Ideal university for Medicine

[Kayt79]

DS is in Y12, and set on Medicine. He's been to a few open days already, but until he's done his UCAT next summer it's impossible to know where will be realistic to apply.

So, just out of interest, and putting aside entry requirements and "prestige", which would be your ideal universities for Medicine, based on the overall student experience?

Whereas when I typed in the name of a London uni offering the course it was very clear about Biological Science/ Biomedical Science and closely allied degrees.

Can't say I've ever been asked what uni I went to post graduation, noone cares

@AsTearsGoBy in order for postgraduate jobs to be allocated based on quality of applicants, my point in a previous post was how can we be sure that IMGs taking and passing their PLAB 2 in the UK that week were the right (as you say) quality if they were given advanced notice of the PLAB 2 possible question areas by the UK academy days before the exam? How is that an assurance of that particular cohort's quality? If IMGs must pass PLAB to work in the UK, perhaps there needs to be scrutiny at how PLAB exams are conducted. It was not a criticism of all IMGs. My point is how is that fair on UK medical graduates? Not sure how many UK medical graduates get access to areas that are definitely coming up days before say, their MLA exams? Apparently the academy's success rate is 99-100% 🤔 I think both IMGs and UK grads should sit the same exams. Reading the experiences of @Lovecatsanddogs @Haffdonga @mumsneedwine and @Needmoresleep it seems to me the current NHS recruitment system has introduced a bias in favour of IMGs.

Doubtless it is an "alarmist article"

Read it here

https://archive.ph/dRJti

FWIW the one girl we knew from DDs peers who became a PA was nowhere near the academic level of the kids who got into medical school. Nice enough girl, degree in sports science. I am a huge fan of nurse practitioners, and was delighted that my mum's GP had two who dealt with the run of the mill geriatric health problems and who knew their area of medicine inside out, with a shout out to the NP who ran the memory clinic and who had the skills and experience to really support me, as well as a great ENT NP in took me through why a virus could stop my vocal chords from working and who I was confident would have spotted anything more sinister. But with the best will in the world I struggled with the PA I saw instead of a GP. Dr Google and Ai would seem a better option.

But the issue is not PAs per se but the fact that they are in posts that doctors, with their wider training, could do better. They are better paid, have regular hours, but more frustratingly have jobs when our young doctors don't. It does not make sense. Then, completely bizarrely F2 are being asked to train them - so they can take the jobs that the F2s might want/need.

The quick fix is to allow UK trained qualified doctors to apply for PA posts. Currently doctors are not allowed to becomes PAs, even though they have undergone a much more extensive training. This then would retain more of the current generation for the long term benefit of the NHS (and the benefit of them and their families.)

Thanks for that Needmoresleep.

No idea why those with a medical degree can't apply for the PA training. So much of this doesn't make sense.

as long as they're at least as good quality as others applying. that is one hell of a proviso.

At the moment UK graduates are competing on equal terms. As it has been explained several times, selection gives weight to conferences research papers and things like "gold medals" (only a couple each year but handed out more generously in India.)

No weight is given to performance reports. At one point whilst at medical school DD was asked how much she had paid the previous consultant. It turned out he has written that she was the most impressive medical student he had come across. She continues to get good appraisals, largely because she is focussed on the job rather than on point grubbing. Under the current selection system she would not count as "at least as good quality as others applying", because the selection is focussed on things DD does not offer. In part because no one spelt out to our student that papers, conferences and top marks in exams would be more important than gaining experience on wards. And no one is offering the help with the application process that can be bought by overseas applicants.

If things don't change and if, after Australia, DD decides to return and reenter the fray, I have every intention to offer to pay for her to go to Asia to have the tailored help and advice available to overseas applicants. I suspect that given the current levels of competition it is something she will need.

Because they would take jobs away from PAs...and we can't be having that can we.

People are not anti PA as such. Just cross about another area where UK trained medics are denied a chance to make a contribution and earn a living.

Needmoresleep that still doesn't make sense.

But this sounds to me like a wasted payment to the dubious companies which claim to enhance the chances of their clients' securing an Oxbridge offer.

The points awarded for published papers are minimal.

I do find it extremely odd that there's no element of reference/ performance report.

But you know, it's probably fair that getting a first class degree garners a few extra points.

