How to get in and out of medical school in style…

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Preface

You are in for a real treat… firstly the truth, and secondly and most importantly for you, a complete, with updates manual on how it should be done. “Medicine is not for everyone,”they say; but what if I told you that medicine can be for anyone, providing one condition – they prepare for it! I like to complete their sentence with, “yet they for whom it is, it really is!” The medical profession is highly diverse, and with this increasing versatility, students from all backgrounds shouldn’t be discouraged from getting on the train to the best vocation, ever!

This book showcases an unbiased observation of the typical progression and stereotypes, of the mainstream, towards becoming medical doctors, starting before university; medical school itself; and thereafter… then provides a more compelling route on how to become a clinician; one who is more success-oriented, more well-rounded and more content. I truly believe that it is so much more about whom, rather than what, you become at the end of medical school – for that is merely the beginning of many beginnings to come.

This is my personal reflection on how it should really be done: How to get in and out of medical school in style, whilst becoming the best version of yourself.

Don’t be: a student who fails to get into medical school; a student who gets into the wrong university; a first year drop out; a depression or suicide statistic; a student who regrets having gone into medicine 4 years-in; a student happy to simply pass through medical school; a student stuck in the library; a student celebrating graduation simply because they are now called Dr so and so; or a student who is simply confused throughout the whole process. (I can go on and on with these don’ts).

This how to guide aims to alleviate all these concerns, and more, providing you with a stage-by-stage synopsis, starting with a career planning chapter; then re-educating you about university and the expectations you should have whilst studying in such an institute; I then describe the “not so fertile” conventional method many students take into medicine; before I present the “more fertile” narrative of how to become the doctor everyone should, even non-medics would, aspire to be.

.  . .

Having experienced a hurdle-centred approach into medicine; one stemming from the love for science, like the majority, I was surprised when I started to feel discontent with my career choice – Is medicine really for me? It wasn’t that I was confronted with difficulty during the course, or that I was facing external struggle; it was when I started becoming more conscious about my being that I really felt this way. Yes. This book has a deeper message. Allowing you to realise the beauty of medicine and becoming a flourishing doctor, whilst nurturing yourself, and more crucially, keeping your main focus on the bigger picture. It sounds easy… just wait for it.

As my interest in self-development grew and I was granted a chance to move to the big city (London), having started my medical studies and lived in the Cambridge bubble for a while, my practice of self-love continued to grow. I started developing holistic habits (the system of which I will discuss in detail), yet the occupational question still bothered me. I took a year out! (I was discouraged by my peers; not only because medical students are horrified to graduate an extra year later; medicine can relentlessly feel like a closed, one-way system for the majority of students – steering them in one direction, the National Health Service, NHS).

I had been practising as a personal trainer before the gap in my studies, but this break was the “break” I had been waiting for. My personal training business took-off and I was healthier, wealthier and had more time to myself. What more could I ask for? Why would I go back to medicine? Yet I came back with strength, more eagerness to become the doctor I “always” anticipated I would be. Why was this?

I have now been practising as a master personal trainer for 4 years to date; and have graduated as a junior doctor, having packed the 7 years of my university life with experiences, lessons and reflections – I now share my knowledge and that of my peers to uncover the myths about medicine and shed light to the next generation of doctors: You and the majority of other medical students will, believe me, encounter the matters discussed in this book. I hope the book allows you to realise them when they arrive, and better equip you to deal with them effectively and robustly. This is the head start I wish I had, the compass I could rely on when I was lost, and I’m glad it is now available for you to embrace. Our world needs more open minded, grounded, and action-geared doctors, which is what I hope I inspire you to become, and what motivates me to write this book.

“Excellence is a continuous process and not an accident.” – A. P. J. Abdul Kalam

This book should be read from beginning to end, aimed at preparing sixth-form students (years 11 through to 13) into medicine; and medical students of all years for the next chapter in their lives. Look, next, through the content page to become familiar with the structure, and be open to use the top tip boxes at the end of each section to take a break for reflection and action upon on the material presented. This first edition will be constantly updated using an online platform before being printed in the coming year, as a more enriched second edition. You are welcome to send your feedback and influence the updated material.

With honest love, appreciation and truth. Prepare and the world is yours!

Dr Mohammed Hamid
MBBS Hons MA (Cantab) ADipSAL, ACertSAL (VTCT)

 

Copyright © 2018 Dr Mohammed Hamid @thedrtrainer

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher, except for the use of brief quotations in a book review. For permission requests, contact the publisher at, [email protected]

First Edition

This digital copy will be under constant updates for a maximum of one year, starting 05/07/2018

www.fitnessfeat.org

 

Preface

You are in for a real treat… firstly the truth, and secondly and most importantly for you, a complete, with updates manual on how it should be done. “Medicine is not for everyone,”they say; but what if I told you that medicine can be for anyone, providing one condition – they prepare for it! I like to complete their sentence with, “yet they for whom it is, it really is!” The medical profession is highly diverse, and with this increasing versatility, students from all backgrounds shouldn’t be discouraged from getting on the train to the best vocation, ever!

