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Dear Future Doctors- an open letter to all students considering an application to medical school.

Rochester Independent College students are celebrating a record year for medical school placement with nine students winning places at UK universities including Southampton, Sheffield and Exeter. Hassan Khan joined RIC in 2017 for a one year GCSE course from an international school in Saudi Arabia. He completed his A levels in the RIC sixth form and has a place at UCL’s medical school, currently ranked 8th in the world by the QS World University Rankings. In this letter to potential future doctors he reflects candidly on his journey to medical school and the vicissitudes of the application process, offering useful advice to anyone considering following this path.

Dear Potential Medic,

Why medicine? An infamous question laid down upon by tight-lipped, fake smiling interviewers on almost all nervous, sweating, stuttering potential medics on interview day. But I ask you as a student, and as someone who truly values your health… Seriously, why medicine? Why are you doing this to yourself?

There are 23,000 medical applicants (figures from 2019 onwards) that apply each year on average, while only 7,500 places are available in the 33 universities across the UK, which means if 4 of you are applying, only one of you is getting in. Yes, it’s fiercely competitive. If you are offered a place, you do know you are willingly giving up a decade of your life to just learn, LEARN, to practice as a GP, with a possible 6 more years if you are looking into becoming a specialist consultant. That’s now almost your whole life till your thirties dedicated to learning. Your education begins with 4-6 years as a university student, which comes with various challenges. One obstacle that is less obvious than others is that the course itself might not even suit you; 1.8% of medical applicants in the UK (according to figures provided in 2014),that pushed through the vigorous application process (more on this later), drop out in the first year, due to not enjoying the course or even just changing their minds on a degree in medicine. If you do start med school, it means you will have to be carefully budgeting, while balancing out your blossoming social life (well, for me my bed and about 17 Reese’s Cups is the perfect night out) and your time spent in academia, all while starting to learn to be independent financially, which is truly an overall huge shift in independence from our A-Level years. After your time at university, the 2 Foundation Years will commence, which follow with gruelling 48 hour shifts a week as a junior doctor (for the next few years), for a yearly income that progresses from £23,000 to £28,000, which is barely enough to cover even a scrap of the mass of student loans you borrowed for your time at university (on average it takes 10 years to pay back your med school loans.)

On top of these initial financial difficulties, as you progress with your junior doctor training, you will more often than not have to work unpaid overtime hours, which is largely due to the huge understaffing in our NHS. In fact, a survey carried out by UNISON showed that 70% of NHS members were not paid when working over their shift, and 77% said that they were not satisfied at all with their pay in general (take a moment to appreciate the bulletproof sheer will of our healthcare workers, to continue to provide such essential services). If you are promoted to working and running ward rounds, know that pushing through days and achieving goals as a team has increasingly become more difficult, as promises to mend our NHS through sufficient funding (which would have provided us with more beds, vital equipment and nurses) are being broken or not being adequately fulfilled by our government, which makes it harder for us to meet the healthcare demands of an ageing and increasing population. Therefore, us potential and current NHS members will have to bear the brunt of cruel statistics; like only 81.4% of A&E patients been seen within the maximum 4 hour waiting time in December 2019 (the worst month since the 4 hour time-target was created in 2004) or that due to our shortages of beds in A&E and shortage of healthcare workers, a four year old Jack Williment last year had to sleep on the floor during a long chaotic EIGHT-hour wait period in order to be seen and diagnosed with Influenza A and tonsillitis. Imagine the anxiousness etched into his mother’s face, and her not being able to do anything but wait those agonizingly long hours till her Jack could be seen. These are not the only stories healthcare workers will be burdened with - do not forget, as of the time this is being written in 2020, we are going to be facing tougher and more demanding winters due to the pressure Covid-19 will force onto our NHS, and already with our lack of vital equipment and apparatus, there are going to be some scary and unforeseeable years to face, with potentially hundreds of more Jack Williments lying on cold floors waiting to be given beds that me and you simply can’t provide.

What, you’re still here? Impressive. See, these aren’t the cold truths and hard realities that we are used to hearing about what being a doctor is like, in contrast to the glamorous rich soap-opera doctor lives we are brainwashed with (I’m looking at you Debbie Allen). I do believe if you have started this sentence, having already firmed yourself with these horrible statistics and possible tribulations being a doctor in the NHS will face, you have already found or are looking for, what I like to call, The “WHY”. That real almost tangible feeling of purpose - where you just know you want to be that doctor. This feeling could have come from a moment in your work experience at your local care home or when you witnessed an A&E consultant quite literally saving your family member’s life in front of you. It is a strong sensation that I can’t explain, but almost surely share with you. Your “WHY” will get you through the countless hardships doctors and medical students might face; the hair-tearing, chest-constricting STRESS of becoming and being a doctor becomes easier to face and deal with, and with the NHS and universities bringing a lot more focus to mental health, we will hopefully have the essential support we need. You know, I hate using clichés, but an avid Grey’s Anatomy viewer should be aware of the true realities doctors live in, and for those who have their “WHY” will know being a doctor goes deeper than the expensive watches and the designer handbags.

