Medical School Application Advice: a Sharp Guide Written by a Cambridge Medical Student

Robert Cronshaw, a Medical student at Jesus College, Cambridge, offers sharp advice for ambitious medical school applicants.

So you’ve decided to study medicine — congratulations.

You’ve chosen a course with brilliant opportunities to challenge yourself, learn about the mechanisms that allow the human body to function from a molecular level all the way up to entire systems and, most importantly, a course that will teach you how to apply this knowledge in the real-world scenario of helping those who are unwell. The problem is – there are many, many other people who have come to the same conclusion about this fascinating and valuable course, and most of them will have outstanding grades as well.

Prepare for stiff competition

You are not the only person who finds the idea of studying medicine appealing, and every year there is a huge discrepancy between the number of people applying and the number of people who are offered a place. In the UK, in 2012 only 7,800 places were offered for medicine, compared to 16,100 for psychology and 9,400 for sports and exercise science.
Things get even more competitive when looking at top universities, such as Oxford or Cambridge, where out of the 1535 applicants, 277 people received offers (or 18% of applicants). Of course, this is probably old news to you. Teachers, parents, siblings and anyone else who can has probably been attempting to give you as much advice as possible. Unfortunately there is no single piece of advice that they, or anyone else, can give you that will guarantee success in medical applications and this is so important it bears repeating: there is no “magic bullet” or secret tip for succeeding in applications.

Having said this, there certainly is useful advice for applying to medicine and I believe that while my approach cannot guarantee success it will certainly improve the odds of success.

A strategic tip to improve your chances

My tip is based on a similar philosophy used by top athletes such as those involved in British Cycling. It is summarised neatly by the phrase “the aggregation of marginal gains,” which I will attempt to describe here, but will doubtless become more clear throughout the course of the article as well.
The idea behind this is that at every step of your application, every paragraph of your personal statement, you want to be one step ahead of the majority of applicants. It doesn’t mean that you have to say something amazing or profound, simply that in every area you need to be a little bit better than everyone else. These are the “marginal gains” which the phrase refers to. The “aggregation” of these is simply describing these small gains coming together to create a large advantage when admissions tutors sit down to decide whom to make offers to.
I will attempt to break down the application process into a series of smaller parts so that each can be analysed in detail and any potential “gains” in each of these areas can be drawn out and made the most of.

The personal statement

Perhaps the most daunting task of applying is the personal statement, so this is where I will start. I can recall very well sitting down in front of my computer staring at a blank word document and despairing. “If I can’t even write the first sentence, how on earth will I be able to write a whole page?”. In fact you will soon discover that it is remarkably easy to fill the word limit of the personal statement and that it is much more important to be efficient with what you say.
Despite this, don’t try to be too distinctive. You may have heard weird stories, especially about intervieiws, which I will discuss shortly, but remember that we are not trying for a magic bullet approach and instead we are trying to do something similar to most other applicants, only better. If you are struggling for an opening line perhaps consider why you want to study medicine or why you think you would be a good applicant. Please do not write “I have always wanted to study medicine since I was young”. Not only is this a huge cliché (featuring in 3 out of the top 5 places of the most overused opening lines of personal statements), but it adds nothing to your personal statement. As I mentioned, the length limit for your personal statement is not very long and so you have to always be thinking in the back of your mind while writing “What does this add? Why will this make an admissions tutor look more favourably on my application?”. Remember, even at this stage you’re trying to make gains over competing candidates.
So having told you what not to write it is probably useful to consider what is worth saying, what admissions tutors say they like to see in a personal statement. Obviously they are all individuals and as individuals they are going to vary in precisely what they like to see, but there are certain general points. They are also meant to be selecting in accordance with the GMC’s document “Tomorrow’s Doctors” which outlines some of the selection points and traits that they wish to see in future doctors. I have also put in some very general points that you should address in your personal statement. The first of these is that you must have demonstrated a commitment to medicine and shown you are keen enough to last the course. The most important way of doing this is through work experience, but no, you don’t have to spend two weeks shadowing a brain surgeon.

