistry, but beyond that, other than for the more academically focussed courses, having As does not give you much advantage. Other science degrees can be different. DD intercalated in engineering last year, and though her peers had similar, if not better academic credentials, some found even the pre-sessional course quite a shock. Not surprising given A, if not 2xA* is a normal prerequisite for an engineering course. (It was quite funny as DD found some students extraordinarily sniffy about being at "better" medical schools, until it became clear that they were not natural mathematicians.) Medicine instead, especially the more hands on courses, require a lot of complementary skills that engineers won't need to the same extent.

There will be some people lurking on this thread whose DC got poor UCAT scores. Mine was lucky as when she was applying Bristol used neither BMAT or UCAT, but at the time it was very worrying that despite a strong academic track record (she took 5 A levels and had strong predictions in all) and bags of volunteering, extra curricular, leadership and shadowing, her chance of being a doctor might be taken away. Simply because she is dyslexic with very slow processing. How is that fairer?

I would add that every year a few people message me for a handhold, as these threads often end up, like TSR, being simply for the overachieving 4 offer types. In the same way as I did to posters before me. (Waves at GoodbyeStranger, Peternas, AlreadyTaken.) I had a lovely message a few weeks back from someone whose son is about to go into his fourth year, and thriving, after one late interview which led to an offer. A poor UCAT is a pain and makes life more difficult, more difficult than it should, but not insuperable. I hope that medical schools start rowing back and start looking at the wider picture rather than increase their use of what is a very imperfect filter.

There is pretty good evidence that good performance in UCAT correlates with good performance at med school and the early years of medical practice. That does not mean there are not lots of people who do badly on the UCAT who wouldn't make excellent Drs and vice versa. But if you take the whole cohort, the results do correlate. And med schools have nothing else that tells them this, except A levels, and there is less correlation with A levels than UCAT, so they work with the best they have, I guess. UCAT has also shown to be less affected by contextual inequalities than academic results. Plus, nobody can come back and argue that you were biased or unfair if it is a straightforward ranking by score! I am strongly in favour of diversity in med school selection, as it gives the most diverse group of applicants possible a chance of studying medicine, and I do not believe underperforming in one element (within reason, obviously) should remove all chances of a place.

Using the SJT more makes a lot of sense. Since an SJT exam is going to be 50% of final score for students from 2023.
DD always says the stuff isn't hard there is just so much knowledge to cram in. However the ability to think on your feet and make quick decisions is something she says was definitely a UCAT skill.

I thought you said that you were baffled why Exeter would put more emphasis on academic achievement and predictions, rather than on UCAT. I was trying to explain why.

My understanding is that your DD got at least in the 70th percentile in UCAT. This is excellent. 70% of applicants, some of whose mums will be lurking here, will have got lower scores. Your daughter was able to apply tactically because she had four places she could apply to, and as you have said before, never even considered a different career. This does not apply to others, whose kids, despite perhaps excellent school achievement or outstanding personal characteristics, are facing the prospect of Plans B, C and D. It is a very different experience.

I find it odd that you feel schools over predict. DDs school were very careful. Universities will know who consistently over-predict, and well known schools want to retain their credibility. And to be honest I have no idea where you would find professional PS writing help. It was certainly not recommended or even suggested. DD had very much the opposite of vague comments, rather than drafting suggestions, which left her puzzling what she needed to write. (It was fine, as it read like a statement a dyslexic would have written!)

Ditto for work experience/volunteering etc. DD had to provide a list of contacts to Bristol, so no chance to make it up. It always astonishes me that volunteering is seen as being so hard to get. Not rocket science. DD just asked at the local leisure centre for the names of local disabled sports groups, and the swimming group were delighted to have her on board. Similarly cleaning/waitressing/kitchen portering in her grandmother's sheltered housing. Our local council maintains a list of local groups interested in recruiting volunteers, and libraries often do. If need be schools could signpost kids. Instead we have kids spending their time in their bedrooms practicing UCAT. Whether they get the place or not, broader experience of society must surely be a better use of time.

The whole thing seems a weird attempt at "fairness", when the switch which was forced upon Bristol seems to have taken away much of their ability to spot "rough diamonds" and instead, by requiring the sort of test where practice and preparation helps, has changed the cohort makeup to seemingly give it a much more private/grammar school slant. Like DD, several of her friends are there because, frankly, they had few options. DD because of her dyslexia, the others because their schools/families were not wised up.

Seriously though. Posts on this board can come across as smug. It is understandable that mums will be proud of their DCs scores and their four offers or whatever. However most people applying won't get a single offer. Having been through the process and seen DD have to wait until March for an interview, I think it is important to be careful.

