No. You don't need A/A* at A-level to be intellectually capable enough to do a degree in medicine. Entrance requirements have become so high in the UK because it is one way of filtering the high volumes of applicants. If a degree course is recognised by the GMC, then that means that that course is sufficiently rigorous and demanding to train someone to be a doctor. If a student has successfully completed the assessments for that course, then what does it matter what their A-levels were? There will occasionally be issues of bribery and corruption in certain places, but overall, someone with average / mediocre A-level grades may very well be capable of doing medicine - especially if, for example, grades are a result of lack of effort / motivation. Doctors can only practice in the UK without doing an equivalency exam, if the course is recognised by the GMC. Otherwise doctors must sit an equivalency exam - PLAB. So no, I don't see an issue.