Medical work experience

Volunteering once a week in a care home is actually likely to be more useful, as it shows both a commitment to medicine and a commitment to caring for patients, both of which are key. As mentioned above you must be committed enough to make it through a long and challenging course which can sometimes have a substantial workload and also it is important to be commited to care so that when you qualify as a doctor you are genuinely interested in helping patients.
Now, let us consider how we can get ahead of other candidates in this area so that we are always picking up extra points throughout our application. Most people will try to talk up how much they enjoyed their work experience and caring for peple so that they seem like they would be a nice and caring doctor and this is very important, up to a point. However, in volunteer work as in pretty much all aspects of life not everything will go perfectly and you will come across as a lot more mature and considered if you also reflect upon the parts which you perhaps enjoyed less or found challenging, but then weigh the positives against the negatives and say how you still enjoyed it overall. It is very easy to tell when someone is being overly positive about their work experience and it’s likely to make an admissions tutor simply distrust everything you tell them about it.

The science of being a doctor

Medicine is not all about commitment, however, and another point to consider is that at least initially you will be learning a great deal of science in order to back up the future clinical skills you will learn. As one lecturer put it “We are teaching you to be engineers, not simply mechanics” and I think this is a very neat way of putting things. A mechanic can diagnose a fault in a car and knows what part to replace in order to fix it, but an engineer will understand why. They will know why it makes the presenting sign of the fault, they will know why that part has failed and perhaps they can use this knowledge to design a way to prevent this fault from occuring again.
Therefore it is important in your personal statement to demonstrate an interest in medical science. How much you focus on this will depend both on how interested you are and also where you are applying to, as the very traditional universities (Oxford and Cambridge) have a very science-driven course. One of the very important ways of demonstrating scientific interest is through extra reading about particular areas you are interested in. This does not necessarily have to be huge undergraduate-level textbooks or research papers, but can take the form of a pop science book that you liked the look of.
This is something that a lot of applicants will do, however, so we need to consider how to impress more than them in this area. One way to do this is simply by following your interests a little further: if a chapter in a book really interests you, go out and find more about it. Search it on Wikipedia, find a relevant research paper or even ask a teacher if they could point you in the direction of more relevant reading. This will set you well apart from the main body of candidates who will simply read the book and write that they found it interesting; if you can show your interest through your actions then it will be a lot more convincing.

Extra-curricular activities

The final part of the personal statement to consider is perhaps the most contentious part: extra-curricular activities. Some people will tell you not to bother talking about them and save the valuable space for talking more about your scientific interests and why you want to study medicine. I would say it is pretty much vital to devote a reasonable portion of your personal statement to activities outside of working. Why? If you don’t, whoever is reading your personal statement will probably assume that you don’t have any to talk about.
Remember when choosing whom to accept for medicine you are not only choosing a student, you’re also choosing a person to become a doctor. If you give the impression that all you ever do is sit in your room reading books about science you’re going to create a preconception of yourself that will work against you. By talking about extra-curricular activities you can also talk about the skills you’ve gained from doing them and in order to really get ahead of the rest of the pack, talk about why those skills would be relevant as a medical student or a practising doctor. While it may at first seem difficult to come up with ideas for exactly what skills you’ve learned, there is virtually no activity that will not provide useful skills. For example if you play on a football team you will have learned how to communicate effectively and concisely with the rest of your team, how to work well within a team (sometimes taking a leading role, sometimes hanging back to allow others the opportunity to use their specific skills) or even to respond to feedback (from a coach or a captain) and use it to make a positive change.

BMAT and UKCAT tests

I will discuss the interview process shortly, but first it is worth mentioning the two admissions tests that are taken for medicine. These are the UKCAT and the BMAT and there is a plethora of information about their format on the internet. The most important thing I will say about these is that you must practise for them. If you believe what you read on their websites you will be led to believe that you will get the same mark in these tests regardless of your experience of them. This is simply not true. If you are experienced with the format you will know how long you have to answer each question, you will know what bits of information to look for in each question to answer it and you will have experienced similar calculations or processes in the practice questions you’ve done. It is relatively easy to maximise your score in these tests, there are practice books out there with questions which will step you through how to answer them.
If, unfortunately, you don’t do very well it is not a disaster. In the case of the BMAT you will have already applied, so you must hope that it is not weighted too strongly, but if you do badly in the UKCAT you can mitigate your losses by careful selection of where you apply to. Certain universities such as Sheffield were part of the group that originally designed the UKCAT and therefore will tend to place a lot more weight on your score, whereas many other universities are a lot more sceptical of its ability to predict good students. It is worth looking at the Wikipedia article on the UKCAT as there is a discussion of which universities will be more interested in your score and which do not value the UKCAT as highly. Conversely, if you’ve done very well in it then you will be doing yourself a favour by applying to one of these institutions as you will be maximising your success. Remember the concept of marginal gains: you want to make the most you possibly can out of what you succeed in to tip the balance between you and other candidates in your favour.