And at least the UCAT is a purely objective measure in current times when the objectivity of academic grades is compromised. I agree that using the SJT makes a lot more sense too. Everyone agrees that there is a lot more to being a good doctor than just being academically smart and a higher weighting of SJT alongside interview scores reflects that.

It seems to be the only fair way, to use an exam that sort of levels the playing field. Using predicted grades just means that students at schools where teachers have more leeway to change them get preference. We used to be quite rigid and not change them but realised we were doing our students a disservice in relation to others. So we play the game and up the grades, but my DDs school wouldn't change them ever. So students at her school rarely apply to Exeter (they predict cautiously 😞).

@Needmoresleep I'm not sure why my posts upset you, they really are not meant too. I agree it's a horrible process and requires so much resilience and patience. My DD worked v hard to get in, works very hard to stay in middle of year and will have to work v hard to qualify. Because her UCAT wasn't stellar she had to apply strategically as otherwise she'd have not got interviewed. She knew her UCAT should be high enough for those she applied to but was close on all of them. Luck plays a huge part I think.
I've spent this afternoon consoling one of my students whose UCAT is not good, but we have worked out 2 she should get interviews at, and 2 punts. None were her favourites but she won't get interviews at those 🤷‍♀️.

Agree mumsneedwine, my son's school never changes predicted grades but I know of others where students only need to ask. Same with the TAGs, I know of a number of students in his school year group who have lost out on their Uni places (including Medicine ones) due to them not reaching their offer grades. They played it by the book whilst other schools seem to be handing out top grades. My son got the grades he deserved and I'm pretty sure would have got had he sat the exams so it's not a personal issue but I find it very sad how unfair it all is.

Mumsneedwine, you don't seem to be aware of how exceptional your DD is. For lots and lots, anything in the top 30% is stellar, and it is naïve to think differently. And yes it is upsetting to feel that because your own child is not as perfect, MN would see them as not good enough. One reason why people with less than high achieving kids are reluctant to post.

They all work hard. They really do. I am so proud of mine overcoming dyslexia, when her primary said she could not cope with an academic school and when her CAT score was so low that had she gone to a state school she would have been set rock bottom targets. She, like your pupil, have to accept that there are only 2 places they can apply to. She, like your pupil, will have to think hard about what else they might do, as they will probably not be "good enough" for medicine. It is a very different sort of tactical. DD chose not to visit the places she was applying to, because there was no point. If she got an offer she would have to go there whether she liked it or not.

And of course she came across plenty who would boast of their four offers. She used to get so upset, that she and her two friends who were also waiting had to skulk in the corner of the sixth form common room to avoid the bragging. The lovely message I got a few weeks back spoke of how proud they were that her son, who got just one late interview and place, was doing fine, just fine. Not all DC can be top 30%.

The idea that Exeter is doing something wrong by looking beyond UCAT seems bizarre. Surely you should be pleased that Exeter is offering your pupil, and others that are not quick at tests, a chance of being considered. It may not be her first choice, but it is a very good medical school.

Obviously there is some correlation between aptitudes and future performance, but it is not that strong that you would want to deny consideration to other strong candidates. As for SJT....those scores can fall all over the place.
A friend of DDs, who se parents wanted him to be a doctor and whose social skills weren't great, got a 1, which Amused him a lot.

Your DD is right that the course itself is not that demanding for someone capable of an A in chemistry. But not a reason to give so much weight to a single test. Others including those from non English speaking households and those with SLD deserve a level playing field.

Predictions clearly are hugely inflated, in general, as only around 40% of students make or exceed their predictions (although it is probably a bit more than this at the very top end of the spectrum).

PS writing companies make good money - and there were a lot of them around, and prior to the GMC's recommendation that they were to be less relied upon, would tailor what they wrote to the med school of choice.

Some GMC backed research concluded
-Overall, research evidence suggests that autobiographical submissions (PS) have limited validity in relation to medical student selection.
-Research evidence suggests that autobiographical submissions are more susceptible to contamination and input from third parties than many other common selection methods, which disadvantages applicants from lower socio-economic groups who are less likely to have the appropriate networks and resources to provide this.
Hence the recommendation they were given less weighting.

The same research concluded, about admissions tests in general
-Widening access is an aim of aptitude tests, and there is preliminary evidence that it has a positive effect.
-There appears to be a small impact of preparation on performance in UKCAT, but is less than the standard error of measurement.
(I think this may be a bit out of date now, as the preparation tools have expanded and adapted, but bursaries have moved forward in line with this).

Educational performance, ie GCSEs and A levels is far more affected by contextual factors, and those with WP flags will perform comparatively worse in school/exam testing than they will in the UCAT. As the research concluded
-there is clear evidence (in a UK context) that use of academic records introduces a significant socio-economic class bias.