 

This book showcases an unbiased observation of the typical progression and stereotypes, of the mainstream, towards becoming medical doctors, starting before university; medical school itself; and thereafter… then provides a more compelling route on how to become a clinician; one who is more success-oriented, more well-rounded and more content. I truly believe that it is so much more about whom, rather than what, you become at the end of medical school – for that is merely the beginning of many beginnings to come.

This is my personal reflection on how it should really be done: How to get in and out of medical school in style, whilst becoming the best version of yourself.

Don’t be: a student who fails to get into medical school; a student who gets into the wrong university; a first year drop out; a depression or suicide statistic; a student who regrets having gone into medicine 4 years-in; a student happy to simply pass through medical school; a student stuck in the library; a student celebrating graduation simply because they are now called Dr so and so; or a student who is simply confused throughout the whole process. (I can go on and on with these don’ts).

This how to guide aims to alleviate all these concerns, and more, providing you with a stage-by-stage synopsis, starting with a career planning chapter; then re-educating you about university and the expectations you should have whilst studying in such an institute; I then describe the “not so fertile” conventional method many students take into medicine; before I present the “more fertile” narrative of how to become the doctor everyone should, even non-medics would, aspire to be.

.  . .

Having experienced a hurdle-centred approach into medicine; one stemming from the love for science, like the majority, I was surprised when I started to feel discontent with my career choice – Is medicine really for me? It wasn’t that I was confronted with difficulty during the course, or that I was facing external struggle; it was when I started becoming more conscious about my being that I really felt this way. Yes. This book has a deeper message. Allowing you to realise the beauty of medicine and becoming a flourishing doctor, whilst nurturing yourself, and more crucially, keeping your main focus on the bigger picture. It sounds easy… just wait for it.

As my interest in self-development grew and I was granted a chance to move to the big city (London), having started my medical studies and lived in the Cambridge bubble for a while, my practice of self-love continued to grow. I started developing holistic habits (the system of which I will discuss in detail), yet the occupational question still bothered me. I took a year out! (I was discouraged by my peers; not only because medical students are horrified to graduate an extra year later; medicine can relentlessly feel like a closed, one-way system for the majority of students – steering them in one direction, the National Health Service, NHS).

 

I had been practising as a personal trainer before the gap in my studies, but this break was the “break” I had been waiting for. My personal training business took-off and I was healthier, wealthier and had more time to myself. What more could I ask for? Why would I go back to medicine? Yet I came back with strength, more eagerness to become the doctor I “always” anticipated I would be. Why was this?

I have now been practising as a master personal trainer for 4 years to date; and have graduated as a junior doctor, having packed the 7 years of my university life with experiences, lessons and reflections – I now share my knowledge and that of my peers to uncover the myths about medicine and shed light to the next generation of doctors: You and the majority of other medical students will, believe me, encounter the matters discussed in this book. I hope the book allows you to realise them when they arrive, and better equip you to deal with them effectively and robustly. This is the head start I wish I had, the compass I could rely on when I was lost, and I’m glad it is now available for you to embrace. Our world needs more open minded, grounded, and action-geared doctors, which is what I hope I inspire you to become, and what motivates me to write this book.

“Excellence is a continuous process and not an accident.” – A. P. J. Abdul Kalam

 

This book should be read from beginning to end, aimed at preparing sixth-form students (years 11 through to 13) into medicine; and medical students of all years for the next chapter in their lives. Look, next, through the content page to become familiar with the structure, and be open to use the top tip boxes at the end of each section to take a break for reflection and action upon on the material presented. This first edition will be constantly updated using an online platform before being printed in the coming year, as a more enriched second edition. You are welcome to send your feedback and influence the updated material.

 

With honest love, appreciation and truth. Prepare and the world is yours!

 

Dr Mohammed Hamid
MBBS Hons MA (Cantab) ADipSAL, ACertSAL (VTCT)

Contents

 

Chapter 1

Career planning…………………………………………………………………………………………………………7

Chapter 2

What is University?…………………………………………………………………………………………………13

Questions you should be asking about University ………………………………………15

Chapter 3

Why does medicine put students off?….……………………………………………………………….TBC

How do I explain the perceived “disadvantages” of a medical career? ……………….TBC

Chapter 4

How it should be done. Preparations:

Before university………………………………………………………………………………………TBC

During medical school………………………………………………………………………………TBC

Life after graduation…………………………………………………………………………………TBC

Chapter 5

My top-tips. Bonus content:…………………………………………………………………………………TBC

Chapter 6

The A-Z future doctor’s checklist…………………………………………………………………………..TBC

Chapter 7

Help me expand the book……………………………………………………………………………………..TBC

References……………………………………………………………………………………………………………TBC

 

CHAPTER 1

 

Career planning

Career planning is an ongoing process in which you create your future work success by: [1]

Exploring your interests and abilities;

Strategically planning your career goals, and;

Designing action and learning plans to help you attain your goals.

Career planning organisations continues to expand in every sector, not only in educational institutes, to support students and the population progress. Career development teams and workshops are being set up as early as primary (elementary) school, endorsing the importance of occupational awareness and success.

