Medicine 2022 - Decision time!

[Monkey2001]

Support thread for aspiring medics.

We want all our DCs to succeed, whatever their school type. We share knowledge to help them to achieve their goals, celebrate success and support if things don't go well.

Lots of interviews now done, fingers crossed for lots of offers, but we know it is a tough year and that most applicants will have a bumpy ride. Best of luck everyone!

Previous thread - www.mumsnet.com/Talk/higher_education/a4358647-Medicine-2022-entry?msgid=114590369#114590369

2023 applicant thread - www.mumsnet.com/Talk/higher_education/4459778-Medicine-2023-Entry

A few of the GPs at my surgery have confessed that they'd fail at today's selection process.

I applaud those med schools placing the UCAT and character defining qualities above the acquisition of A stars.

As somebody said earlier, it's in no one's interest to mainly recruit anxious perfectionist types. I'd add arrogant to that latter sentiment too.

Bristol switched from not requiring UCAT to placing huge emphasis on it. Like many of her peers, DD would not get a place now. Indeed despite being academically bright it is quite possible she would not get a place anywhere. Dyslexia and UCAT don’t mix.

Weirdly though you might applaud Bristol for taking this route, DD and friends are confident they will be as good doctors as those in the years below. The social mix in their year is also greater. DD was the first for a decade to get a Bristol offer from her private school despite several applications each year, and the pattern was the same for similar schools. With the switch to UCAT this has completely changed. Practice helps and parents/schools who know the system can seek/pay for support.

Or should people avoid Bristol trained doctors who have graduated over the past few years?!

Not at all! I certainly had no idea how things worked now. It’s been very useful for DD to see the wise words of Mumsnet. Her school really has no idea- so I need to help them next year now I’ve seen a bit of the system. It’s a good state comprehensive- 8 applied to medicine and only 2 have offers. It’s such a shame as some rejections were completely predictable ( 3 applied to Edinburgh with average UCATs for example), but I also understand how stretched the schools are at the moment.

My ds is one of few from his state school with offers and a lot of this seems to be due to lack of guidance on chances of getting in to places like Edinburgh. Through this forum and TSR I was able to give ds quite a lot of advice on where he was best to apply to and it seems to have made the difference.

A big problem was the school giving generic advice about applying to where you'd most like to go which is not very helpful for medicine.

Thank you!

DD suffered from teachers who did not believe dyslexia exists, and could not understand how she could be genuinely talented in maths (top 2%) yet struggle with English (processing speeds in the bottom 2%.) UCAT is a timed test and difficult for dyslexics, Welsh speakers and others. Great for those who are good at timed tests or who put in the practice.

A neighbours boy practiced UCAT every evening for six months and scored on the 98 the percentile. (The mum phoned me to brag!) My DD was school prefect, captain of girls sport, represented county and region, and stayed with her volunteering through sixth form and beyond. (Indeed she has just agreed to help out with a residential camp for disabled this summer. PhaB is fab.)

Which is the better predictor of who will be a good doctor, grades being equal? Unfortunately now focussing on UCAT to the detriment of community activity is more likely to get you a place.

It's why I get a little grumpy when I see people saying there is no need to apply strategically. It's so important.
DD wouldn't have got into Notts this year - her verbal reasoning score would have ruled her out 😂. She's an A girl, not an A star one. Not a perfectionist ! But she gets told every OSCE and placement that she is brilliant with patients. It's certainly not all about grades and I think Unis are now good at seeing this. They just don't have enough spaces for all the fantastic students.

I agree that UCAT should not be everything but it isn't. It is only one part of the equation and the majority of schools don't weigh it as heavily as Bristol. It is valid though as it is measuring something different to what A Levels are measuring and there strong evidence of scores being an accurate predictor of medical school performance. It is also a much more accessible exam than BMAT, which has much more taught content so DC who have had better teaching will have an unfair advantage in that exam. UCAT practice shouldn't need to impact on volunteering/community service. We are talking about roughly a month's preparation time. Six months' preparation seems overkill - the DC must have been running out of practice material. Volunteering is of course good but that is also taken into account in the process and some med schools like Keele take a lot of notice of it. I think that, although a conundrum to fathom it all, it is a good thing that med schools place different weightings on different aspects. Which brings us nicely back to why strategic application is so important.