So evidence suggests practice, preparation and support have a far bigger impact on exam results than on UCAT/admissions tests, so using the latter should make it a more level playing field, not a less level one. Med schools continue to be encouraged to try and level it further and many have made massive strides, with, for example, clear contextual points at Birmingham, Bristol, Kings, HYMS, etc etc

So I am not sure there is a fair-to-all way of selecting medical students, and there are winners and losers however it is done, but medical schools, on the whole, try to stick to that for which there is an evidence base and which disadvantages the disadvantaged the least, so UCAT and exam results, with an allowance for those with WP flags.

What is a WP flag, or am I the only one who does not know.

As for results, DD undershot her predictions, albeit by one mark in three subjects because she had a 3xA offer. Totally logical then to go on a school ski trip at Easter and have a complete break from the madness as she was confident that she would make the offer. Statistics etc. Presumably some might argue that her private school should have anticipated this!

In other subjects Universities get round it by contextualising offers depending on school So 4xA* offers were commonly handed out by Cambridge for STEM to London private school pupils. And they made their offers. I really think it worked better when medical schools varied their requirements so they were fishing from different pools. Yes, Exeter might be a problem for some, but then with a 70th percentile UCAT they would have plenty of other choices.

I really don't think kids should spend hours in the bedrooms practicing for something like UCAT. They would be far better off volunteering with the disabled or elderly to discover for themselves whether they were really cut out for medicine. (I say as someone who had a long conversation with a junior doctor who was wondering how much longer he could hack it. He apparently decided to apply for medicine because his chemistry teacher pushed him. Well I guess it would have looked good on the schools destination list.)

Is there anywhere in there where they looked at retention rates? And do those who score highly on UCAT do better here than those who have a full personal statement of community involvement?

@GANFYD I’m not surprised to hear that the UCAT is less affected by extrinsic factors than the other means used to select medical students - from what I saw, it looked like an advanced version of the 11+/school CATS/ IQ test so apart from becoming familiar with test format and tools, probably not much that you can do to improve scores (I may be shot down for saying this😀). Excluding the SJT part, of course. Probably why DD’s school said you couldn’t prep for UCAT

@GANFYD, DD has shortlisted a number of med schools based on her profile. Would you mind giving us a second opinion on whether they would be right for her or not? DD’s school hasn’t a clue unfortunately.

The preparation for the UCAT doesn't have to be so intensive that it gets in the way of volunteering or work experience (or festivals!). It's only a few weeks preparation and even then not full-time. Surely kids can do both if they are contemplating a demanding career like medicine. I appreciate that it is more daunting for some than for others but I don't think you would improve your score practicing for months on end (probably peak and dip) and in any case you would run out of resources.

WP is widening participation @Needmoresleep!
As to UCAT prep, tsr posters recommend not more than six weeks and using medify

@nonmedicmum totally agree with you. My son did all the prep for the UCAT as he wouldn't have dared not to but his scores barely moved at all, if anything they went down a bit. I am all for WP and what GANFYD says is very encouraging.

@Needmoresleep

What is a WP flag, or am I the only one who does not know.

As for results, DD undershot her predictions, albeit by one mark in three subjects because she had a 3xA offer. Totally logical then to go on a school ski trip at Easter and have a complete break from the madness as she was confident that she would make the offer. Statistics etc. Presumably some might argue that her private school should have anticipated this!

In other subjects Universities get round it by contextualising offers depending on school So 4xA* offers were commonly handed out by Cambridge for STEM to London private school pupils. And they made their offers. I really think it worked better when medical schools varied their requirements so they were fishing from different pools. Yes, Exeter might be a problem for some, but then with a 70th percentile UCAT they would have plenty of other choices.

I really don't think kids should spend hours in the bedrooms practicing for something like UCAT. They would be far better off volunteering with the disabled or elderly to discover for themselves whether they were really cut out for medicine. (I say as someone who had a long conversation with a junior doctor who was wondering how much longer he could hack it. He apparently decided to apply for medicine because his chemistry teacher pushed him. Well I guess it would have looked good on the schools destination list.)

Is there anywhere in there where they looked at retention rates? And do those who score highly on UCAT do better here than those who have a full personal statement of community involvement?

Sorry, WP flags are widening participation markers designed to address patterns of under-representation in higher education. It usually involves targeting prospective students from groups that are currently under-represented, eg: -from low income backgrounds and low socioeconomic groups; -from postcodes where participation in higher education in low; -who are the first in their generation to consider higher education; -who attend schools and colleges where performance is below the national average; -who are care experienced; -who have a disability; -who are young carers; -who are estranged from their families; -from under-represented ethnic backgrounds.

Contextual relating to schools would fall under a WP flag.