“Your Career Is Not a Sprint;

It’s a Marathon” – Jason Santa Maria

Why is it important?

Career planning helps us to grow! Having a realistic career plan is often an essential part of our personal growth and development. The future can provide an extremely uncertain ride but having a solid career plan in place can serve as a reliable roadmap to get you wherever you would like to go [2].

The quality of your life is determined by the amount of energy you dedicate to each of the 8 holistic components of living. Your career can greatly influence how you chose to distribute this energy, therefore directly impacting the quality of your life [3]. I’ve demonstrated the holistic components of our lives below in Figure 1: Physical, Nutritional, Mental, Social, Intellectual, Spiritual, Environmental and Financial.

Building positive habits to balance the energy between these 8 broad categories not only promotes your growth in each aspect, but also provides more total energy subsequently, for you to spend as you wish.

“Where focus goes, energy flows” –

Tony Robbins

Figure 1: The Holistic components of our lives, by @thedrtrainer

 

Energy, our universal drive: (Section under review, to be inserted soon.)

The importance of each component: (Section under review, to be inserted soon.)

 

The 3 Steps of career planning (See the how section for an alternative approach.)

You should aim to delve into this process immediately whatever stage you are currently at, and maintain a healthy balance of continuous career planning throughout life. It is especially essential to allocate a specific time to meticulously plan your higher education prior to committing to a university degree.

1)   Review and articulate your values and skills

Complete the following exercise; taking some time to reflect on your answers to the following questions:

 

What do you love doing?
What are you good at?
What do you want from your career?
What do you need from your career?
What can’t you do for a career?
What would you rather not do?
What evidence do you have for your answers?

Note: If you are finding it difficult knowing what you want, know that this is a normal feeling: The majority of people simply don’t know what they want! This is primarily because we practice less meditation, reflection and mindfulness as a society. You don’t need to postpone this exercise to find yourself first – simply start working to “make yourself” based on your current preferences and knowledge. If you continue to struggle, and would like to be coached, have a look at my holistic mentorship services (link coming soon).

2)    Investigate your options

We have been granted a plethora of ways to explore the array of opportunities out there. I have already shown why it is important to make a good career choice, so make time to go over the options,keep open-minded to more than one vocation and be patient:

  •     Literature research via books, search engines, and university prospectuses;
  •     Find a mentor who can coach you to find your personal needs;
  •     Take a career test online;
  •     Ask for help – this may well be directed by a careers team;
  •     Network with those who are already in the career you are investigating;
  •     Try an internship;
  •     Explore unconventional careers.

3)    Devise and implement a plan for your next career steps

What you investigate through the literature, reviews or search engines, doesn’t always match up to its equivalent reality. You never know until you try– so the best form of discovery of a suitable career is to try it!Go visit the university faculty or plan an internship.

Increasingly, occupations are demanding a level of work experience from their trainees to be presented at the application process; and we often find students fulfilling this criterion by applying for a short post averaging a fortnight. Habitually, the students would have already made their mind up about the career before starting, or even before completing the post, allowing the experience to simply consolidate their previous perceptions and beliefs – this does not serve them any benefit. Work experience should allow you to explore the waters, not to simply taste it before diving-in, head first.

In a fast-paced era, with change manifesting in all sectors of work, it makes no sense to take a snapshot of a career and base your foreseeable future on it. The most tedious factor to any single career is the routine associated with it; and this cannot be established from a 2-week internship! It takes on average 66 days to form a habit [4], and so the minimum period a student should aim to apply for should be 2 months – to allow the individual to recognise whether the routine of that particular job title matches their interests; supports the maintenance of their contentment; and, enables them to continue developing in all components of their life [figure 1]. We will discuss how one can set themselves in the right direction to obtain the correct level of experience in the how chapter.

It is also necessary to investigate and try other career options, for a similar length too. Maybe you really liked your first job placement, but what implies you won’t like the second one even more. Remember, you are only as wise as your perspective. Being ignorant in this matter manifests un-blissfully and could be the difference between you trying to find peace – moving from one job to another, having a mid-life crisis; and growing as a person in your first or second job. Caring for the sick is a noble goal, but it should not be the de facto destination for all straight-A students.

Similarly, basing your career aspirations on an open day visit (again only a snapshot) only provides you with enough time to palate the advantages of the career. We will discuss later in more detail how you should and shouldn’t base your choice to study medicine, how you should use university open days to your advantage, and why only seeing the mainstream “disadvantages” can knock you off your knees when it comes to applying for medicine.

 

“The secret of your future is hidden in your daily routine” – Mike Murdock

Don’t forget that there are alternative routes to most careers besides university [5]:

 

Apprenticeships and traineeships

School leaver programmes

Gap years

Part-time study

Distance-learning (online)

Studying overseas

Foundation degrees or Higher National Diplomas

Taking extra qualifications

Self-employment

Top learning points:

  • Career planning is an ongoing process.
  • It is important as it influences all major components of your life.
  • Improving your holistic health = improving your quality of life.
  • Know yourself; Know what’s out there; and, Test them out.
    • Is Medicine really for you? Is University really for you?

