Medical School Blues Opinion: Majid Ahmed

There has been recent widespread UK press coverage about the case of medical school applicant Majid Ahmed.

By all accounts Ahmed appears to have a glowing academic record and many personal traits that reinforce his suitability to practice medicine. His university application initially made a very positive impression, securing him interviews at several UK medical schools. One of the medical schools, that of Imperial College, made Ahmed an offer following his dazzling performances both on paper and in person.

But then it all fell apart. Imperial retracted their offer when it became known that Ahmed was a convicted burglar. He had received a conviction for burglary only two years earlier, yet considered it so insignificant that he failed to declare it openly as he should have done. It was only at the eleventh hour that Imperial discovered his previous misdemeanour. That left them little option but to reassess Ahmed's application after an offer was in place.

There is widespread sympathy with Ahmed's plight. Most in support cite the fact that Imperial College is discriminating against someone who has already paid their dues to society. He has been convicted by the courts so why punish him a second time by shattering his university dreams? The conviction relates to an offence committed when he was a naive 15-year-old, who simply got in with the wrong crowd in his hometown of Bradford. Lots of people make mistakes when they're a teenager, don't they?

Entangled in their sympathy for the apparent underdog most people have failed to grasp the most pivotal issue of the case - Ahmed is a burglar who failed to declare his criminal status transparently from the outset. That's an indisputable fact.

UCAS ask people to declare relevant convictions when they complete their application form. Sadly the word 'relevant' is open to interpretation because it only applies to offences considered 'unspent' under the auspices of the Rehabilitation of Offenders Act 1974. It appears Ahmed, perhaps acting on duff information, had used this interpretation to withhold information about his conviction of 2-years earlier. That was a mistake.

A little elementary investigation would have told Ahmed that medical careers are exempt from that legislation. This means they are never truly spent because future employers (or universities) can consider them during the recruitment process. Serious medical school applicants know these rules inside out.

Medical school admission is a cut throat business. Every year tens of thousands of applicants chase only a few thousand places. Every year thousands of exceptionally well qualified applicants face heartbreaking rejection, but accept their defeat graciously and with maturity. Contrast this with Ahmed's behaviour - a convicted criminal in a position of entirely his own making, yet he's still trying to get one up on the universities.

The universities have to separate the wheat from the chaff and, with the spiralling number of grade As being awarded at A-level, it's getting increasingly difficult to do that on a purely academic basis. This means that the universities are paying closer attention to factors like the applicants' interview performance, work experience and personal qualities.

This being the case why shouldn't Imperial College favour an honest applicant with glowing qualifications over a convicted burglar with comparable qualifications? Criminal actions have consequences.

Thinking a 2-year-old conviction for an inherently dishonest offence is too irrelevant to mention shows a severe lack of judgement and integrity on the part of Ahmed. Vulnerable people deserve to be treated by honest medical staff of unblemished character.

I also find Higher Education Minister Bill Rammell's intervention quite worrying. He is in no position whatsoever to dictate admissions policy to any UK institution. No doubt he has chosen to speak out in a hapless attempt to win the maligned Government some urgently needed brownie points.

Mr Rammell: Just because your profession and Government is morally void in every sense doesn't mean we should dilute the standards required of our medical practitioners.

Medical School Immunisations

The UK's Department of Health has strict guidelines on the immunisation of Health Care Professionals. Since most medical degree programmes now involve early clinical contact it's advantageous to get the necessary injections before turning up at the start of the course.

The medical schools will advise potential students of which immunisations they will require before coming into contact with patients. The usual requirements are as follows:
  • Proof of immunity against Hepatitis B or, if the immunisation process is unsatisfactory, proof of non-infectivity. The immunisation process involves three doses of vaccine over a period of about 6 months. A blood test will be required shortly after the final dose to determine whether immunisation has been successful. The test will either need to show the presence of Hepatitis B surface antibody or, if insufficient antibody is produced, that you are negative for Hepatitis B surface antigen and Hepatitis B e antigen.
  • Proof of immunity against diptheria, polio and tetanus. This is achieved by a combined vaccine usually administered every 10 years.
  • Proof of immunity against measles, mumps and rubella. Again, this is achieved by a combined vaccine usually given in childhood.
  • Proof of immunity against tuberculosis. This is achieved by the BCG vaccine, usually given in early adolescence.
  • Proof of immunity against chicken pox. If you've had it in childhood, as most people have, then you're immune. If you haven't had chicken pox you should have the varicella vaccine.
It saves a lot of hassle if you have completed these courses of treatment before turning up at medical school, although it is usually possible to catch up once you're there if need be. Remember to take any evidence you have relating to your immunisations.

