Mauka Chauka
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An older friend of mine applied to medicine and in the interviews said he was mostly interested in the research side of medicine. He says this is the reason why he wasn't accepted to medicine.

This got me thinking what are medical schools trying to achieve: are they trying to form the UK's future doctor so that work only in hospitals; or could they be trying to form the best doctor possible, who works in whatever field and whichever country he wants?
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Ramipril
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There may be a number of reasons why he could have been rejected. Him thinking it was because he mentioned he was interested in research is most likely not the reason at all. What medical schools are trying to achieve are medical students who graduate to GMC standard. What interviewers/the admissions team want is different.
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ecolier
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(Original post by Mauka Chauka)
...This got me thinking what are medical schools trying to achieve: are they trying to form the UK's future doctor so that work only in hospitals; or could they be trying to form the best doctor possible, who works in whatever field and whichever country he wants?
I didn't know the best doctor has to work in research.

If you asked hospital bosses, doctors are there for service provision and nothing else.

Medical school admissions (don't confuse this with medical schools please) is to reduce the numbers as much as possible, especially this year when applicant numbers rose by 21%.

P.S. These days medical admissions is a tick-box exercise mostly; I don't know which med school that is, but that's very specific feedback that usually med schools don't give out.
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Mauka Chauka
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What do the tick-boxes look like ? What does the medical admission look for in a candidate then ?
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ecolier
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(Original post by Mauka Chauka)
What do the tick-boxes look like ?
Depends on the med school.

What does the medical admission look for in a candidate then ?
Also, depends on the med school.

Here's a random example I picked, from BSMS: https://www.bsms.ac.uk/undergraduate...s-process.aspx

https://www.bsms.ac.uk/_word-docs/ab...site-2018.docx

https://www.medschools.ac.uk/media/2...y-medicine.pdf
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edavey103
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Well, a big job of medical schools is to train doctors to work in regions where they are lacking. For example, one of the main reasons the new med school at ARU opened was because of the lack of doctors in Mid Essex and the plan is for people to train there then stay there to work as doctors. So if you're friend is showing the medical school that they are not as interested in that side of medicine (the vocational course to train as a doctor) then I'm not really suprised they rejected him. Why would they spend all that money to train them if they don't think they'll work there as a doctor at the end of it all?
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nexttime
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(Original post by Mauka Chauka)
An older friend of mine applied to medicine and in the interviews said he was mostly interested in the research side of medicine. He says this is the reason why he wasn't accepted to medicine.

This got me thinking what are medical schools trying to achieve: are they trying to form the UK's future doctor so that work only in hospitals; or could they be trying to form the best doctor possible, who works in whatever field and whichever country he wants?
I too doubt his rejection was as black and white as that, if research interest was even a factor at all.

Honestly med school has a degree of autonomy as to the details of their goals. They have to produce doctors who can work in the NHS as a first year doctor of course, but that's probably not too onerous a task. Certainly all the preclinical stuff could probably be cut in its entirety if that were the only aim

So what are the other aims? To produce good future consultants should certainly be one. To produce good teachers, maybe. Good leaders and managers... feels like that's less so but no less valid an aim. And yes good researchers, including both lab research but also clinical research, and evidence interpretation. You can't be a good doctor, without being very familiar with at least research interpretation, I would argue.

The balance of the above will vary by med school, in both the course and in theory be matched by admissions criteria. Though it's of note that medical admissions is often not exactly well resourced and your interviewers may have had one short PowerPoint presentation to read before interviewing real candidates, something they may well be doing for free so not exactly loads of prep time to even read said slides.
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black tea
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(Original post by Mauka Chauka)
This got me thinking what are medical schools trying to achieve: are they trying to form the UK's future doctor so that work only in hospitals; or could they be trying to form the best doctor possible, who works in whatever field and whichever country he wants?
Why on earth would UK medical schools aim to create doctors that are then going to move away to a different country?!
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asif007
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(Original post by black tea)
Why on earth would UK medical schools aim to create doctors that are then going to move away to a different country?!
So do you think graduates of UK medical schools should be forced into serving a minimum number of years in the NHS because their degrees were subsidised by the taxpayer? As in, exactly what Jeremy Hunt was proposing a few years ago?
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black tea
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(Original post by asif007)
So do you think graduates of UK medical schools should be forced into serving a minimum number of years in the NHS because their degrees were subsidised by the taxpayer? As in, exactly what Jeremy Hunt was proposing a few years ago?
I don't necessarily think it's a bad idea. But not everyone who does a medical degree then goes on to become a doctor and I don't think it would be fair to make those people work for a certain number of years before allowing them to quit. And then there's the issue of international students - I know they pay much higher fees, but do those cover the entire cost of their training?