 

CHAPTER 2

 

What is University?

Universities are communities of teachers and scholars awarding degrees that indicate occupational competency [6]. Such organisations started as early as 859 AC, with their origins in both religious institutions, and royal establishments with political agendas [7, 8, 9, 10]. The Robbins report in the 1960s resolved that universities should have four main “objectives essential to any properly balanced system: instruction in skills; the promotion of the general powers of the mind so as to produce not mere specialists but rather cultivated men and women; to maintain research in balance with teaching, since teaching should not be separated from the advancement of learning and the search for truth; and to transmit a common culture and common standards of citizenship.” [11]

“The whole purpose of education is to turn mirrors into windows” – Sydney Harris

Universities have now been given growing power, with many now running identical to businesses despite them being registered as non-profit organisations. It is essential to be aware of both their front-end and back-end facades: The student courses delivered, and the humongous managerial infrastructures in place, respectively, as to be familiar with all the opportunities available.

University communities today continue to operate similar to their predecessors in their approach: They provide an environment to enable your development across the four categories mentioned by the Robbins report; unlike the lesser years of education, it is both impossible and inappropriate to spoon-feed your growth. The power is given to you… to grow into the person you want to be! This sounds terrific – the next stage of maturity and responsibility; however, the leap from sixth-form is often too much in one go, and can be damaging or simply a distraction to the individuals advancement. Many students are humbly unprepared going-in, and come-out of the experience semi-matured: not having taken complete advantage of the chances available; feeling like they could have done better if given a second go; and in a similar sea-storm going into adulthood, cruising in darkness and dodging iceberg obstacles. Of course it doesn’t need to be that way! There is a hand-full of students going in prepared, being fortunate to have sort the correct knowledge, or have excellent mentors who have trained them in how the sails work. These students navigate through the experience as if they’re drifting on the calm Majorcan shores; using the focus of their energy, even when the conditions are brash, to hoist more goods and passengers (i.e. upgrading their holistic life aspects) at each port (academic terms). When these students graduate, their vessel is both enriched and expanded, affording them more energy to coast through adulthood, with a higher projected quality of life.

Going into Medicine, you have paid for and should expect the following of your university:

  •     An environment enabling you to acquire the skills of a competent doctor;
  •     An environment to enable your personal growth;
  •     An environmentenablingyou to research and support your on-going career engagements;
  •     An environment supporting cultural differences and tolerating diversity;

… And you should never be afraid to demand more of the university.

Students do describe how their university years were some of the best in their lives. At such a critical part in your youth, it is essential that you nurture your holistic health and build positive habits to evolve each life component, for the next stage of living. University can be easy, or it can be hard. Some blame the system, but once you understand the role that universities play, it is more accurate, that students fail themselves.

 

Top learning points:

  • Universities are environments enabling study and scholarship. Take a proactive stance to your experience, as a sense of entitlement will only lead to your downfall.
  • Skill acquisition is only part of the process. Use this phase of your life to expand and cultivate all aspects of your life; plan your next career steps; and ground yourself with the surrounding and distant cultures to build an understanding of the world you live in.
  • University can be the best years of your life, but it is only a transition phase into adulthood.

 

Questions you should be asking about University
Once you have decided what career path will support your personal growth, it’s time to find the most suitable University for you– yes this is an important hurdle! Despite universities awarding the same degree titles or setting a course with the same name; the content and its delivery can be completely different; coupled with all the holistic factors we will discuss shortly, each university experience becomes tremendously distinct. My Cambridge experience was unlike the one I had in London in so many ways that it often felt like I was studying a completely different degree.

This second obstacle is important because you want to be in the best university for cultivating your future well being; utilising your youth building your character, habits and the networks that will remain for a lifetime. Hypothetically, if you were to graduate two identical twins going into university the same persons, on the same course: one from Oxford, and the other from Edinburgh University. They will come out with similar degrees, but with completely different characteristics built over the 4-6 years of study – it is impossible to list all the nuances, as they are many, but we will look at the factors influencing university life, and hence the character built in the next section. It is important to note, that in this analogy, neither twin is more privileged than the other. The Edinburgh graduate might come-out more self-actualised and holistically healthier than the Oxford graduate, if the university was compatible with his needs, and vice-versa. I can’t reiterate how important it is to choose the universities most harmonious with your holistic requirements.

However important this stage, make sure your primary intentions are applying for the course first, then the university. In your medical career, medical school is only a fragment in the journey head, and with the degree awarded being standardised (inter) nationally, going into the second stage of your training, the same circumstances will be thrown in your direction as any other student graduating from another medical school – what differs between doctors going into the line of work, is how they have used their university experience to sculpt their personality, health and energy – what preparations they have made in university to become the more success-oriented, well-rounded, and content doctor.

When narrowing down your choices, you should pick universities based on the 8 components of living, and only after securing a visit should you make your final decision: It doesn’t matter what they offer for the current cohort or on their online reviews, it matters what they will offer you when you are there and how best it fits you. Ensure you explore each of the different factors listed below to give yourself the best possible advantage… Make sure you’re doing what’s best for you! The decisions you make based on these factors should be influenced by none other than yourself – not your peers, your family, or online reviews which are likely to be biased. Of course your parents and peers may be an important factor for your social well-being, but this needs to be the case when deciding. The national student survey is collected annually by the Higher Education Funding Council for England (HEFCE) and provides the most accurate results on some of the most important factors influencing university student life [13].