Med school applications are now at their most transparent and fair to date (and can still do better). In the 70s, A levels were arguably a reasonable predictor of coping academically when CCC in the 3 sciences was relatively rare. At a stroke you were ruled out if you did not have the prescribed subject combination. You had to know that you had to choose by 16 if your vocation was enough to dump any subject you loved as much or more than those three. Now that A levels are more prone to gaming, and we all know that free-style interview boards are more prone to self-image bias, entrance tests are the most effective way to reduce bias against educational and economic deprivation. When someone attends a school that has never turned out 3As, and aces the UCAT, and passes the life experience probing at MMIs or structured assessment panels, despite having never shadowed or volunteered, I have little doubt that they will have earned a 2-3 grade reduced offer. When a graduate has spent 3 years growing academically and in life experience, they are not the school-leaver they were. Med school is competitive because a school leaver is also competing against the equivalent of their future selves. There has always been a mini-industry of paid med school application support, and the UCAT arguably more than the BMAT reduces the impact of that paid support. The test is a snapshot judgement. Just because you are down or up one day does not mean the same next year. Likewise it would be unreasonable for people to avoid “pre-UCAT” doctors. There are other checks
and balances to ensure med schools train adequately. UCAT is about selecting the better ones of a very good bunch, for limited places. For eg Newcastle and Warwick’s no-subject specification and UCAT not GAMSAT points to how out of date some courses have become with their 2 or even 1 science requirement. Especially since you have to unlearn the scientific mis-learning at A level. If med schools would change their courses to make the playing field more level, we might end up with even better doctors. You have to wonder what “fears”, or is it laziness, these GCSE and A level requirements are shielding. Tactical applying is about reasonable research and awareness of the competition. Sadly nobody can apply strategically because that means choosing your parents, how you mixed their DNA, shaped your development, and influenced your environment. If that were possible, why bother with med school when you can already control the universe.

Opoponax, DD found she was very limited in where she could apply. She got two offers, Birmingham and Bristol, neither would consider her if she applied now. For a bright kid taking five Alevels and some very strong GCSEs.

You say that BMAT is unfair because it is gives an advantage to those who know more science. Why should kids who do well at school and who study hard not have an advantage? (DD was ill that summer so had to ditch plans to take BMAT. Others she would almost certainly have been funnelled through that academic private school then Oxbridge/London med school route simply because it was the more accessible.)

You also suggest that UCAT provides a strong predictor of medical school performance. Is there really that much evidence that those with strong academics who receive poor UCAT scores do significantly less well at medical school. (My understanding is that of all the subject aptitude tests only STEP used for maths provides particularly strong predictors of future performance.) What about those who studied in the Welsh medium or who have slow processing speeds or the other known reasons for poor UCAT. Can they all be expected to make bad doctors.

There is a huge range of jobs in medicine and room for those with different skills and interests. DD has just been accepted to spend her upcoming two month elective in a research lab, apparently full of really cool kit. Not everyone’s choice, but one which could help her into a niche area of research medicine that interests her. Something she was able to talk about in her med school interviews, which may be why she got her two offers. She is very lucky that at the time there were still med schools that did not require UCAT or focussed on things like GCSEs.

@maryso I teach at a very deprived school with high numbers of single parents, EAL, PP and v non traditional medic students. But we now get many into medicine every year. Because they apply strategically. Medify is free for most of them (school get a bulk membership) and contextual offers are common. So it's not all about the parents or background. Things are a changing 😊

@mumsneedwine things should be changing! Still more to change, too. Also not to give up because there are many routes for those who have the vocation. It is dreadfully competitive (as we all know).

I think with the competition these days (especially with covid) even an academically perfect and life-savvy teen would be fortunate even with a single offer.

Having had some experience of the UCAT and BMAT recently, practising for more than a month is counter-productive. It's about getting enough knowledge of how you respond and then play to your strengths.

Not getting into med school is nothing new. The hoops today are a lot less off-beam than of old. In the end it is competitive, and if some of us old doctors would not survive the entrance process now, perhaps we did then only because our competition was struck off way before to allow us through. If only there were (even) more places, but it is what it is (i.e. better than before, and not as good as it could be).

@mumsneedwine do your school DC tend to go to more UCAT or BMAT-heavy schools? I think Oxford contextualises BMAT score now, which is obviously a good thing (although not for my own DC!). Are other BMAT schools doing that too?

@opoponax I hate BMAT !! Last few years have been so badly run. But some do want Oxbridge so still give it a try, and we do get several in as once they get to interview they have good stories to tell ! Feedback over the years has been our students 'stand out'.
But UCAT is used by so many Unis. We provide 6 weeks free Medify, access to the 1001 questions book (my DDs copy) and endless hours of me giving support (this does not help as I am useless at it).

Mary so, UCAT is essentially a speed test. More practice does help. The more you see different types of questions the faster you will be.

Its a bit like American University SATS. They were brought in to make admissions fairer, but then people discovered they could game them and an industry in SAT preparation emerged. Kids we knew, aiming for the US would start SAT prep three years in advance. Now, and because of this, Universities are starting to drop them.

Why is it thought that being able to reach the 98th percentile on UCAT predicts you will make a good doctor. DD really struggles with timed tests, but has an amazing memory and strong observation skills. An oral exam or interview is a breeze. Why are these skills less important? Which might be a better predictor of, say, a good A&E doctor? My own observation is that broader skills like emotional resilience, application, and communication are the real deciders of who thrives.