It’s the chase of the wide breadth of knowledge medical professionals have collected and shared as our species evolved intellectually, the countless chances to unravel the unexplored complexities of the human body, the genuine warm feeling that spreads through your body when you are able to alleviate someone from misery and pain, while forming real connections with the patients you work with. You will have your own “WHY”, and that was mine. I discovered I wanted to apply to medicine and become a doctor in the summer of my Year 12, I will not go into the fine details, but it was not something that I wanted to do for a long time (another cliché, please don’t say “since forever” when someone asks you how long you wanted to be a doctor, you did not come out of the womb wanting to do the UCAT), and this new interest was ignited after an emotional experience I had when volunteering, which I then actually wrote about in my personal statement (more on this later). I had no idea I wanted to apply to do medicine when I was volunteering, but after that experience, I researched for weeks into different healthcare professions and the parts they play in various multidisciplinary teams across many healthcare settings, and finally decided being a doctor was a profession most suited to me.

See, being a nurse, a psychologist or a doctor are all equally important pieces that make up our healthcare system, and they all interact and share information together to deliver the most holistic approach to healthcare for our patients. So I ask you, why not become a nurse instead? They actually do most of the work in our wards, and in fact form deeper connections with our patients, as doctors usually carry out more final decisions, while nurses work more hectic hours during the day for patients; feeding them, cleaning them and looking after them. You need to make sure you are aware of the differences in the services healthcare professionals provide, and why being a doctor is most suited to you.

I remember dedicating time every day to look into various ethical situations doctors might encounter (like whether we should carry out blood transfusions for a Jehovah Witness in A&E) or how new innovative treatment options scientists in Japan are using to cure cancer, or that there are actually 36 different reasons dementia can arise in patients. It has become part of my daily routine to learn and read more about the medical world. Why not take out 20 minutes a day reading an article or two when you can, it could really help you find certain passions, and will then allow you to come across more genuine when talking about fields of medicine you would be interested in on interview day, or just about medicine in general. But of course, before our interviews, we have to deal with our beloved UCATs, BMATs, and personal statements don’t we.

I thought maybe you would like an insight into what applying to medicine was like at RIC, and maybe I can give you small pieces of advice on applying, from a student’s perspective, who has gone through exactly what you’re going to put yourself through.

Here at RIC, I had to balance my BMAT and UCAT preparation (yes I did both, yes it was horrible, yes it was worth it) with the new Year-13 workload I was being given, alongside the 15th October personal-statement deadline looming ahead. Getting used to the sudden shift in gear in the beginning of Year-13 was difficult, but to be honest with you, I had received a lot of support from various sources at school and elsewhere, which helped ease me more into “work-mode” after a long, reflective and rather lazy summer. I remember my Biology teacher, Katharine, giving me personal statement advice at 10:16 pm on a Friday, where she usually had free after long hours of teaching our snobby, moaning class (we appreciate you Katharine), and it was help like that which really allowed me to deal with the constant deadlines and tasks I was burdened with in the first two months of sixth form.

The most difficult obstacles to get through during those two months of year 13 were my aptitude tests, and the reason I took both was so I could apply to UCL, Imperial, Bristol and St. George’s; which are all medical schools that require a mix of the UCAT and the BMAT (you can look up the specific requirements for each university online). Yes, I chose mostly London universities, but I had fallen in love with the city; Tate Modern, the fashion weeks, the cafes, the diversity and the hustle and bustle. I just loved the thought of being a doctor in the non-stop, always-awake metropolis that is London. Location is an important part of the application process; do you want to get out of the city for your time to study, or maybe stay near your family? Think about it, as you will be spending 5-6 years learning and living there. I applied to Bristol just in case I would have not received a place from the London schools, but I was rejected after the interview. Whatever, the coffee at the bus station was cold, but not as cold as their interviewers.

My main advice to you when it comes to the aptitude tests is simple, DO NOT OVER-PRACTICE. It is a measurement of how well you can cope under timed pressure when given masses of information to sift through and deduce, not to see how well you have practiced over your 2 month summer. Now, that doesn’t mean I didn’t practice, I did, but just a few weeks before the UCAT (October 1st for me), and around 2-3 weeks before the BMAT (November 1st), just to get a feel for the timing of the questions. This was more than enough for me to secure interviews at UCL, St.George’s and Bristol (I will talk more about interviews). I was rejected from Imperial as I didn’t make the cut off for section 1 of the BMAT, but as my personal tutor, Tom, and I had strategically selected universities to apply to, we also applied to UCL as it did not have a pre-set “cut-off” for the BMAT. I had done well enough in the BMAT to have received an offer for an interview in March, and I believe it was my Section 3’s impressive (relative to the abomination that was my Section 1) score on the essay that secured me that interview place. I was particularly good with Section 3 and 2, but you may be a lot more adept at Section 1, which leads me to another key piece of advice; when you are practicing for your aptitude tests, focus on your weaknesses not your strengths. Say you’re particularly good at juggling numbers in your head and spotting patterns in shapes (which is something I found I was a lot better at than I thought), then practice more on the Verbal Reasoning section and Situational Judgment tests when revising for your UCAT. This means you can polish yourself overall, which will help you achieve a higher overall score (don’t sit there getting all the abstract questions right no matter how satisfying). One last point on the aptitude tests; don’t just use one website to practice on, but pick a combination of sources you like (books, websites, etc.), which allows a larger breadth of difficulty in questions. This makes your revision time a lot more efficient. When preparing for both tests, I used Medic Portal and Medify; the former as the questions were harder, and the latter because the website was more user-interactive. It is up to you how you want to practice.