 

Holistic framework of the factors influencing university student life:
Traditionally, it was enough to ask the 6 W’s when electing to enter university; but I have provided a more robust, complete framework below, that fits with the new fast-paced, fast-changing, information-overwhelming era.

“Balance is not something you find, it’s something you create” – Jana Kingsford

Physically:
·     Does the university provide and support an extracurricular activity that you are interested in? Is the activity group nationally or locally recognised to be successful and flourishing? In America, many students enter universities through sports scholarships; and although the numbers aren’t as comparable in the UK, the number of students opting for a specific university based on its activity provisions are increasing. This is also true for academic universities such as Oxbridge, who sustain activity groups and sport teams at elite levels of play. Due to the sizeable volume of academic hours in medicine, medical schools often have separate extracurricular societies to the affiliated university, with different recreational hours and logistics. Are these ‘MedSoc’ groups prosperous?
·     If you currently don’t have an extracurricular passion, does the university house a wide array of activities you can try?

Nutritionally:
·     Does the university support a healthy eating environment? Houses outlets with healthy choices? Or provide meal recipes and plans?
Availability is a major key when it comes to food. It is very easy for students to get stuck in a relentless cycle of feeding their bodies insalubrious energy, as it is often easily accessible. However, this fosters a detrimental habit that becomes coerced into their future working lives; compounded by the increasing sedentary nature of jobs, it is adding to our obesity epidemic. Some of my nursing student colleagues in medical school would find it easier to binge on microwave food or snack due to the amount of working hours and exhaustion; But this harmful habit built during their youthful years continues, and we are seeing increasing numbers of nurses being categorised as being obese or overweight – this isn’t new to the medical field, with doctors following the same trend. In 2007, the Physician Health Study found 40% of US doctors being overweight and 23% obese [14]. In the UK, 50% of NHS workers are obese [15].
·     What food stores are open in the local vicinity? And do they provide nutritious energy?
o   Areas with big stores often allow for bigger choice, but this is not necessarily better. You want to look for more organic-based stores, who appreciate the importance of fuelling the body in a harmless way.
o   You will also need to make time to cook the food you eat. If you are new to cooking, you will find the following guide of great use: How to effectively meal prep in 3 easy steps. This guide was created to support individuals prep their meals whilst sculpting the body composition they desire.

Mentally:
·      What level of welfare, mental health, and crisis support does the university provide? This is a vital question to ask any university, especially in medicine. In the Journal of the American Medical Association (JAMA), researchers analysed nearly 200 studies of 129,000 medical students in 47 countries. They found that 27% of medical students had depression or symptoms of it, and 11% reported suicidal thoughts during medical school. This is two to five times more than the general population, with a prevalence ranging from 9% to 56%. Despite these statistics, few medical students, “Only 16% of the medical students who screened positive actually saw someone,” said the study author Dr Douglas Mata, “It’s kind of paradoxical, give that they should recognize the signs better than anyone.” [16]
Universities and society as a whole are getting better at tackling mental health issues, including the stigma surrounding it, with the recent royal stance through the Heads Together foundation.

Socially:
An enduring research topic, one recently producing additional literature, is the study of student belonging. University can feel like an alien atmosphere, with students feeling like strangers for the duration of their study. Despite, making friends on their course, at halls, or within society groups, there is still a sense of disconnectedness. Coalesced with the communal dynamics of the new social-media age, students can be left puzzled. Altogether, this leads to a lack of continued interaction with university alumni networks, and even sometimes, once good friends. Indirectly, a university’s alumni network numbers parallels the level of community built for students whilst at university. Students are likely to return and give back towards the university if it cultivated a sense of belonging for the individual during their student life.
·     What community feeling does the university environment accommodate? Will this enable a sense of comfort and belonging?
·     Does the locality celebrate diversity and breed tolerance? Or house a fraternity you’d like to be apart of?
·     What do you prefer: a university close or far from home? As mentioned above, for a large number of students, staying ‘home’ is a suitable option as it provides for them more security and a social network they already trust. For the majority, leaving home sounds more exciting and befitting. However, the preference should be made with careful consideration, into which option will support your personal growth, rather than choosing to take a leap away from your guardians, or sticking to your comfort-zone [Figure 2].

Figure 2: Balance leads to development. Choose not to be too comfortable, or too risky.














