Fast Stream Medicine


Changing career course is daunting at the best of times. Switching from a funded PhD, with a guaranteed stipend for 3 years and with worldwide travel to conferences as an all-expenses-paid luxury bonus, to a medical degree with no income that meant more years of intensive study is a more trying move than most. So why have I done it?

I have been in hospital environments for as long as I can remember. My mother is a dental therapist and on countless occasions I had to go along with her to work at our local hospital in Benin City, Nigeria. Over time, I got used to the smell, the work being undertaken, people coming and going. I was never allowed to sit in on consultations but from an early age, I caught the health care bug.

I came to the UK to take my A levels, and studied science, of course. I applied for medical school, but my grades (2 B's and a C) weren't good enough to get me a place. The compromise was to read biochemistry at Kingston University, where I had a brilliant time. And, just before the end of my final year, I applied to medical school once again.

Horror of horrors! I got a rejection letter in early January 2000. It took me a while to get over this, but as my finals were coming up, I had to think of something else I could make a career out of. This is where the PhD came in. My undergraduate dissertation was on the up-regulation of surface antigens in non-Hodgkin's lymphoma and at the time, it seemed a logical progression to go into a PhD with the Imperial Cancer Research Fund in Leeds. The stipend was brilliant so, on completing my B.Sc., I went to Leeds in August to start my career in research. Or so I thought.

In early September, I received a call from Leicester-Warwick medical school, offering me a place in the graduate-entry course I'd previously thought was a nonstarter. Once again my dream was being rekindled. The week that followed that phone call was one of the most difficult in my life so far. Deciding to resign my position at Leeds was very tough. I got on particularly well with my supervisor and the staff at the laboratory where I worked. I considered finishing my PhD before going on to the medical course, but this was a long-held dream, and the fact that the offer was nondeferrable meant I could not refuse.

The "I've always wanted to help people" line used by most people at medical school interviews is not flawed, but my main reason for wanting to become a doctor is because I feel the pros of the profession far outweigh the cons. The standing of doctors in society means they have a lot of influence over decisions taken in the primary health care sector. Practising medicine offers stability that a career in research cannot guarantee. After a PhD, postdoctoral positions are the next step and they only offer 3-year contracts at the most. In medicine, as long as one stays focused as to the training pathway for specialisation, the future is more certain in terms of wage-structure and career progression. Medical doctors also hold a lot of clout in research circles, as they play an influential role in clinical trials.

One of the deciding factors in my selection of the MB.ChB. course at the newly formed Leicester-Warwick Medical School was the time it would take me to qualify. Four years sounds like a long time, but that's a year less than usual because a year is knocked off for biological science graduates. The course also sets out to provide a very patient-oriented approach to the practise of medicine, in line with the General Medical Council's "Tomorrow's Doctors" report of 1994. This, I believe, will lead to my colleagues and I (if and when we qualify) being able to deliver health care to our patients with empathy, compassion, understanding, and less arrogance; all attributes I think should be emphasised at interview by budding applicants.

Everyone on this pioneering course at Warwick is a biological science graduate. We are quite a diverse group though; of 67 students, about 10 have M.Sc. degrees, 3 have PhDs, about 4 are practising pharmacists, and we also have a practising dentist. Next year, the medical school is set to receive around 130 new entrants who'll all be biological science graduates.

This course differs from a conventional, undergraduate medical course in a number of ways. Firstly, it is very community-oriented in its approach. Most of our modules comprise both university- and community-based (external visits to local health centres) learning. Secondly, we are put into first-hand contact from the first term with the elderly and bereaved parents, for example, in order to confront stereotypes and understand the impact of grief. Thirdly, we are compelled, due to our extra maturity, to direct our own study routines, and the group work sessions we undertake. This involves completing workbooks before lectures and working in small groups of about eight to tackle pre-set questions with the help of a facilitator. The group sessions are particularly eye opening in assessing how in the future we shall adapt to the multidisciplinary teams the government is so keen on.

Having spoken to a couple of my colleagues, the consensus is that a first degree in science is pretty advantageous when studying at medical school. This is because a lot of the studying is self-directed and in some instances, A-level entrants might find this difficult to cope with. Our communication skills are also more developed as is the ability to undertake academic tasks like dissertations. Experience really is the best teacher.

Over the next three and a half years, the role of doctors in the National Health Service is set to be scrutinised more closely by government ministers anxious to get rid of the "Consultant is God" approach that has prevailed in the past. Changing such attitudes to the practise of medicine should start at the training level. I see some of the challenges when I qualify as including being able to work effectively in multidisciplinary teams, and working to tackle the risk factors that determine health in any individual such as socioeconomic status and social behaviour. This graduate-entry course is, I hope, a step in the right direction in addressing these challenges.

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