Are GEM courses aimed more at those who have done a degree, gone down a particular career path and then decided to switch to medicine or do people who have gone straight from A levels into a degree and now want to do medicine have the same kind of chances? At the end of the day, a lot of GEM applicants are those who didn't have the right grades at A level so how can they compete with someone who has more life experience, a career and in many cases even a PhD?