The Student Room Group

Will my past failures impede on my future in medicine?

Hi,

I'm a second year student and I am in need of some advice from fellow medical students/doctors.

I failed two modules in first year due to a combination poor revision/exam technique and personal circumstances. This got me down a bit as I had a wasted summer revising for re-sits but I managed to get through to second year. I started this year with an increased morale and in my January exams I passed Neuro which I'm pleased about but failed the second module by 3 marks. Due to extenuating circumstances I have grounds to appeal, so in the summer I should be able to sit this exam as a first attempt. I am desperately trying to ensure that I have a clean record for second year (no failures) so I'm working hard from now (exams are in May/June).

I really want to improve my decile score as I know that this will be important for FPAS applications, but I'm worried that my failures in first year will have an impact on this. Can I still get a decent decile ranking if I do well in exams from now on? Will I be able to get onto a good Foundation Programme? The thing is, I know that I can do better than what I have achieved so far - I honestly don't think I am much different to those students who get the top decile scores, it's just that I need to start revision earlier and probably need to revise differently as well, both of which I'm working on.

I'm also interested in research, and have just completed an audit which will provide me with PubMed citable authorship. If I want to get involved in more research in the future, like as a summer project - will I face any problems?

I just don't want these two modules to define who I am, as I am starting to get a bit sick of the competitive culture within medicine. I'm trying to pave my own journey but sometimes other people on my course get me down a bit with their attitude.

Any input from anyone willing to answer will be really helpful.

Regards,

Med student in need of a break

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Decile scores depend on how exactly your medical school weights things. So the decile score will include various exams, each contributing a certain proportion to your school. It is worth remembering, especially if you intercalate, that not many deaneries will be out of reach purely due to a poor decile score. Most aren't actually that competitive (London, Oxford, Severn need highish points to get into, but poor decile + good SJT + intercalated degree can still get you into some of those).

About research in the future. I don't necessarily think having to do resits should be a barrier. I guess for some formal summer projects, they may use academic transcripts to award places, so that could potentially be a small issue, but even then, if you seek out opportunities, plenty will be keen for a student to be involved without a formal advertised admissions process. Even stuff like the Academic Foundation Programme (like a normal FPAS application except with 1 research block instead of 1 of the hospital placements) doesn't necessarily care about resits - they won't even know you've done them, since there's nowhere to declare it on the form, and it is still possible to get an Academic Foundation offer with a poor decile (although I presume it makes things more difficult).

People fail stuff in medicine sometimes. I'd try just to focus on yourself and not compare yourself to others. I certainly don't think you should care about these modules "hanging over you" too much, as long as you pass it on the resit, then you'll get your medical degree.
Try not to worry too much about deciles and points etc.

During my time at medical school the application for jobs changed beyond all recognition a couple of times and it has done again since - and if you're only second year now, there is nothing to say that it might have changed yet again before you get there. So there is nothing to say that stressing about deciles now will do you any good in the future if and when things change.

Do the reasonable best you can but have a life too and look after yourself and make sure that these things don't take over your life.

At present, unless you are within the very top and get honours, then as far as I know there is no distinction made in ST applications between those who were 1st and 10th decile. The further beyond med school you get, the less relevant these things are and the more of a melting pot the applicants are in terms of background, year of graduation, career journey to date.

All foundation programmes are good. The aim of foundation is to get a good basic knowledge of being a doctor, doing the basics well and learning some decent general skills in some medicine and surgery jobs. You can do that pretty much anywhere. The biggest teaching hospital is not always the best place to be an FY1, and your average DGH can give you a perfectly good experience. Personally I think it can even be a better experience. You might not get your first pick of geography, depending on whatever the application hoop-jumping is when you graduate and how you manage to jump those hoops - but again a lot of people move round after med school, and most people nonetheless get reasonably close to where they wanted.

Often but not always, people find clinical years quite different to non-clinical - so progress in preclinical years cannot be directly extrapolated to predict how you'll do in clinical. it's not as clearcut as 'people who do struggle through preclinical will fly through clinical' and vice versa, but it's nonetheless not an uncommon experience for people to think that their clinical progress will mirror that of their preclinical years and then find the reality to be somewhat different.