I think you’re being a bit unfair to the juniors who do get points for application. Some of them are both fantastic ward doctors and find the time to write papers and get the other points needed. I have certainly had juniors in this position. Any consultant worth their salt should be helping their F2s through the process and explaining it to them and helping them with projects and presentations. We certainly do for the juniors in our team and the ones I am ES for.

My DS is certainly not a consultant but he mentioned in passing last year that he was helping an F2 with a paper for the next step. Those further along do seem to help those who are junior. I'm sure that they'll help those that they think should get a training post so to that extent I guess there's a disguised element of performance review. I agree that there's an air of snippiness here about those who secure a training post. Not all papers are second rate; some seem to be pretty well received and take time and effort to produce - thinking about the dates, DS must have produced his while working in a central London hospital through Covid, doing nights and weekends etc. One has to assume that the filter filters with some vague level of accuracy.

Here is a link to the country of qualification breakdown for 2023 speciality training. The relevant info is under appointable applicants, offers made, accepted offers. The more competitive entry level training schemes are very skewed to UK graduates in that year.
https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/equality-and-diversity/equality-and-diversity-2023-recruitment-data/country-of-qualification-2023-recruitment-data

I can't find any Universities that are asking for anything other than a first in a science subject. All masters for the PA look to be an intensive two years.

I also do not like the personal attacking of PAs. These people are also someone's son or daughter who could be highly academic and choosing this career at post-graduation, in good faith. Attack the system by all means.

FWIW - I used to rate the Nursing Practitioner role but have had two experiences of my adolescent/young adult children being treated for far too long by an over confident Nursing Practitioner and moving through the algorithm of medications when really they needed to be seen by an experienced GP. One of them ended up on oral antifungals (which requires monitoring of the liver). They then moved back to their University practice and saw a GP who took them straight off them recognising the skin problem was not fungal.

A role between nurse and doctor can be useful but I think if they treat a problem and the patient comes back still with the problem, they need to be referred to a GP. It is all rather confusing for patients to have Nursing Practioners and PAs working in place of some GP roles. Did we need both?

Sendsummer, you made an interesting point earlier about statistics, and our DC disappearing, perhaps leading to an overstatement of the the need for IMGs.

Taking the four DC Mumsneed, LoveCats, Haff's and mine. They all seem to have had a smooth path through medical school and so should be standard if not good applicants.

Mine: made an early decision to prioritise busy F2 placements over studying for exams. Original intention was then an F3, but has been put off by the 1000+ applications likely even for the 2 positions she is immediately aware of. So Australia.
Haff's: is trying to apply for a local F3, but is facing huge competition. Otherwise Australia.
Mumsneedwine: hopes to pass exam or will go to Australia.
LoveCats: Not applying for F3 positions. Instead will take a break after F2 and will pick up shifts as a bank locum.

In short out of the four, there may be only application for an F3 position, and three leaving for Australia. Given that an overseas applicant may apply for just about everything available, the statistics will be off. The old saying: lies, damn lies and statistics. Either the NHS or the BMA need to drill down and find out what is going on. The solution will not be to further ease recruiting requirements for IMGs. Instead they need to consider the barriers facing UK trained doctors.
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I can't find any Universities that are asking for anything other than a first in a science subject. All masters for the PA look to be an intensive two years.

Two years, yes, but ours have done seven or eight. Not the same. The Telegraph article linked above suggests "science" is a broad term. Our own observation is that sports science is sufficient.

I also do not like the personal attacking of PAs. These people are also someone's son or daughter who could be highly academic and choosing this career at post-graduation, in good faith. Attack the system by all means.

No one is attacking individuals. No one is denying that some PAs might be highly academic. All I said was that the one we knew didn't seem to be. (She ended up moving from a selective secondary school because, despite tutoring, she was struggling. Future medics would have been in higher - 3 science GCSE - sets.) It is reasonable to suggest that academic requirements for medical school are more demanding. Whether this is important or not is a different question.

FWIW - I used to rate the Nursing Practitioner role but have had two experiences of my adolescent/young adult children being treated for far too long by an over confident Nursing Practitioner and moving through the algorithm of medications when really they needed to be seen by an experienced GP. One of them ended up on oral antifungals (which requires monitoring of the liver). They then moved back to their University practice and saw a GP who took them straight off them recognising the skin problem was not fungal.