·     Where would do you prefer to live: In shared university halls, or to “live-out”? Many students start in university halls to get the grasps of living away from home first, before settling-in with a few of the close friends they’ve made in a shared house, or flat rental.
Some of the advantages of student halls include a vibrant community, safety, and links with the university. On the contrary, it can also be a lonely habitat if making friends is not your cup of tea; and this option is often the much more expensive one.
For living-out, students often make their best friends-for-life due to the shared nature, and this option can support your course advancements if you study the same subject; the cost can be minuscule compared to student halls, and students often develop more self-esteem, maturity and a sense of responsibility. These as well as: the contract length; deposit amount; total costs including bills; level of refurbishment; parking if you have a car; garden for outside living; disabled access if necessary; extent of sharing living rooms and bathrooms; catering options; number of tenants; their gender; the age difference; course of study; the common languages spoken; and any pets, are the main factors to explore when deciding on a shelter option away from home.
·     What daytime hangouts/recreation and/or nightlife does the university bring? Note: this is separate to the local leisure opportunities, as it is perceived to be more secure if provided by the university; however, the locality can compensate, and so, it is also important to ask what the vicinity offers too.
·     Safety, safety, safety! Police.uk provide statistics, on the safety levels of university neighbourhoods in England and Wales, on:           
o   Robbery;
o   Burglary, and;
o   Violence and sexual offences.

Unfortunate as it is, students, like any other citizen, are not exempt from safety issues whilst at university… And for students who become involved, it can be life changing. My top tips here are:
·     Take responsibility when you are out, and try to transfer in packs until you gain more confidence, taking extra precautions when you are out alone.
·     Register and/or insure your valuable belongings such as laptops and bikes; Keep your dormitory, or room door secure; and keep your personal details and belongings safe.
·     Watch how much you drink on social occasions; and be aware of the environments and social circles you associate with.

University Student Unions have been tackling safety issues impacting their students for many years, and are very likely to have built extensive educational material and support links if something does go wrong. This may not be the case if an event occurs outside the university environment, such as a city pub, so If you do feel unsafe, call 999; and if you become a victim, do speak with someone! There are numerous confidential services and platforms available for you to seek help. Don’t suffer in silence!

 

Intellectually:
·     We are all after the best quality of teaching, and this should have a significant bearing on our final choice. (Not necessarily the institution; we shall discuss university ranking below).
o   The top two factors for students indicating high quality teaching, collected by the international student survey, were: High qualified teachers and high employment rate [Figure 3]. In medicine, the employment rates on graduation are very similar across each university, with almost every graduate going into a foundation doctor training post; teaching quality is not necessarily based on the research capability of a university which we discuss later in this section. It is safe to say, that the majority of medical schools provide good quality teaching, except of course on off-days and individual educators, which are apart of every organisation.

Figure 3:International Student Survey 2017
·     What are the curriculum’s specifications, pedagogy and timeline? I.e. the content of the course, its delivery, and potential adjustments to its schedule: The former two factors are often very dynamic to keep up with novel research and the changing landscape of the world. With constant developments in the medical field and political endeavours affecting the vocations prospect, the academic departments of medical schools, who play a large role in setting the curriculum, must adapt the course content and delivery to keep up with the “trend”. This allows medical schools to graduate doctors with up-to-date knowledge and grounding with-in their times. Both the Cambridge and King’s College London curriculums changed during my time at university and they will continue to drift.
o   What learning methods suit you? Do you prefer smaller groups, or do you learn better through lectures? This is the primary difference between Problem-Based-Learning (PBL) and Traditional courses, respectively. The literature is quite unambiguous as to which approach produces the best medical graduates – however, more-and-more PBL elements are being incorporated more openly into traditional courses [17].
o   Teaching hours in medicine is practically standardised due to the large volume of content one must be competent in. However, the time spent on the different portions (practical, seminars, supervisions etc.) will vary.

·     Assessment styles can also differ. Medical schools use numerous exams to qualify whether you are competent for the next stage. These include multiple choice questions, essays, short and long answer questions. The proportion of each method differs and is a component you need to investigate. Oxbridge is quite keen on written essays, which also influences their teaching methodology. So be aware of your strengths and weaknesses before applying, and the assessment style that will develop the skills you are chasing.
o   Objective Structured Clinical Examinations(OSCEs) are the practical assessments that form part of every medical school exams. They were originally introduced to assess clinical competency in the later years (years 3 and above). However, with the changing curriculums, they have now been introduced as early as year 1 in some courses.
·     Are you considering a career in research or a clinical responsibility?
It can make a significant difference to the number of opportunities available and the level of specialist connections a university has in research or teaching. In my first week in Cambridge, we were encouraged to lead the academic research in our careers, and it is not surprising once you realise the substantial focus it has, as an institute, on research.
Similarly, teaching hospitals have outstanding clinical teaching facilities and world-class educators. It is important to note that not one institute is the best in every field, so if you are interested in a particular research topic or clinical speciality, investigate the university that is leading in that area.
·     What year does the curriculum introduce clinical work placements? If you are interested in becoming one of the best clinical doctors, then early, substantial exposure in a university commencing clinical placements in their first year will be paramount to your goal. Traditional schools will introduce less clinical contact (several hours) in the first couple of years, making you wait a little before feeling like a doctor trainee; however, their curriculums make up by being more academically oriented – predominantly benefitting those interested in academic positions in their future career.
o   Clinical placements also vary based on their geographic distribution – hence the number of teaching hospitals available; and their speciality focus.

