Poll: Should Medicine be Graduate Entry Only?
Yes (36)
34.29%
No (69)
65.71%
becausethenight
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(inspired by ecolier, as all great things on the medicine TSR are )

Basically what it says on the tin. There's a poll, but I'd be more interested to hear people say why they think what they think in a post!

My position: no, because as an 18yo I don't feel that I'd be made 'more ready' to do medicine by an undergrad degree, and 18yos do appear to be capable of doing the degree and having some success.

I've mentioned people from medicine forums who might be interested
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ecolier
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(Original post by becausethenight)
(inspired by ecolier, as all great things on the medicine TSR are )

Basically what it says on the tin. There's a poll, but I'd be more interested to hear people say why they think what they think in a post!

My position: no, because as an 18yo I don't feel that I'd be made 'more ready' to do medicine by an undergrad degree, and 18yos do appear to be capable of doing the degree and having some success.

I've mentioned people from medicine forums who might be interested
This has been asked before on TSR

Granted it's probably more than one year ago so I'll let you off :lol:

Remember that medicine is always post grad in America (rightly or wrongly).
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Razza2000
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ah, hey everyone. yeah, I'd like to add my bit. as an undergraduate myself and not having been to medical school yet, I do feel inclined to point out that my opinion may not be fully informed. from a logistical prospective, making someone study at university for 5 years for an undergraduate degree is pushing on a very long time. I can't imagine having to go through at least 8 years just to be a medic.

even if i did want it enough to study for 8 years (personally, I'm already experiencing academic burnout from school studies), finance would be a huge issue. I am getting help from family to help me through university without haveing to take out too many loans and I understand that this is a very fortunate situation to be in. I can't imagine what it would be like having to study for 8 years and being burdened with debt from that time for a very big part of my life afterwards. it is not what we should be aiming for for any student who had taken the time to study a degree, never mind for just medics.

finally, I would like to agree with @becausethenight and say that after my gap year, I feel like I am ready for university and to learn more about being an adult. I don't know about anyone else but I can't wait to get some independence and try to succeed living on my own. I feel ready to move on with my life and the life experience I've gained over the past few months, although limited, have helped me feel more ready for the next step. so I do believe that undergraduate entry into medicine is a good thing
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0603
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one of my a-level teachers (knowing that i want to go to med school) told me that she thinks it's silly how students are allowed to enter med school at 18 because they are still "too young" to make right decisions for themselves. LOL i replied by saying how 18 is (usually) the age that people are considered to be an adult. if 18 year olds are old enough to make the decision to drink, smoke, drive etc, what makes her think that it's too young to decide what career path we want to go down? why does she think that 18 is too young for medicine but ok for other career paths like law or the army ? :lol:
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qeachy
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(Original post by Razza2000)
ah, hey everyone. yeah, I'd like to add my bit. as an undergraduate myself and not having been to medical school yet, I do feel inclined to point out that my opinion may not be fully informed. from a logistical prospective, making someone study at university for 5 years for an undergraduate degree is pushing on a very long time. I can't imagine having to go through at least 8 years just to be a medic.

even if i did want it enough to study for 8 years (personally, I'm already experiencing academic burnout from school studies), finance would be a huge issue. I am getting help from family to help me through university without haveing to take out too many loans and I understand that this is a very fortunate situation to be in. I can't imagine what it would be like having to study for 8 years and being burdened with debt from that time for a very big part of my life afterwards. it is not what we should be aiming for for any student who had taken the time to study a degree, never mind for just medics.

finally, I would like to agree with @becausethenight and say that after my gap year, I feel like I am ready for university and to learn more about being an adult. I don't know about anyone else but I can't wait to get some independence and try to succeed living on my own. I feel ready to move on with my life and the life experience I've gained over the past few months, although limited, have helped me feel more ready for the next step. so I do believe that undergraduate entry into medicine is a good thing
i definitely agree, especially with the finance bit. we've all heard horror stories about student loans in america and having so much debt on your shoulders may deter people from applying to study medicine. though i agree with 8 years to become a doctor being extremely long, don't you think there's an argument that a lengthier course would filter out people who aren't dedicated enough to study medicine? that isn't my stance, but i can see why people would argue that.