The NPs I have come across have been in quite niche roles where they have been able to build up real expertise. So the NPs in my mother's GP practice only worked with the elderly patients, would do home visits and could sniff a UTI from 100 meters. It worked well. They knew my mum had a reliable carer so if she phoned saying that my mum was unwell and the urine testing strips were positive my mum would be prescribed antibiotics straight away. On the couple of occasions where these did not work my mum got prompt admission to hospital. Given my mum lived till 90 and with Alzheimer's for a decade, she needed remarkable little GP or hospital time and was able to stay in her own, albeit sheltered, home. . In contrast I would be wary of either a NP or a PA who was undertaking a general medicine role but who did not have the broader education and experience of a doctor.

It's such a mess of arguments it's almost like it's deliberately done.

1. we have trained enough doctors in the UK to supply the jobs. Extra jobs should go to IMGs (as they do in every other country in the world)

2. a few doctors are not good. They will not pass each ARCP ?

3. some v lucky doctors have consultants who help them get papers published. Most don't. My DD was the only doctor on her ward yesterday and was there 16 hours due to sickness. Yes she exception reported it, no one cares. She has 2 papers published from medical school - doesn't count for her speciality. All down to an exam that had 1 question on her chosen career.

4. it's not snippy. 2 years ago, even last year, all the paediatric applicants I know would have got training due to their portfolios (many have several published papers). This year they haven't due to massive numbers of applicants.

5. no one is personally attacking PAs (except the ones illegally prescribing or trying to force F1s to sign things off without seeing the patient, or doing operations on babies). But a 18 months course does not make you a doctor. It makes you a PA. You should not be diagnosing. People have died.

6. doctors pay is rubbish for what they do. £20 an hour for running a cardiac arrest.

Fix it. Or they'll leave. As will many IMGs. These are the future consultants. We won't have any in 20 years at this rate.

www.universityworldnews.com/post-mobile.php?story=20240403113258777

Oh and they earn more than doctors for up to 8 years. Not even saving money.

Soundofshuna Some F1/F2s do find the time to study and write papers. However hours, scheduling and support vary hugely across deaneries. Some F1/F2s do no nights at all. Others are having to hold the fort through busy nights in places where staff shortages are really biting. DD's F1 cohort quickly reduced by 20% and not all passed the year. A choice then between pulling your weight and being a team player, or making clear boundaries. Then a further choice. Do you embrace where you are, play sport and have a life, or do you live in hospital accommodation and treat the two years as an intensive work/study period. I know DD could do the latter, but given the way Covid messed up her University experience I understand her choice of work hard/play hard, with F3 the time to knuckle down. Indeed I think it might cause her to be a better more relient doctor in the long term.

AsTearsGoBy More pejoratives. A consultant who posted earlier confirmed that conferences and papers could be variable in quality. Content in British journals and invitations to conferences in the UK will be far harder to achieve. It is very possible for a UK F2 to submit to competitions all around the world with a reasonable expectation of success, at least in the more obscure places. No one is saying that some of this activity is not valuable. However it seems reasonable to question whether all of it deserves to earn selection priority. If you feel this is snippiness so be it.

And nice that your DS is helping an F2 with a paper for the next step. DD decided early on to go for a demanding set of F1/F2 rotations and leave the rest to an F3. I assume that if she really worked at it, she would find someone/something linked to the local medical school, but in the same way as she is busy, everyone else is busy. There is a real shortage of consultants, apparently the Trust did not have a single consultant in a very key area, and they are having to recruit for consultants posts from overseas, which is causing problems in terms of understanding of the NHS. In DDs second month a registrar did not turn up. The on-call consultant stayed till midnight, but then had to say to 2 F1s and an F2 with less than 2 years experience between them that she had to go home leaving them in charge of the hospital in an infamously deprived area where pub closing could mean some very sick patients. They should phone if anything serious came up. Understandable. She was 70. The NHS, at least where DD is, is on its knees. And worth remembering that new F1s get allocated, so can get a London teaching hospital or somewhere where firefighting is the norm. DD suggests that one advantage of Australia is that she will get to practice medicine in a less challenged environment.