Keep up the good work, remember to look after yourself, eat and sleep, keep up some hobbies and keep your friends and family close, this will stand you in good stead throughout the years ahead and help you to do as well as you can.
(edited 8 years ago)
My decile is pretty poor, no one seems to really care that much. Got an AFP post for next year, although not in the most desirable location. I'd say enjoying your time as a med student is more important, although failing something makes life pretty stressful.
(edited 8 years ago)
Reply 4
Original post by Anonymous
Hi,

I'm a second year student and I am in need of some advice from fellow medical students/doctors.

I failed two modules in first year due to a combination poor revision/exam technique and personal circumstances. This got me down a bit as I had a wasted summer revising for re-sits but I managed to get through to second year. I started this year with an increased morale and in my January exams I passed Neuro which I'm pleased about but failed the second module by 3 marks. Due to extenuating circumstances I have grounds to appeal, so in the summer I should be able to sit this exam as a first attempt. I am desperately trying to ensure that I have a clean record for second year (no failures) so I'm working hard from now (exams are in May/June).

I really want to improve my decile score as I know that this will be important for FPAS applications, but I'm worried that my failures in first year will have an impact on this. Can I still get a decent decile ranking if I do well in exams from now on? Will I be able to get onto a good Foundation Programme? The thing is, I know that I can do better than what I have achieved so far - I honestly don't think I am much different to those students who get the top decile scores, it's just that I need to start revision earlier and probably need to revise differently as well, both of which I'm working on.

I'm also interested in research, and have just completed an audit which will provide me with PubMed citable authorship. If I want to get involved in more research in the future, like as a summer project - will I face any problems?

I just don't want these two modules to define who I am, as I am starting to get a bit sick of the competitive culture within medicine. I'm trying to pave my own journey but sometimes other people on my course get me down a bit with their attitude.

Any input from anyone willing to answer will be really helpful.

Regards,

Med student in need of a break


I don't think the first two years of the undergrad medical degree counts towards your foundation application does it? As i'm aware, the first two, and final year doens't impact at all. And intercalated doesn't in terms of deciles, but you get more points for it.

You can also improve your total points by getting involved in research, no need towrite a paper, jsut help out, get your name published (even last) and you'll get an extra point. Alternatively jsut keep working as hard as you can to improve your grades, and smash the SJT
Original post by Freyr
I don't think the first two years of the undergrad medical degree counts towards your foundation application does it?


It's 40% at my med school.
Reply 6
Original post by AnonymousPenguin
It's 40% at my med school.


ah, sorry to hear that... both your 1 and 2 year are worth 20% each then? At imperial only the 3 and 5th year (out of 6) for the undergrad programme is counted.

could be difficult for your first year then... The only thing you can do is jsut work extra hard to bring your decile up this year, and future years...

But still look into getting involved with research, if you do it right, you can spend minimal time on it (so it doens't distract from your normal studies) and have your name placed last on the author list to get the extra points. if your med school doesn't require you to do an intercated year, you could look into seeing whether they will allow you to since it again gives more points, and again smash the SJT.

Unfortuantely thats all you can do, so good luck in your studies, and I would reccommend you look into the other things too even if you are able to get better grades.
But you shouldn't be so hung up on it. Provided you pass your medical degree, you're pretty much guaranteed a foundation job somewhere, and essentially, it doesn't matter where you do your foundation placements (from a career prospective) since all programs will allow you to learn the required competencies. So even if you're somehwhere you never thought you would live in, it's only 2 years, work hard during those two years and apply for specialty programmes in areas you do want to live.
Overall, it won't negatively affect your career as a whole even if you're not top of your class etc. as long as you're not hung up on working in the super competitive deaneries for foundation.
And, as an extra, if you ever did want to become a GP, then even more reason not to worry! since the competition for specialty training can barely be called competition, you can practically put your name down and you'll get in since the uk is lacking GP trainees (not that competition should dictate your specialty!! definitely hasn't for me, cause I couldn't never see myself as a GP)
(edited 8 years ago)
Original post by Freyr
ah, sorry to hear that... both your 1 and 2 year are worth 20% each then? At imperial only the 3 and 5th year (out of 6) for the undergrad programme is counted.



I'm not the OP. Yes Y1 and Y2 are 20% each - this is Oxford, but I would imagine many med schools do the same. The other downside is that some places won't let you do an intercalated degree if your ranking is low. Not a big deal really, just something to be aware of.
(edited 8 years ago)
Reply 8
Original post by AnonymousPenguin
I'm not the OP. Yes Y1 and Y2 are 20% each - this is Oxford, but I would imagine many med schools do the same.


does it? Even in the past when clinical years in london was allowed? They still took into account your grades at oxbridge?