i think having to study so long would change the demographic of medical students greatly. in general you'd have to wait longer until you can earn a good salary and many people are in positions where they may want to support their parents who don't earn a great lot financially, or siblings, or grandparents etc etc. they'd be likely to go down different career paths if that's the case i think, and then only those who don't mind all the fees because they won't need to support anyone besides themselves (and may get financial help from wealthy parents) would become doctors. i don't think you can argue for that being a good thing, but then again the scenario would only apply if an 8 year course would actually result in so many people not wanting to study medicine anymore
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Catherine1973
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If they did that, maybe the university part would just be 1-2 years and then you are working and studying (and being paid) for rest of the years.
In America plenty of degrees are graduate only. Law as well as medicine.
Studying law myself as an older person, I can’t imagine how 18 year olds get their heads around stuff like land law or do public law without having ever voted (potentially). I enjoy it much more having seen land law in practice (ie bought a house).
But it won’t change I imagine.
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becausethenight
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(Original post by ecolier)
This has been asked before on TSR

Granted it's probably more than one year ago so I'll let you off :lol:

Remember that medicine is always post grad in America (rightly or wrongly).
Oh no, at least it means it's a good question

I have tried to see if the US has, for example, lower med school attrition rates, but couldn't find anything easily (the data may exist, but behind a paywall!) I did find a comparison of UK undergraduate versus graduate med students (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808300/) which possibly indicates grad students do slightly worse in some exams (I'm not even going to try to comment on their statistical methodology, though, so it may be nonsense)
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ecolier
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(Original post by becausethenight)
Oh no, at least it means it's a good question

I have tried to see if the US has, for example, lower med school attrition rates, but couldn't find anything easily (the data may exist, but behind a paywall!) I did find a comparison of UK undergraduate versus graduate med students (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808300/) which possibly indicates grad students do slightly worse in some exams (I'm not even going to try to comment on their statistical methodology, though, so it may be nonsense)
Here is a slightly more up to date study with several references pointing to the opposite: https://bmcmededuc.biomedcentral.com...909-018-1355-3

Several studies of attainment at individual UK medical schools have shown that graduate-entry students have performed comparably [4, 5] or better [6,7,8,9] than undergraduate students in common assessments during the shared full-time clinical phase of those programmes. Some studies [10,11,12,13,14,15] have attempted to identify predictors of attainment in graduate-entry programmes, with mixed conclusions, but commonly that prior academic record (e.g. secondary or tertiary educational qualifications) is a reliable predictor.
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becausethenight
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(Original post by Razza2000)
ah, hey everyone. yeah, I'd like to add my bit. as an undergraduate myself and not having been to medical school yet, I do feel inclined to point out that my opinion may not be fully informed. from a logistical prospective, making someone study at university for 5 years for an undergraduate degree is pushing on a very long time. I can't imagine having to go through at least 8 years just to be a medic.

even if i did want it enough to study for 8 years (personally, I'm already experiencing academic burnout from school studies), finance would be a huge issue. I am getting help from family to help me through university without haveing to take out too many loans and I understand that this is a very fortunate situation to be in. I can't imagine what it would be like having to study for 8 years and being burdened with debt from that time for a very big part of my life afterwards. it is not what we should be aiming for for any student who had taken the time to study a degree, never mind for just medics.

finally, I would like to agree with @becausethenight and say that after my gap year, I feel like I am ready for university and to learn more about being an adult. I don't know about anyone else but I can't wait to get some independence and try to succeed living on my own. I feel ready to move on with my life and the life experience I've gained over the past few months, although limited, have helped me feel more ready for the next step. so I do believe that undergraduate entry into medicine is a good thing
(Original post by qeachy)
i definitely agree, especially with the finance bit. we've all heard horror stories about student loans in america and having so much debt on your shoulders may deter people from applying to study medicine. though i agree with 8 years to become a doctor being extremely long, don't you think there's an argument that a lengthier course would filter out people who aren't dedicated enough to study medicine? that isn't my stance, but i can see why people would argue that.