The issue is the extraordinary level of competition for F3 jobs. Great if you have time during F2 to write numerous applications, write papers and research. Not great if you are getting bags of experience (DD suggested that one procedure she was allowed to carry out is, in the rest of the UK, normally limited to senior registrars) but need your free time to sleep and unwind.

Apologies Needmoresleep I've read the Telegraph article now on PAs being admitted to the masters.

"The Telegraph sent Freedom of Information requests to universities offering courses to become a physician associate in the UK.Fourteen provided full data. Between them, they accepted 148 degrees in 2021, 173 degrees in 2022 and 135 degrees in 2023 which were neither biomedical science nor a professional medical qualification such as nursing, midwifery or an allied health profession."

I had assumed most graduates came from a biosciences background. even sports science isn't so bad if from a top University. But yes, it all looks rather desperate doesn't it. It used to be a difficult course to get onto but it looks like there are many more Universities offering the course.

My large GP practice definitely uses Nurse Practitioners (who can prescribe) as generalists. The same one who prescribed for asthma prescribed for a skin condition. Both DC ending up on strong medications that I now feel ought not to have been prescribed before a doctor's input.

You either need a 5/6 year degree, 2 years of being ward supply and then 5+ years of training to be a doctor. Or you don't and can do the same thing after 18 months. Which is it ?

bookmarket Thanks. There is a huge problem. It is fine to question assertions, but my quick summary of four long standing MNetters with F2 kids suggests something is badly wrong. All four should not be dropping out of the system. They need jobs which are reasonably accessible. They are not allowed to apply for PA roles, even though these roles were often ones filled by young doctors and they face massive, massive competition for the remaining suitable doctor roles.

I once applied for a long-shot job. 2,000 applicants for 20 places. When I got to final interview I was asked why I wanted the job. Because it was such a long shot I did not have an answer prepared. Despite this I got it. The F3 jobs are 10 times more competitive. 1000:1. It is obvious why our young doctors cannot find the time to apply for more than one or two.

FWIW I am close to completing a full bingo chart of skin cancers, including melanoma. The result of having lived in the tropics with fair skin and freckles. I pay for a check up every six months at a private skin clinic in the same way as I pay to see a dental hygienist, or indeed a hairdresser.The nurse that does my checks looks at skin all day every day, and immediately sends photos of anything unusual to a specialist doctor. The meloma did not look particularly unusual but she spotted it straight away. Yes I could go to the GP and probably get regular checks on the NHS, but I would not be confident that a PA, or even a GP has the same level of experience. Depth or breadth? It depends on what the patient needs. A NP or PA with very specific knowledge can be great, but patients will often need the broader knowledge that doctors will have had.

Needmoresleep a poster said that papers were of variable quality which by definition they will be. Some will be excellent. DS presented his first one at the international conference on the subject so presumably it wasn't complete trash. I think possibly the idea that my own DS 'had time' during his F1 and F2 years is a bit sharp, let alone wholly innacurate. His hospital was and is still the busiest in the UK and he wrote this particular paper during the pandemic. Implying that he wasn't as busy as the current F2s is just, well, wrong. I didn't ask too many questions but the F2 he offered to help was obviously good and he saw her as having real merit, hence the support, freely given not sought. sendsummer's posts are helpful in sorting fact from fiction. DS has since written another paper or maybe other papers but that isn't because he's not always extraordinarily busy but because he's always just got whatever need doing done.

Just see this. How depressing

You have a very odd way of arguing.

"Some will be excellent" is not a counter argument to "some will be of variable quality".

I have also made very clear that DD had a choice. Work hard-play hard, or work hard - study hard. She opted for the first, which given the Covid disruption I completely understand. This ought not preclude her from a medical career in the UK. However it will as the odds of her ever getting an F3 job which would have allowed her a work less study more, are vanishingly remote.

I appreciate your DS is thriving in the current system. But suspect that in the future he may regret the the loss of the current F2s. You may disagree, and support the status quo, but I hope you can agree that others are not unreasonable in seeing a problem and are unhappy about it.

@AsTearsGoBy it's not a competition as to whose DC had it harder. It's about ALL doctors getting the jobs they've all worked so hard for.

Most of the students I teach had jobs all through medical school as they had to for money, no time to publish papers or funds to attend international conferences. Even now a lot of them could t afford those things