Its quite possible for those with A* predictions to stuff-up UKCAT, not produce a particularly good PS, not have enough work experience, or the right attitudes/qualities, or just fail an interview. And Unis know that just 'being clever' doesn't always make you a good doctor - so they are looking for far more than just A* grades. And btw, it doesn't matter where you train as a doctor. Make sure you spread your 4 choices, and include some less 'glamorous' choices. It isnt a vanity context, and it certainly isnt 'first one to get an offer from Imperial is the winner'.