i think having to study so long would change the demographic of medical students greatly. in general you'd have to wait longer until you can earn a good salary and many people are in positions where they may want to support their parents who don't earn a great lot financially, or siblings, or grandparents etc etc. they'd be likely to go down different career paths if that's the case i think, and then only those who don't mind all the fees because they won't need to support anyone besides themselves (and may get financial help from wealthy parents) would become doctors. i don't think you can argue for that being a good thing, but then again the scenario would only apply if an 8 year course would actually result in so many people not wanting to study medicine anymore
The finance point is a good one, I hadn't thought of that! Even in the UK with student loans the debt after 5-6 years of loans and living costs for that period can already be prohibitive to medical students. And if we moved to 100% grad med presumably that wouldn't be funded, as typically you can only get funding for undergraduate study, as I understand it? I suppose we could theoretically up salaries to US Dr levels, but I doubt the gov't would be up for it and more privatisation isn't really a good idea.

The demographics point is interesting as well - it would be quite hard to say if the US has a less diverse medical cohort (if it does) for primarily financial or other social reasons, but it must play a part (although they also have more scholarships). And at a time when calls for more diversity in medicine are rightfully increasing (did anyone else read the BMJ report on racism in medicine?), increasing costs won't help.
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Catherine1973
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You can get masters funding so make it a post graduate degree and funding could continue.
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becausethenight
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(Original post by ecolier)
Here is a slightly more up to date study with several references pointing to the opposite: https://bmcmededuc.biomedcentral.com...909-018-1355-3

Several studies of attainment at individual UK medical schools have shown that graduate-entry students have performed comparably [4, 5] or better [6,7,8,9] than undergraduate students in common assessments during the shared full-time clinical phase of those programmes. Some studies [10,11,12,13,14,15] have attempted to identify predictors of attainment in graduate-entry programmes, with mixed conclusions, but commonly that prior academic record (e.g. secondary or tertiary educational qualifications) is a reliable predictor.
Thanks! I saw that paper and didn't read it as it was comparing graduates, but I should've done for the citations :yep:
Interestingly just opening citation 7 (https://onlinelibrary.wiley.com/doi/...2009.03559.x): "Graduate‐entry students had a marginal academic performance advantage during the early years of this medical course. Most graduate‐entry students had a first degree in a science discipline; thus their advantage may be explained by prior bioscience knowledge. Their performance advantage in clinical skills is less easily attributed to prior learning. Instead, this result provides some evidence for a possible advantage related to age." (this is from the clinical skills assessments rather than the clinical years, though, as that was when they stopped the study) - possibly evidence for the 'grad students are more competent' theory?
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realtimme
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(Original post by ecolier)
Here is a slightly more up to date study with several references pointing to the opposite: https://bmcmededuc.biomedcentral.com...909-018-1355-3

Several studies of attainment at individual UK medical schools have shown that graduate-entry students have performed comparably [4, 5] or better [6,7,8,9] than undergraduate students in common assessments during the shared full-time clinical phase of those programmes. Some studies [10,11,12,13,14,15] have attempted to identify predictors of attainment in graduate-entry programmes, with mixed conclusions, but commonly that prior academic record (e.g. secondary or tertiary educational qualifications) is a reliable predictor.
I agree that graduates perform better, but my fundamental issue with making medicine graduate only is that ultimately it makes it less accessible to students from disadvantaged backgrounds. Unless there was a complete overhaul of the way Higher Education is funded in the UK I couldn't support this.
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ecolier
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(Original post by realtimme)
I agree that graduates perform better, but my fundamental issue with making medicine graduate only is that ultimately it makes it less accessible to students from disadvantaged backgrounds. Unless there was a complete overhaul of the way Higher Education is funded in the UK I couldn't support this.
I agree, it should all be about making more better doctors but there are plenty of other factors which means it isn't as easy as just flicking a switch.

Interesting debate to be had though.