Either way, I think British medical schools should be aiming to produce doctors that are suited to work in the British healthcare system first and foremost.
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ecolier
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(Original post by black tea)
...But not everyone who does a medical degree then goes on to become a doctor
I think the vast, vast majority of graduating final year medical students will go on to work as an FY1 doctor.

...And then there's the issue of international students - I know they pay much higher fees, but do those cover the entire cost of their training
Well we know that the government subsidises £163,000 per home medical student. Training a med student costs ~ £230,000 and the ~ £67,000 is "paid" by the student via loans and tuition fees.

So it's actually quite easy to work out that for most UK med schools, fees of ~ £40,000 per year will cover it.

Here are some example international medical student fees:

Buckingham charges £37,500 per year + inflation.

Brunel's fees are £40,000 per year exactly.

Edinburgh charges ~ £32,000 per year for the first 3 years, and then ~ £50,000 per year for the last 3 (clinical phase).

Cambridge charges > £60,000 per year (including college fees).

The vast majority of med schools will therefore recoup their fees (and indeed international students are so lucrative for them that the government has to set a limit on them, otherwise they may end up taking all international students :lol: )
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edavey103
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(Original post by asif007)
So do you think graduates of UK medical schools should be forced into serving a minimum number of years in the NHS because their degrees were subsidised by the taxpayer? As in, exactly what Jeremy Hunt was proposing a few years ago?
I'm sure there are a lot of problems with this idea as black tea said and I think anything compulsory like that is always going to create tension. I know Wales covers the fees of some other health profressionals in return for them working there for however many years after they graduate and I think that is completely fair. However, because we do have to pay for our fees the idea you suggested, I think, is unfair. But I can completely see how it would be in a medical school's interest to train someone who is interested in working as a doctor in their region post graduating compared to someone who's happy to get their degree then swan off without a second look you know
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black tea
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(Original post by ecolier)
I think the vast, vast majority of graduating final year medical students will go on to work as an FY1 doctor.



Well we know that the government subsidises £163,000 per home medical student. Training a med student costs ~ £230,000 and the ~ £67,000 is "paid" by the student via loans and tuition fees.

So it's actually quite easy to work out that for most UK med schools, fees of ~ £40,000 per year will cover it.

Here are some example international medical student fees:

Buckingham charges £37,500 per year + inflation.

Brunel's fees are £40,000 per year exactly.

Edinburgh charges ~ £32,000 per year for the first 3 years, and then ~ £50,000 per year for the last 3 (clinical phase).

Cambridge charges > £60,000 per year (including college fees).

The vast majority of med schools will therefore recoup their fees (and indeed international students are so lucrative for them that the government has to set a limit on them, otherwise they may end up taking all international students :lol: )
OK, fair enough, international students are not an issue then haha

I know most people do become doctors but there are those who are really miserable at uni and realise medicine is not for them and it wouldn't be fair or good for their mental health (and potentially not safe for patients) if they are made to work for X years before they can quit...
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edavey103
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(Original post by asif007)
So do you think graduates of UK medical schools should be forced into serving a minimum number of years in the NHS because their degrees were subsidised by the taxpayer? As in, exactly what Jeremy Hunt was proposing a few years ago?
I personally also think that medical schools should prioritise giving places to those who's moral values align with those of the concept of the NHS. So many of the decisions made in the privatization of health care are, sadly, endorsed by some doctors in decision making positions. If you're being trained in the UK as a doctor you should believe in the NHS and want to work to improve it, from the view of patient care being the main priority and understanding how important it is as a system for the care of all patients.
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ecolier
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(Original post by black tea)
...I know most people do become doctors but there are those who are really miserable at uni and realise medicine is not for them and it wouldn't be fair or good for their mental health (and potentially not safe for patients) if they are made to work for X years before they can quit...
Oh sure, of course.

To play Devil's Advocate, couldn't we just prevent people from working as doctors overseas? They are very welcome to leave the profession but just can't work in a doctor capacity elsewhere?

P.S. As someone in the trade union, I voted, protested and campaigned against Jeremy Hunt's plans to force doctors to work in the NHS for four years when the plan was (briefly) touted. So I am very very much against it, but just wanted to see what your views are.