After aptitude tests (or in between in my case) I had written my personal statement as well. This is something I quite enjoyed actually, as putting down, in words, my love for the future I was chasing, and the knowledge I was gaining, was quite appealing for me. I found it a little stressful to keep perfecting the drafts, but I enjoyed it, and I was lucky to have the linguistic support from Tom, Katharine, and Alistair (our cool-family-BBQ-principal) to guide me through the best personal statement I could write. What I learnt from them was something I will always remember when writing something like a personal statement or a piece on what applying and getting into a medical degree is about; and it was to write it in a way that screamed ME. See, I told you I hate clichés (last one), but seriously, be yourself. Write your personal statement in a tone you feel comfortable with, whether it is densely filled with fancy medical jargon, or written entirely as a metaphor - it is whatever you feel really encapsulates you as an entirety, because it is YOU that the interviewers at your favourite university are looking for.

After you get those wonderful aptitude test results back, you would be approved for interviews at the universities where you had met the cut-off for the specific tests, whether it was the UCAT or BMAT required. I attended 2 MMI’s, my first at Bristol and my second at St.George’s. My panel interview was with UCL over a Zoom call actually, as universities had closed down due to Covid-19 around February-March time. I had prepared thoroughly for my Bristol interview, as in I spent FOUR hours a day for a few weeks on article reading and potential interview questions (I used a book by iSCMEDICAL called Medical School Interviews), only to be rejected. This was very disheartening, as it was my first interview, so I was afraid there would be a domino effect, and all my future interviews would be failures too. So I decided to switch it up and take a huge risk; I didn’t revise at all for my St.George’s interview. I wore the same clothes I had worn for Bristol, and ate the same breakfast (I had controlled the other variables, you Biology students will feel the pain in those words) and I went to my interview on a Friday, and got a conditional offer the Monday following. I was shocked. What I realised was that they are looking for ME. Can you believe it? So, they DON’T want a regurgitating, lobotomised moron who knows all about the government that built the NHS, but someone who can express genuine interests? My advice here is, yes, again, be yourself (technically the same cliché). Of course, it helps to have some knowledge of the NHS, and a few facts on scientists and important figures in medical history, but what I didn’t realise, is that it was the 20 minutes I took during the day, reading in the morning on the bus to school, or in the toilet instead of scrolling through my Instagram, was all the information I needed. No, bathroom reading didn’t get me through a medical school interview, but I was passionate about being a doctor and I had strong interests in certain fields of knowledge already, so I didn’t need to spend so much time learning random facts, but to be confident enough to speak about the stuff I loved already, like a book I had read on Alzheimer’s, that I bought up not once at St.George’s, but twice with UCL as well. So, take out the time to read something fascinating within the huge scientific medical universe of knowledge we have embedded in our tiny little smartphones when you’re bored, you never know, you might bring it up in an interview that might secure a foundation to your future.

Fast-forward 4 uncertain, murky and upsetting months of lockdown, and I have luckily received the grades I needed; in Biology, Chemistry and Maths A-Level, to secure a place at UCL Medical School - one of the most prominent universities in the world (I gave an imaginary crowd a “thank-you”-Oscar-winning speech in my shower on results day). I am grateful to the teachers at RIC, who genuinely cared about my progress (Katharine, Jon, Tom, Sophie, Magic Michael, Dave, Cool Constantine, Alistair), and to the few, good friends I had for making me smile when I was buckling under the stress. Becoming a doctor, and having the chance to fulfil my “WHY” is something I am very grateful to have, and was a bright moment that shone through the dark 4 months that have passed.

Now, why medicine? I want you to feel comfortable, and relaxed when answering this, whether it is to yourself in the mirror, or to a friend or to your interviewer. I want you to put into the words the hours of pondering, researching and reflecting you have done, and to allow that strong rush of passion to coat your answer when describing the future as a doctor that you see. I want you to find a “WHY”, and to believe in it, because it is a long, stretching road up ahead, and the NHS would really appreciate a strong-willed, intelligent doctor that you might become. Do not dwell on little dips, but move on and learn from them. I wish you the best, and please, be ready to treat me for engulfing 17 Reese’s Cups a day.

Good luck,

Hassan.

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