(DDs fall back would have been Ireland which weighs heavily on academic results, but it seemed strange that we had to assume that there probably would not be a place for her.)

And back to my earlier point. Observation suggests that Bristol medical students were from more diverse backgrounds when UCAT was not used. The much greater use of UCAT seems to be helping those who understand the system.

We get many more into Bristol now it uses UCAT than before. Their Insight programme does help though.
But pure UCAT takes the advantage of knowing people to help provide experience out of the equation I suppose. No system is ever going to be perfect. More funding for more F1 places would help though.

@needmoresleep I know what the UCAT is. I know what dealing with dyslexia is like. I know the school your DC went to extremely well, and how they might have responded to a student with dyslexia. I know all these from personal experience.

It does not take more than a month to become familiar with how you respond to UCAT sections, after that it is directing that awareness to your advantage as far as you can. Longer than that is counter-productive, unless a young person in a competitive environment lacks confidence, which I suspect probably fits the picture given their score. That remaining centile must be hugely irritant when others leap over it cold.

Nobody is saying that every single type of medicine gets better with the UCAT centiles because it is an unproductive question. This is an entrance test. It is competitive. There are many routes to medicine and many branches thereafter. Once you are in med school nobody is interested in your UCAT score any more than in when you started to read independently. My DC have always expected that they will pursue different interests, and would be shocked that that had any relation to their UCAT or BMAT scores.

I am told that when Bristol first switched to UCAT, the MMIs were overseen by their equalities staff. If the diversity outcomes were not as intended, they surely would have changed back, and then have not.

Regarding the almost 800 initially unplaced F1s, they have now all been placed. Indeed there have been ungracious comments by some who were placed but not at their higher choices, while the initially unplaced have been given newly recreated posts at these places. Just goes to show, you can't please everyone all the time

Bristol is currently around 40% WP isn't it? Doesn't sound like the UCAT has taken it backwards at all.

Sorry - I meant my reply above to be to @Chilldonaldchill - clearly I’m not very savvy at how this Mumsnet thing works !

@maryso they have all now been placed thankfully. But the added stress caused by the reserve list, while many were sitting their finals, was awful. Communication was not good initially as students thought they could end up with no F1 position after their degree - not something anyone thought was possible.
Medicine is weird I've decided. You get little say in where you work for many many years. Culture now is just be grateful you have a job. Not the best way to run a health service & keep doctors happy (& here in the NHS).

Yes @mumsneedwine , a doctor friend told DS1 that he will always have a job but it probably won't be the job you want or the place you want. Very few get their first choice. It is going to be particularly bad for his cohort as he started a 6 year course in 2020, so will be hitting F1 with the huge cohort from 2021.

DS2 wants to be a GP (at the moment) so should be in a better position to choose where he goes.

Agree with @mumsneedwine and @Monkey2001 about the years of very limited say over what people see as key life choices. I think though they almost bed into that while at med school. Every time a new demand comes along, they say I suppose that's my life now... You really do have to get something out of medicine, and it's certainly not financial.

PS for any student with any recognised need UCAT have always offered extra time. Hopefully this may help someone.

www.ucat.ac.uk/register/access-arrangements/

Mumsneedwine, if you teach dyslexic pupils you will understand that extra time is not the all and end all, merely an attempt to compensate. It works well in some circumstances but UCAT is a long test where everyone is drained at the end of normal time. Including those who have slow processing speeds and those working in their second language, so who if anything have had to concentrate more. FWIW DD has always performs poorly in things like CAT, 11+, and UCAT. She has always performed far better in exams which require actual knowledge of subject matter. An extreme example perhaps, but I really don’t have your confidence that UCAT performance is the magic solution.

Bristol has a lot of outreach via linked schools, offers a foundation year and gives contextual offers. There are schools who have a strong track record on sending pupils there so will encourage current applicants. I would expect them to still be able to attract good numbers of applicants from disadvantaged backgrounds. The observed difference over the last few years is that they are taking far more from the sort of schools that previously used to advise against applying: SPS, SPGS, Wycombe Abbey, Eton, Harrow etc.

The new intake is obviously different. Previously a lot was on personal statement and these needed to be good, and verifiable. Now you need to be way up there on your UCAT score. DD has some lovey friends who will make good doctors. It is sad that some of these might struggle to find a place now.

On salaries, I am surprised that many find doctors salaries low. They seem fine in comparison with many other public sector, geographically flexible and secure jobs. A fair number of the super high paying professions are London based, require long hours, can be quite dull, and if you don’t survive the latest redundancy round and you are over 40, things start looking bleak.

DD knows plenty who are starting in the city and has no envy at all. Medicine is far more interesting.

I don’t quite understand the fuss over F1 placement. DD knows the speciality she wants so is thinking of putting an unpopular deanery fairly high on her list on the assumption that if she does not get London, which is super competitive, she has a good chance of getting experience in the specialisation she wants. The bigger concern is getting the training place later, and the advice she has, is to focus on that.