(Original post by becausethenight)
Thanks! I saw that paper and didn't read it as it was comparing graduates, but I should've done for the citations :yep:
Interestingly just opening citation 7 (https://onlinelibrary.wiley.com/doi/...2009.03559.x): "Graduate‐entry students had a marginal academic performance advantage during the early years of this medical course. Most graduate‐entry students had a first degree in a science discipline; thus their advantage may be explained by prior bioscience knowledge. Their performance advantage in clinical skills is less easily attributed to prior learning. Instead, this result provides some evidence for a possible advantage related to age." (this is from the clinical skills assessments rather than the clinical years, though, as that was when they stopped the study) - possibly evidence for the 'grad students are more competent' theory?
Potentially, there are also plenty of GEM students who worked in the healthcare industry (whether they were actual healthcare professionals or just as part of work experience which is easier to obtain for over 18s) which will help.
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nexttime
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Yeah, I'm quite conflicted on this topic.

On the one hand, your entire career is such a huge thing to decide at 18, when most haven't even lived alone yet, many haven't managed their own money before, some can barely cook... but you are required to decide what your entire life is going to be like from now on?

I personally felt that the grads just seemed more confident and brought so much different life experience to the profession when I was being educated with them at med school. However, academically they do seem to do worse at med school according to the paper cited above and also Swansea - one of two grad only med school - does the worst in postgraduate exams of any med school. Warwick is the other, which also does below average.

On the other hand, there reasons to not do this. The main one is cost associated with more years of uni, for student and government. That also makes timing of having children even more awkward. Extra delays are just frustrating for anyone who is set on medicine. People entering are likely to have very heterogeneous existing knowledge, making early education difficult.

You also really couldn't do this with the existing grad med funding - that bizarre funding gap of £3,000 in first year that you have to self fund would just mean no one poor can do medicine any more. Not a good direction to go in.

Overall, against.

(Original post by Razza2000)
I can't imagine what it would be like having to study for 8 years and being burdened with debt from that time for a very big part of my life afterwards. it is not what we should be aiming for for any student who had taken the time to study a degree, never mind for just medics.
You'd never get close to paying back the debt though - its just an extra tax for 30 years.
(Original post by 0603)
one of my a-level teachers (knowing that i want to go to med school) told me that she thinks it's silly how students are allowed to enter med school at 18 because they are still "too young" to make right decisions for themselves. LOL i replied by saying how 18 is (usually) the age that people are considered to be an adult. if 18 year olds are old enough to make the decision to drink, smoke, drive etc, what makes her think that it's too young to decide what career path we want to go down? why does she think that 18 is too young for medicine but ok for other career paths like law or the army ? :lol:
I agree with your teacher for sure! As I say above - sure you can vote or whatever, but many can barely even take care of themselves when they arrive at uni! Hardly an "adult"!

A law degree isn't a law career - that decision comes later. The army... that is a huge decision, but I guess you could argue they actively need young people, unlike medicine, so we as a country don't really have a choice.

I think if we have a choice you do not put such huge decisions on 18 year olds as they will get it wrong.
(Original post by Catherine1973)
If they did that, maybe the university part would just be 1-2 years and then you are working and studying (and being paid) for rest of the years.
Not going to happen though! The opposite direction is what we are heading in - nursing students, who very much do work on the wards to learn, recently went from having to work for free to having to pay to work! And med students are far less useful than nursing students.
(Original post by becausethenight)
Oh no, at least it means it's a good question

I have tried to see if the US has, for example, lower med school attrition rates, but couldn't find anything easily (the data may exist, but behind a paywall!) I did find a comparison of UK undergraduate versus graduate med students (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808300/) which possibly indicates grad students do slightly worse in some exams (I'm not even going to try to comment on their statistical methodology, though, so it may be nonsense)
Wouldn't bother comparing with US - different culture, different fee structure etc.