As far as i'm aware, at imperial, the first 2 and final year play no role whatsoever since the graduate entries and direct entries sat different exams from the normal undergrads, therefroe makign it unfair to compare the three groups together, so they only look at the exams where everyone has sat the same exam papers (in terms of content at least)

First two doesnt count since they're preclinical, and final year doesn't count since job offers are given before exam results are given out
(edited 8 years ago)
Original post by Freyr
does it? Even in the past when clinical years in london was allowed? They still took into account your grades at oxbridge?

As far as i'm aware, at imperial, the first 2 and final year play no role whatsoever

First two doesnt count since they're preclinical, and final year doesn't count since job offers are given before exam results are given out


At Leicester our 4th year exam counts for 50% of decile with the rest being made up of our preclinical results (the later exams being weighted more heavily).
I think I prefer it that way. It gives you the chance to have a bad exam and it not have such a massive impact on your decile.
Original post by Freyr
does it? Even in the past when clinical years in london was allowed? They still took into account your grades at oxbridge?

As far as i'm aware, at imperial, the first 2 and final year play no role whatsoever since the graduate entries and direct entries sat different exams from the normal undergrads, therefroe makign it unfair to compare the three groups together, so they only look at the exams where everyone has sat the same exam papers (in terms of content at least)

First two doesnt count since they're preclinical, and final year doesn't count since job offers are given before exam results are given out


Cambridge weights preclinical 40% too.
Reply 11
People vastly overestimate the importance of deciles when it comes to life after med school. Ostensibly application to foundation weights academics and SJT 50/50. But if you look at the EPM part the lowest you can score is 34. And then decile rankings are worth one point each up to a maximum of 43 points, with the remaining 7 being for extra degrees etc. So your decile itself is only worth 9/100.

Now you can theoretically get 0 in the SJT but no one ever does. So let's say that you're not an exceptionally low scoring applicant and the lowest you might expect to score is 28. That means everyone scores a minimum of 62 on FPAS. Of the remaining 38 points, only 9 are from your decile. 9/38 = ~23%. So your decile is actually worth less than a quarter of your application! Considering the law of diminishing returns when it comes to revision, and the amount of blood, sweat and tears it takes to climb a few deciles, the easiest way by far to bump your EPM is to screw revision and just intercalate.

But considering the SJT is just an expensive random number generator thay composes over half the points you can gain, it's still not that worth troubling yourself over your EPM score.

And anyway, FPAS only really determines where in the country you'll live for two years. Which is important, but fairly irrelevant when it comes to your long-term career prospects. And in all likelihood no one will ever ask you your decile again once you've graduated unless they're being an arse.

So what I'm saying is... none of it matters, don't worry, just focus on passing and do your best. Everything will be just fine
(edited 8 years ago)
Original post by Freyr
does it? Even in the past when clinical years in london was allowed? They still took into account your grades at oxbridge?

As far as i'm aware, at imperial, the first 2 and final year play no role whatsoever since the graduate entries and direct entries sat different exams from the normal undergrads, therefroe makign it unfair to compare the three groups together, so they only look at the exams where everyone has sat the same exam papers (in terms of content at least)

First two doesnt count since they're preclinical, and final year doesn't count since job offers are given before exam results are given out


I'm not sure what happens with the guys who transferred to London. I believe the UCL guys were told the results from the first 2 years will be discarded, which made everyone quite happy there.

For people staying and the GEM guys they took a decile score from pre-clinical and used it for 40% and then just somehow mashed everyone together to get the deciles. Possibly not the most refined process, but that's what the policy document states.
Reply 13
Original post by AnonymousPenguin
I'm not sure what happens with the guys who transferred to London. I believe the UCL guys were told the results from the first 2 years will be discarded, which made everyone quite happy there.

For people staying and the GEM guys they took a decile score from pre-clinical and used it for 40% and then just somehow mashed everyone together to get the deciles. Possibly not the most refined process, but that's what the policy document states.


ah that sucks, I just checked, and definitely at imperial, grades acheived at oxbridge are ignored, imperial keep it fair and only judge exams that graduating students have in common, not that its an excuse to be lazy since knowledge in preclinicals still need to be learnt and cuase problems in later years if not done properly!
Original post by Freyr
I don't think the first two years of the undergrad medical degree counts towards your foundation application does it? As i'm aware, the first two, and final year doens't impact at all. And intercalated doesn't in terms of deciles, but you get more points for it.