  •  Regional differences: Your university’s medical school may be affiliated with a few or many hospitals. Based on the size of the medical student cohort of the school, you may be paired with a few or many students on the same placement, dramatically influencing your experience and the level of opportunities in the clinical setting. The size of the region also dictates how far away from the university locality you will be living away for some of your clinical placements. For some of my clinical placements, I was placed 70 miles away from the university campus; further than my parent’s home. Accommodation is likely to be provided, saving you some money, however, the distance can affect any extracurricular or social commitments based within the university locality.
  •  Hospitals within the region can be large – often with sizable and specialised units, as well as departments great for research opportunities; or smaller, district general hospitals – who are often very good at teaching the bread and butter of clinical medicine, advancing in supporting your foundation skill acquisition. As mentioned above, hospitals around the country lead in different specialities, therefore, depending in which region these hospitals are located, they will often be affiliated with the closest medical school.


    ·     Optional modules, otherwise known as student selected components (SSC’s), can either be limited to scientific and medical subjects, or open to any subject area. This will be specific to the university and needs to be researched. I personally encourage students to take SSC’s as opportunities to widen their knowledge in different subject areas, creating a well-rounded personality. You could however explore medical specialities of interest to advance your portfolio. I will discuss the details in the fourth chapter.
    ·     Are there any restrictions to degree intercalation? All medical schools now allow their students to acquire another degree over the period of one year. Some are mandatory as opposed to being voluntary, however, other aspects need to be considered. We will discuss the primary advantages in the fourth chapter, however it is important to note that an extra degree does benefit your foundation doctor post application by up to a few points. The main quoted disadvantage is that it is an extra year (involving fees), which may not be of interest to students in a hurry to start working and earning.
    o  In which years are the intercalation allowed? Traditionally, and if compulsory, this would be restricted to the year between medical sciences and clinical placements (i.e. after the second year); on the other hand, some university curriculums allow for intercalation in any year after your second. The advantage of doing it directly after the second year is that it enables a cohesive continuity of focus during your clinical studies; however, for many students this is too early for them to realise which degree will benefit their future career, or where there clinical/academic interests lie without having experienced a clinical placement – reducing their intercalated degrees to a title, and a few points towards their work application.
    o  What degree can I do and where? Again, in traditional, compulsory schools, the majority of students, with a few exceptions, complete the degree within the same university; and out of a list of degrees made available by the university. The restriction can also limit the degrees to scientific backgrounds. However, in optional schools, the degree list is limitless and can be done within the same university if available or in any other, even abroad. This can be a great occasion if you are interested in a specific course the university doesn’t provide, to boost your career prospects; or interested in building other components of your living for a year, for example trying a course now further away or closer to home; one providing a particular activity group; or the area itself if you are considering working there in the future…
    ·     Study abroad opportunities are currently intrinsic to medicine through the elective placement, which on average lasts 8 weeks, exploring other health organisations or specialities in different countries health care systems.
    o   Some medical schools have strong links with top worldwide institutions, be aware of these chances, especially if you are considering working abroad.
    ·     Does the university accredit extracurricular activities with titles, medals or cups? Which will boost your CV tremendously.
    ·     What career services are available for medical students? Career services are now part of every university, however, some departments are better than others, and some are lacking for medical students. For medicine, the next stage of your career is supported by governmental bodies linked to the NHS through the foundation year programmes, so you are almost always guaranteed to secure a job after graduation; however, the medical school should also support you during this phase. The national process is started for every final-year medical student towards the start of the year, and they usually have secured their job placements and location before their graduation ceremony. Employability rates in medicine as mentioned above are very similar in every medical school, mainly affected by final year students deciding not to enter their foundation programme or failing their final exams, which is not many, and also independent of the medical school.


    o   What is important to consider about the career services and support is their involvement in earlier years, and what modules the course includes such as career development placements and their extent.
    o   Is the medical school or university happy to continue supporting your career endeavours should you need their support? (They should do, if they have a well-developed career services team, which is an import question to ask).
  •     Note:Similar to the graduation rate in medicine, freshman retention rate and retention rates within the course may be affected by the university itself; however, it is most likely the result of a lack of preparation on the students side. Don’t be unprepared!

Financially:
·     What are the total costs and potential debt you will be in? In the past several years, with the influence of political judgment, tuition fees as well as living costs have skyrocketed at an unanticipated rate. Many companies have also used this chance of commercialising the student life to their advantage, steering students into accumulating incredible debt – distressing all social classes, not only the unprivileged. Although, I don’t believe this should deter one from going to university individuals needs to make an appropriate decision to reduce their overall debt whilst living a comfortable student life.
o   The total cost will be influenced by all factors we have discussed in this section. Financial struggle is a real pain; so seek the university that will support your circumstances if this is an overarching factor for you.
o   Scholarships and funding opportunities are available on university pages, and many universities support students who are struggling financially. The level of support differs and can be linked to the condition of accepting your offer, such as the A2B scheme of the University of Birmingham.
·     Are there financial incentives or awards? Non-taxing part-time work?  Opportunity to run your own business? If your financial goals are priority, or you would like to develop financial success habits, then a less academically weighted course may provide you more time to flourish financially. Oxbridge prevents their students from part-time work as it can distract their scholarly potential and impact their education.