As above - it looks likely grads do do worse in exams. Not what I expected.
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ecolier
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(Original post by nexttime)
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I thought Warwick is GEM only too...
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becausethenight
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(Original post by 0603)
one of my a-level teachers (knowing that i want to go to med school) told me that she thinks it's silly how students are allowed to enter med school at 18 because they are still "too young" to make right decisions for themselves. LOL i replied by saying how 18 is (usually) the age that people are considered to be an adult. if 18 year olds are old enough to make the decision to drink, smoke, drive etc, what makes her think that it's too young to decide what career path we want to go down? why does she think that 18 is too young for medicine but ok for other career paths like law or the army ? :lol:
It's hard to argue that medicine is a bigger decision than becoming a parent (which we allow 16yos to do!) Age limits vary, though - I wonder if part of the reason the US runs mainly graduate vocational academic courses is because it has generally higher age limits than most of Europe for most other things? Possibly it reflects social attitudes towards younger people, which is kind of what you're suggesting.
I do agree with you, though
(Original post by Catherine1973)
If they did that, maybe the university part would just be 1-2 years and then you are working and studying (and being paid) for rest of the years.
In America plenty of degrees are graduate only. Law as well as medicine.
Studying law myself as an older person, I can’t imagine how 18 year olds get their heads around stuff like land law or do public law without having ever voted (potentially). I enjoy it much more having seen land law in practice (ie bought a house).
But it won’t change I imagine.
Maybe, that could actually be quite a good solution! I would love for med students to get paid in their clinical years.
I can't comment on law, but I see your point. Medicine is possibly different as experiences with hospitals, being ill etc aren't age-limited.
Also I take your point with funding for grad degrees - I've seen people on here complain about it for medicine, which I guess indicates you can't always get it, but it is there.
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nexttime
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(Original post by ecolier)
I thought Warwick is GEM only too...
Ah yes, I'd forgotten.
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Catherine1973
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Maybe you can’t get it now as gem is currently an undergraduate degree, even if you already have a degree. But they could re-sssigb it to be post graduate.
I do graduate law (called senior status) but it’s still sane cost as normal degree per year, just takes 2 years.
Wonder if any other subjects have graduate entry paths?
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adrewp
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(Original post by nexttime)
Yeah, I'm quite conflicted on this topic.

On the one hand, your entire career is such a huge thing to decide at 18, when most haven't even lived alone yet, many haven't managed their own money before, some can barely cook... but you are required to decide what your entire life is going to be like from now on?

I personally felt that the grads just seemed more confident and brought so much different life experience to the profession when I was being educated with them at med school. However, academically they do seem to do worse at med school according to the paper cited above and also Swansea - one of two grad only med school - does the worst in postgraduate exams of any med school. Warwick is the other, which also does below average.

On the other hand, there reasons to not do this. The main one is cost associated with more years of uni, for student and government. That also makes timing of having children even more awkward. Extra delays are just frustrating for anyone who is set on medicine. People entering are likely to have very heterogeneous existing knowledge, making early education difficult.

You also really couldn't do this with the existing grad med funding - that bizarre funding gap of £3,000 in first year that you have to self fund would just mean no one poor can do medicine any more. Not a good direction to go in.
Overall, against.
I was about to raise (practically) the same points!
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becausethenight
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(Original post by ecolier)
I agree, it should all be about making more better doctors but there are plenty of other factors which means it isn't as easy as just flicking a switch.

Interesting debate to be had though.
The impression I'm getting is that it's just very difficult to work out who will be a good/successful med student and doctor. Unsurprisingly, I suppose, as there are many different ways to be a good doctor. But that's the question at the heart of this

For example, if we could say that one of the reasons grads might do better is their previous experience in healthcare, that might be a case for changing the way undergraduate medical degrees work to include a period of HCA/caring work, as well as or rather than moving to graduate-only medicine.
(Original post by nexttime)
...Extra delays are just frustrating for anyone who is set on medicine.
Speaking my language here
That, tbh, is one of the main reasons I'm glad grad med isn't the only option here, because I just don't see the point for me of needing to spend 3 years doing something else (and probably not other things I find interesting, as it would just be racking up the pre-med credits with basic science courses) You're probably right that letting 18yos make big life decisions isn't the best idea, but boy do we want to!
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