I am not aware of any research looking at retention rates of high UCAT scorers v full PS. I think the latter would be too subjective to quantify easily. Two people could have done exactly the same things and learned different things or developed different skills as a result, so the "value" would be different - though I agree, volunteering anywhere, doing anything is beneficial, just hard to give it a "score". The advice would always be that it is not what you have done, but what you have taken from it and how it has developed skills and qualities relevant to being a Dr. And there are SOOOOOOO many other factors at play there over and above just turning up for volunteering or a placement.

It is hard to know exactly what being a Dr entails without doing it. There are so many different jobs possible at the end of a medical degree. My average day would be nothing like volunteering with the disabled or elderly, and a Radiologist would be even further away! But trying to inform yourself, eg by reading, podcasts, shadowing, talking to medics is good in my eyes, as is volunteering where you can learn about empathy, compassion, communication, teamworking, responsibility, ec etc.
Some kids have to work, or have caring responsibilities within the family, so do not have the time for formal volunteering, and many of these skills are well learned/showcased by a public-facing job, too, so there are lots of ways to demonstrate the qualities med schools are looking for

[quote notmedicmum]@GANFYD I’m not surprised to hear that the UCAT is less affected by extrinsic factors than the other means used to select medical students - from what I saw, it looked like an advanced version of the 11+/school CATS/ IQ test so apart from becoming familiar with test format and tools, probably not much that you can do to improve scores (I may be shot down for saying this😀). Excluding the SJT part, of course. Probably why DD’s school said you couldn’t prep for UCAT[/quote]
UCAT is an aptitude test. I am never too sure what it tests, but people have an innate level of ability. I think you can prepare and practice, so you are familiar with what to expect, as it is a bit confusing when just faced with it, if you have not looked at it before, but there are lots of free resources available to help with this.
I always say it is like any skill, eg tennis - we can all hit a ball and all improve with practice, but you are pretty much going to max out at your natural aptitude, and we cannot all be Serena Williams or Roger Federer!

I've spent today with a student who got no offers this year. She has 8 GCSEs at 8/9 (and 3 at a 7). She got a UCAT right at the top of the 8th decile and band 1. She was predicted (and achieved in a school which based results entirely on formal exams) A * A A.
In any other year she would probably have got 3 interviews (one medical school she applied to would have been a stretch just because of its location). As it was, she got one interview only and was then waitlisted.
This year really was enormously tough. She missed out on interviews at 2 of the need schools by 30 UCAT points at one and less than that at the other.
I'm hoping she achieves similar UCAT this year and then she should be guaranteed an interview at Leicester at least. UEA looks promising too.
It's still not very easy to work out where she should be able to "guarantee" interviews.

@Chilldonaldchill

I've spent today with a student who got no offers this year. She has 8 GCSEs at 8/9 (and 3 at a 7). She got a UCAT right at the top of the 8th decile and band 1. She was predicted (and achieved in a school which based results entirely on formal exams) A * A A. In any other year she would probably have got 3 interviews (one medical school she applied to would have been a stretch just because of its location). As it was, she got one interview only and was then waitlisted. This year really was enormously tough. She missed out on interviews at 2 of the need schools by 30 UCAT points at one and less than that at the other. I'm hoping she achieves similar UCAT this year and then she should be guaranteed an interview at Leicester at least. UEA looks promising too. It's still not very easy to work out where she should be able to "guarantee" interviews.

I hope she has got whatever passes for a big hug in this all-new covid world! Poor girl.

I know! She got work experience for two days with us so I'm hoping that helps her at interview (assuming she gets them!)

I wanted to comment on the gcse grade queries.
My dd only sat 8 gcses, she got 8's
She was suffering from a serious eating disorder and had been in hospital for Yr 9 and some of Yr 10
She got interviews at Bristol, Exeter, Cardiff and offers from all of them.
She didn't have conceptual points as she was at private school
So gcse results are not something to necessarily get hung up on.
I do realise her circumstances, which she referred to in her ps, and at interview was able to use to demonstrate resilience, may have made her a more unusual candidate and possibly she got the interviews based on that and then performed well.

@mumsneedwine

It seems to be the only fair way, to use an exam that sort of levels the playing field. Using predicted grades just means that students at schools where teachers have more leeway to change them get preference. We used to be quite rigid and not change them but realised we were doing our students a disservice in relation to others. So we play the game and up the grades, but my DDs school wouldn't change them ever. So students at her school rarely apply to Exeter (they predict cautiously 😞).

Apologies if I sound like a grumpy cow, but I'm bed ridden with Covid!

The problem is that there is a disconnect between the predicted grades required for interview at places like Exeter and Edinburgh and the offers given out.

If Exeter gave out 3 A star offers then schools would be reluctant to predict those grades unless they were achievable. As it is, SOME schools will think, we are doing our students a disservice by not getting their foot in the door for interview.... so will give them the 3 A star prediction even if 3 As is aspirational. OTHERS won't. Totally unfair on the student IMHO.