Medical school interviews: rumours and myths

So now we come to the part of applying that is shrouded in myths and rumours, the interview. Students leaving bananas on the table to try to be more memorable, interviewers asking people to throw a brick through the window. None of this will actually happen and most interviewers will actually be trying to make it as easy as possible for you.
At interview you have to be able to impress as much as possible, not through some ridiculous gesture, but rather by trying to seem a little bit more mature, a little bit more committed and a little bit more adept than the other candidates throughout the interview. One of the easiest ways to improve how you will come across at interview is simply through practice; get someone to sit you down and ask you questions about your personal statement, why you want to study medicine and also some ethical questions (which I will discuss shortly). It will help if this person is not one of your peers, as otherwise the situation will seem too informal and will not prepare you for having to answer questions under pressure. You can then get them to give you some feedback, but you will also notice things yourself that could easily be improved on. Do you get a dry mouth from being nervous? Bring some water. Did you start talking without knowing what you were going to say? Realise that it’s acceptable to take a pause or even repeat back the question to the person asking it to you, to allow yourself time to consider it. In fact, if you take a moment to consider your answer it will seem as if you are really engaging with the question.

Ethical dilemmas in medicine

One type of question that is commonly posed to medics at interview is an ethical dilemma. It is very important to remember that with these questions there is rarely a “correct” answer and it is instead much important to demonstrate that you understand some basic principles of medical ethics and how to apply them in a real-life situation. Practise talking through both sides to the argument to demonstrate this.
Some examples of ethical questions include:
– “Would you preferentially give a liver transplant to someone injured playing rugby as opposed to an alcoholic? Why?”
– “Do you support assisted dying becoming legal in the UK?”
– “Would you force treatment on someone who has cancer in order to save their life?”
– “Would you give one person life-saving dialysis or ten people hip replacements?”

There are four main principles of medical ethics, which you can use as a starting point to tackle these questions. Very often the reason an ethical dilemma comes about is due to two of these principles coming into conflict. The principles are (i) benificence (acting in a patient’s best interests), (ii) non-maleficence (not harming the patient), (iii) autonomy (respecting the choices of the patient) and (iv) jurisprudence (assigning resources fairly).
In the question about forcing treatment on a cancer sufferer, the conflict between benificence and autonomy arises; in the case of dialysis vs. hip replacements it is jurisprudence and benificence. With regard to jurisprudence it is worth researching something called “QUALYs” or Quality Adjusted Life Years, a system used to weigh up the merits of treatments. As long as you discuss these questions in a reasonable way you will be fine, but if you really want to be making gains over others then try to justify as much of what you say as possible. Don’t simply say “Alcoholics shouldn’t have a liver transplant because drinking is bad”, as immediately after they will ask you why it is any worse than playing rugby.
Remember that when applying for medicine, you are competing against hundreds of other applicants, who will very likely have had the same advice from teachers and family on their application and as a result the difference between you and them can be very small. Some people will be discarded early on due to poor grades or an inadequate personal statement, but everyone else who makes it through will be on a fairly level footing. Therefore it is vital at all stages of your application to try to make gains over other candidates wherever possible and this will go beyond what I have explicitly advised. If you have re-read a book just before your interview you can demonstrate a much greater understanding; if you keep a diary of your work experience you’ll be able to reflect much more carefully; if you keep up to date with medicine and medical advances in the news you will seem more engaged with the subject area.

Conclusion

Always be thinking “How can I make this better?” not “How can I make this good?” and you will find yourself instinctively making the marginal gains over others that will combine to earn you a place at medical school. Good luck!
Last reviewed: November 2014
Next review: November 2015

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