P.P.S. Many med schools in Europe integrate the "internship" i.e. the FY1 year into the course (unpaid, of course). The government could have done that if they wanted to...
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edavey103
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(Original post by black tea)
OK, fair enough, international students are not an issue then haha

I know most people do become doctors but there are those who are really miserable at uni and realise medicine is not for them and it wouldn't be fair or good for their mental health (and potentially not safe for patients) if they are made to work for X years before they can quit...
Especially for people who are sadly forced into medicine as school leavers and only realise at a later date how the career doesn't suit them
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nexttime
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(Original post by black tea)
OK, fair enough, international students are not an issue then haha

I know most people do become doctors but there are those who are really miserable at uni and realise medicine is not for them and it wouldn't be fair or good for their mental health (and potentially not safe for patients) if they are made to work for X years before they can quit...
For me, the two main arguments are:
1) it would be so unfair on those who realise they don't like medicine (like you say) - not being able to quite else you are 'fined' >£150,000 is very very much akin to indentured servitude, and
2) currently the NHS is a monopoly and in many ways treats its transient temporary employees (i.e. junior doctors) like absolute ****, but there is still a line there - ultimately if they push them too far they can either move elsewhere or quit medicine. If you take that away, literally giving them slave labour to play with... I'd be seriously fearful for what might happen to working conditions with no safeguards at all. Not immediately, but in 10, 20 years time.
(Original post by ecolier)
Well we know that the government subsidises £163,000 per home medical student. Training a med student costs ~ £230,000 and the ~ £67,000 is "paid" by the student via loans and tuition fe
I mean, we've been through this before but I really don't think this is accurate. Yes, its the official figures, but what that actually represents is amounts of money that change hands due to historical agreements, not actual costs. It works out as £220 per medical student per day on a clinical placement, in addition to what the uni is paid. Five med students nets £5500 per week.

We have 5 med students on the ward at the moment. They get 1 hour with a consultant as a one off at induction, ~2 hours SpR teaching per week, they stand in the background of ward rounds and clinics, perhaps occupying, I dunno, 2 further hours of doctor time if we're generous? And.... that's it. And I don't think that's abnormal? That does not cost £5500.

Now you might argue that its worth £5000, in that some people might be willing to pay that. But that's not its cost, which is surely the relevant term here.

I reckon the actual cost is a fifth of that widely quoted figure. And if you consider that med students are occasionally helpful, and that many doctors actively enjoy teaching and actually would be willing to do it for free, arguably the actual cost is significantly less than even that.

Honestly I think that figure is widely promoted, purely as a way to slur doctors.
(Original post by edavey103)
I personally also think that medical schools should prioritise giving places to those who's moral values align with those of the concept of the NHS. So many of the decisions made in the privatization of health care are, sadly, endorsed by some doctors in decision making positions. If you're being trained in the UK as a doctor you should believe in the NHS and want to work to improve it, from the view of patient care being the main priority and understanding how important it is as a system for the care of all patients.
I mean... to an extent. If you said you were only going to admit people who were completely against healthcare privatisation in any form and who must be in favour of keeping the NHS exactly as it is no matter what, you have clearly gone way too far.

But having core ethical positions as a selection criteria i definitely reasonable, and widely done.
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ecolier
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(Original post by nexttime)
...Honestly I think that figure is widely promoted, purely as a way to slur doctors...
I mean it's been fact checked, so I'm going to stick to it unless you can find a better source?

https://fullfact.org/health/cost-training-doctor/

The £230,000 estimate can be broken down into approximately:

  1. £163,000 paid in grants that the government won’t get back. These either go directly to students, to healthcare providers to support clinical placements, or to universities to reflect the higher costs of delivering medical education.
  2. Another £64,300 comes in student loans. These are similar to loans for other kinds of university courses, covering tuition and living costs.
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black tea
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(Original post by ecolier)
Oh sure, of course.

To play Devil's Advocate, couldn't we just prevent people from working as doctors overseas? They are very welcome to leave the profession but just can't work in a doctor capacity elsewhere?

P.S. As someone in the trade union, I voted, protested and campaigned against Jeremy Hunt's plans to force doctors to work in the NHS for four years when the plan was (briefly) touted. So I am very very much against it, but just wanted to see what your views are.

P.P.S. Many med schools in Europe integrate the "internship" i.e. the FY1 year into the course (unpaid, of course). The government could have done that if they wanted to...

I don't think it would be fair to stop doctors from working oversees - they are not property of the NHS or the government, they are individuals with lives who should be able to have as much choice as an an individual on any other profession ( I have a feeling there might have been a thread about this on here a few months ago?)

Why are you so against it, out of interest?

I guess the government could have done that, but I can't imagine that just one year would repay the £163,000 that the government subsidises!
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ecolier
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(Original post by black tea)
...Why are you so against it, out of interest
As you said, doctors should have the right to work wherever and for whoever they want.


I guess the government could have done that, but I can't imagine that just one year would repay the £163,000 that the government subsidises!
Even one year would make a significant dent into this, if the government doesn't have to pay their wages and "forces" them to work that year in the NHS.
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