Environmentally:
·     Separate to extracurricular groups provided by the university, what does the area provide? What is the predominating culture and what cultures are available?
·     Does the university support clean energy and recycling?
·     Are their enough green outdoor spaces, sunshine, and clean air? Note: Water has different qualities (hard, medium and soft) across different areas in the UK.  
·     Is the university a student campus with the main population being students and educators, or a city campus at the heart of a busy metropolis, surrounded by non-scholarly opportunities?
o   Do you prefer a big city or a small town? A place familiar or different from home?
·     What transport links are available? Does the vicinity have safe bike routes, or support your preferred mode of travel?

Spiritually:
·     Does your university involve itself in philanthropy that you can get involved in? Does it support charity (RAG) weeks and other fundraiser events supporting the welfare of others?
·     Are their opportunities to support the younger generation, such as teaching or sports days for example?
·     Does it house a religious, faith, or fraternity circle you are associated with? Is the group active and does it flourish in that area?

Supplementary points:

  •     Prestige once had a huge influence on ones university choice, despite the reputation-stereotype still existing within the senior generation of employers; it adds little value to medical employment. “Do what is best for you, not what others think of you!”
    ·     Ranking is distinct to prestige. With many tables available, each weighing different elements to score the institutes, it is ultimately useless to base your medical school choice on these very unstable statistics. You must understand that the research score often trump most of the hundreds of points, and this often doesn’t influence the study of the curriculum, except for research purposes.
    ·     Some students aim to get into universities with high admission rates, but this should be a last resort contingency, after investigating which university will support your holistic development best.
    ·     Aim to do what is beneficial for you first. Many students are still pressured by their families into careers such as medicine, law and engineering; however a large portion of these students continue to struggle for many years during study and work once they realise the career path doesn’t suit their personal needs. Try to discuss your current ambitions with your parents if they are insistent on what career choice they like for you.
    ·     If you come from a family of doctors, you are in a great advantage, as you will have been mentored from birth without having to be conscious of it. Be careful to double-check some of the advice you are given as the medical school experience has been changing dramatically over the past twenty years.
    ·     For international students, it is of huge importance to investigate the level of support provided by the university for non-nationals. You will often have to pay a huge amount relative to home-students, so ensure you are getting your money’s worth, and a university that will best develop your holistic life components and quality of life.
Top learning points:

  • Remember your primary objective is finding the right course for you; picking the top 1-2 factors in each holistic category, or the top 3-5 across the range of components, for the university will amplify your experience, putting you on the edge – ready for your foundation doctor role; and most likely much further down your career.
  • Don’t obsess over finding ‘the best university’ – Use this chapter to find ‘the best university for you’.

 

CHAPTER 3-6
(Coming soon)

 

CHAPTER 7

 

Help me expand the book: (Section under review, to be inserted soon.)

References:

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  3. Barcaccia, Barbara (4 September 2013). “Quality Of Life: Everyone Wants It, But What Is It?”. Forbes/ Education. Retrieved 10 May 2016.
  4. Phillippa Lally, Cornelia H. M. van Jaarsveld, Henry W. W. Potts, Jane Wardle, How are habits formed: Modelling habit formation in the real world, 16 July 2009, https://doi.org/10.1002/ejsp.674
  5. https://www.ucas.com/alternatives/alternatives-higher-education
  6. “Universities”.Encyclopædia Britannica(11th ed.). 1911.
  7. Encyclopædia Britannica: “University” Archived 15 May 2013 at the Wayback Machine. 2012, retrieved 26 July 2012)
  8. Haskins, Charles H. (1898). “The Life of Medieval Students as Illustrated by their Letters”. The American Historical Review(s). 3 (2): 203–229. doi:10.2307/1832500.
  9. “Medina of Fez”. UNESCO World Heritage Centre. UNESCO. Archived from the original on 29 May 2010. Retrieved 7 April 2016.
  10. Verger, Jacques: “Patterns”, in: Ridder-Symoens, Hilde de (ed.): A History of the University in Europe. Vol. I: Universities in the Middle Ages, Cambridge University Press, 2003, ISBN 978-0-521-54113-8, pp. 35–76 (35)
  11. Anderson, Robert (March 2010). “The ‘Idea of a University’ today”. History & Policy. United Kingdom: History & Policy. Archived from the original on 27 November 2010. Retrieved 9 December 2010.
  12. Motivation and Personality, Abraham Maslow, 1970.
  13. http://www.hefce.ac.uk/lt/nss/results/
  14. Beck M. Checking up on the doctor: what patients can learn from the way physicians take care of themselves. Wall Street Journal. May 2010.
  15. https://www.theguardian.com/commentisfree/2013/mar/10/stay-healthy-better-than-medical-quick-fix
  16. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214–2236. doi:10.1001/jama.2016.17324
  17. Yeo S1, Chang BH1. Implementation of problem-based learning in medical education in Korea. Korean J Med Educ. 2017 Dec; 29(4):271-282. doi: 10.3946/kjme.2017.73. Epub 2017 Nov 29.

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