Medicine and engineering

Hey i am in year 11 and for my alevels i have chosen maths physics and chemistry and further maths to do engineering , but i really dont want to do further maths as 4 alevels is just way to much for me and also i dont do it for gcse and ny collage wont let me drop it in the middle of the year . So if i pick just maths physics and chemistry than i would be able to go to a mediocre university, however if i did maths chemistry and biology i could do medicine at a higher level university a russel group for example . I like both bio and physics , though i an better at biology , but medicine is very long and also very isolated as you cant get a different degree easily after , also moving to another country is also difficult due to laws - for example the usa where you would have to study 3-6 years more even after you are fully qualified in the uk . But engineering wont be like that as it’s accepted in most places . If i was to do medicine i would 100% do dermatology as its very high paying and im also very passionate about skincare and the skin . However , engineers have more flexibility as i can do finance if i dont enjoy it and move countries more freely , also my main goal is a good income, so engineering sounds more appealing-but more risky in terms of salary . What should i do for alevels and wich courses does anyone recommend? Bio or physics ?

You don't need FM for the vast majority of engineering courses. I don't even think it's technically required for Oxbridge or Imperial.
You don't need biology to do medicine - only about 1/3 of medical schools erquier A-level Biology. Chem/Phys/Maths will let you apply to most medical schools.
You shouldn't plan for a single specialty at the outset when applying to medicine really. You will need to study the whole range of medicine in medical school for 5-6 years (and often many specialties have very limited coverage in the medical school curriculum), then work across the whole of medicine for at least 2 years as a foundation doctor. For dermatology specifically you'd then need to work across the whole of medicine for another 2 years before specialising in dermatology. So that's 9-10 years of "all of medicine" before you start specialising in dermatology - if you're only interested in dermatology, you may find it hard to get through that without burning out.
Also, dermatologists don't earn more than other doctors working in the NHS, all NHS doctors regardless of specialty are paid according to the same pay scheme (differences tend to arise due to out of hours commitments which I don't think are very heavy in dermatology). While there may be scope to earn a lot in private practice, this will a) only occur after you become a consultant and b) is dependent on a lot of factors (e.g. location, networking, your own entrepreneurial/business skills, etc).
Finally I'd note engineers can very well earn a good salary in the UK. If you think anything less than 6 figures is a "bad" salary then that's a you problem - because the reality is most people earn less than 6 figures and many can and do live very comfortably. If you consider e.g. a starting graduate salary below 40k "bad" for example, you may need to manage your expectations and gain a better understanding of the relative value of money. Also bear in mind salary is not the be all and end all and quality of life, work life balance, and less tangible benefits including e.g. pension schemes, flexible working opportunities, maternity/paternity cover, etc, are just as important although persistently ignored by school leavers.

So which should I really do i am so stressed , my mum says doctor as it suits me the best and my dad says engineering as he thinks I’ll enjoy it. My best subject is biology and maths and i like them both , so its really just between medicine and engineering? Which one is more flexible , and how do I know which one i would like and is better for me , i dont really have any time to go and do work experience right now , however i worked in a pharmacy for a week and didnt really enjoy it as i had to stand up all day and was very drained and tired when i got home from talking to so many sick people , it was very fun as i like talking but very hard and exhausting. I havent done any work to do with engineering and im scared that not being like amazing at maths can bring me down as im much more confident in science . I would rather be doing the UCAT than the PAT , as im currently in a course at COMPOS that is about physics and maths and has those PAT style questions- and i wont lie i struggle alot with them . However i would much prefer working in an office in the city than in a hospital . Which one is best for me i have no idea and i have no passion

You don't need to choose between them currently at all.
You can do maths/chem/physics and make a decision later towards the end of year 12/in the summer before year 13 - once you've done some medical work experience and have a better sense of whether you want to work in a healthcare environment.
That said everything you've said suggests medicine is not something you're really keen on and you seem to be just picking it up from parental interference. You've only expressed interest in one specific area of medicine (based on not really accurate reasoning about remuneration, which even if accurate isn't a good reason to commit to a vocation like medicine without some other motivating factor e.g. actually being interested in patient care and relationships with patients), what limited exposure to healthcare adjacent work you've done you've said you didn't enjoy, and you've stated you'd rather work in an office based environment anyway.
However as above, you don't need to make this decision now because biology is unequivocally not required to do medicine so you can just pick your subjects as above if that's aligned with your other interests and do some further work experience in a caring role towards the end of year 12/the summer before year 13 and make a decision on that basis.

Thank you i think i will do just that but do you know if further maths would be good if u chose engineering?? I really dont want to do it but so many universitys prefer people who do it , i have chosen it but scared i cant handle 4 alevels and im not that keen in maths anyways . Im scared it will limit my chances of getting into a russel group in the future - but if i pick medicine - maths bio chem are all subjects i enjoy so im super confident i can do really well in them - making my chances better for medicine in a russel group uni - i know degrees like economics and medicine really rely on the university to get better job opportunities, would engineering be like this ??