You can also improve your total points by getting involved in research, no need towrite a paper, jsut help out, get your name published (even last) and you'll get an extra point. Alternatively jsut keep working as hard as you can to improve your grades, and smash the SJT


Being last on a paper isn't easy to do as it usually means you're the senior author/head of department/grant winner. You're most likely thinking of the people who are placed in the middle of the author list (3rd/4th).
Reply 15
Original post by plrodham1
Being last on a paper isn't easy to do as it usually means you're the senior author/head of department/grant winner. You're most likely thinking of the people who are placed in the middle of the author list (3rd/4th).


on journals, first author listed is the lead author isn't it? I.e the one that did msot of the research, and wrote the paper itself. hence its also called "first author". And then it noramlly list co authors in order of contribution, hence least contribution is listed last. Thats how I always thoguht it was at least?...
Literally go to any scientific paper online, when you click "download citation", the author listed first is also cited first, and in the case of citations waranting the use of et al (due to there being many authors) the first author is writen, followed by et al

regardless, what I was getting at was, do as little work as possible to get enough credit to be listed in the list and use the extra time to work at grades
(edited 8 years ago)
Original post by Freyr
on journals, first author listed is the lead author isn't it? I.e the one that did msot of the research, and wrote the paper itself. hence its also called "first author". And then it noramlly list co authors in order of contribution, hence least contribution is listed last. Thats how I always thoguht it was at least?...
Literally go to any scientific paper online, when you click "download citation", the author listed first is also cited first, and in the case of citations waranting the use of et al (due to there being many authors) the first author is writen, followed by et al

regardless, what I was getting at was, do as little work as possible to get enough credit to be listed in the list and use the extra time to work at grades


First name is first author, last name tends to be "senior author" I think. Eg the person who runs the lab.
Reply 17
Original post by Chief Wiggum
First name is first author, last name tends to be "senior author" I think. Eg the person who runs the lab.


Oh I didn't know that. then agian that only applys to research carried out in a lab? Medicine in particular can include studies in clinical settings, or would the senior doctor in charge of the area be listed then?
Original post by Freyr
Oh I didn't know that. then agian that only applys to research carried out in a lab? Medicine in particular can include studies in clinical settings, or would the senior doctor in charge of the area be listed then?


The lab thing was just an example.

I am by no means an expert on this, but in my limited experience of more clinical research, the last name was still the "senior author", for example the consultant, whereas registrars, medical students etc were listed before that, with the person who wrote the paper/did most of the work being first author.
(edited 8 years ago)
Original post by Freyr
on journals, first author listed is the lead author isn't it? I.e the one that did msot of the research, and wrote the paper itself. hence its also called "first author". And then it normally list co authors in order of contribution, hence least contribution is listed last. Thats how I always thoguht it was at least?...
Literally go to any scientific paper online, when you click "download citation", the author listed first is also cited first, and in the case of citations waranting the use of et al (due to there being many authors) the first author is writen, followed by et al

regardless, what I was getting at was, do as little work as possible to get enough credit to be listed in the list and use the extra time to work at grades


Lead author is not the same as senior author. You're right in that the first author will be the one who has done most of the work, however often the concept, planning and funding have all been established by the senior author (who goes last).

With regards to citation yes the first author will be the person who is cited, but most people when discussing the work will refer to "smith et al, of (big name prof's) group", at least they seem to at conferences.

You'll also note that in large landmark papers the senior author (who is usually last) will also sometimes instead place their name first. I assume this is to do with the being cited thing however it seems to just makes it even more confusing. If you're ever in doubt you can simply search the person in scopus/pubmed.

This then of course becomes even more complicated when large collaborations publish however the person who creates the concept will usually be last.

With regards to your last comment it may be a little naive to simply try and dedicate all your time to studies and little time to extra-curriculars, depending of course upon career aspirations. Whilst in the earlier applications your publication/presentation record will not count for a great deal, there will come a point when a few 1st author papers will make you more competitive, and this isn't as difficult to achieve alongside your studies as many people seem to make out.

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