Medical School Interviews

After reading my previous posts you'll be under no illusion that getting a place at medical school is no mean feat. Another hurdle that most people have to cross is the admissions interview.

There are still a few medical schools, Southampton for example, that make offers based purely on the information provided on the applicant's UCAS form. That being the case it is possible to dodge interview if you find the prospect too overwhelming, but in reality you would be foolish to limit your opportunity of getting a place by applying to only non-interviewing institutions. If you are an overseas applicant you are unlikely to be called for interview. If you are a graduate or mature student it makes it all but certain that you will be called for interview before any decision is made.

The interview is perhaps the most important part of the application process. By getting this far you have already proved your academic suitability, performed well in any admissions test and given the appearance of someone who could succeed at medical school on paper. Most applicants have not made it this far. Interview is the final opportunity you have to convince the selectors of your aptitude for medicine.

You only get one chance to make a first impression so make sure you are of clean, smart and practical appearance. Also remember to speak clearly and look at the interviewers when you are engaged in conversation.

Most interviews are conducted by at least two, possibly three interviewers. It is quite common for at least one of these to be a clinician and another a lay person - a non-clinician usually employed elsewhere in the university. Some medical schools invite a senior medical student to act as an interviewer. They will usually have read your UCAS form in detail beforehand and are likely to question you about your qualifications, personal statement (especially) and reference. I can not emphasise enough that you must know your UCAS form word for word and be prepared to answer questions on it. Most interviews begin with a few pleasantries like introductions, shaking of hands and asking about your journey etc.

The questions in the interview are likely to revolve around the following issues:
  • Your previous experiences, which you must be able to reflect on, and how these better equip you for a career in medicine.
  • Your understanding of the National Health Service (NHS): What it is, the general structure and how it works.
  • Ethical questions: What would you do in the situation put to you by the interviewers?
  • NHS awareness: Read some current stories on the NHS and be prepared to recite them and comment on them.
  • Why you want to become a doctor: Almost a cliche and few medical schools bother to ask it anymore. Best to have an answer ready just in case.
  • Why you want to study at [University name]: Know a little bit about the structure of the course and what makes it different from other medical degrees.
When answering the questions remember that there are some key qualities that are expected of all medical students:
  • Honesty
  • Integrity
  • Trustworthiness
  • Empathy
  • Compassion
  • Academic excellence
  • Perseverance
  • Teamwork
  • Reflection
Probably many more which I will add to the list as I think of them.

At the end of the interview there is usually an opportunity for you to ask any questions you have about the course. If you have no questions then don't feel obliged to ask something silly - just explain that you have looked at the course brochure and have already found most of the answers.

The interview usually lasts around half an hour. Once the interview is over it is over - there's no point dwelling on it and torturing yourself with a detailed post mortem.

All being well you should hear their decision within a few weeks.

Medical School Finance

You need to carefully consider the following sources of income and expenditure before you start your journey through UK medical school. You will have to carefully balance the following:

Income:
  • Student loans.
  • Parental/family contributions.
  • Employment.
  • Savings.
Expenditure:
  • Tuition fees.
  • Living expenses.
The student support you are entitled to depends on a number of factors: where you live, whether you have previously been supported in higher education, whether you have any dependents and the duration of your course. Home students are those who are normally resident in the UK/EU or Switzerland. Overseas students are those from elsewhere.

1. Home students on the standard 5-year course who have NOT previously attended a higher education course:
  • In each of the first four years of the course these students are entitled to full support from the Student Loans Company. This support is in the form of a loan covering both living expenses and tuition fees.
  • In the final year these students are entitled to a non-repayable NHS bursary and a reduced loan from the Student Loans Company to cover their living expenses. The NHS will also pay their tuition fees.
2. Home students on the accelerated 4-year graduate entry course:
  • In the first year these students are entitled to partial support from the Student Loans Company. They are entitled to the living expenses component only and will have to fund their own tuition fees.
  • In each of the remaining three years these students are entitled to a non-repayable NHS bursary and a reduced loan from the Student Loans Company to cover their living expenses. The NHS will also pay their tuition fees.
3. Home students on the standard 5-year course who HAVE previously attended a higher education course:
  • In each of the first four years of the course these students are entitled to partial support from the Student Loans Company. They are entitled to the living expenses component only and will have to fund their own tuition fees.
  • In the final year these students are entitled to a non-repayable NHS bursary and a reduced loan from the Student Loans Company to cover their living expenses. The NHS will also pay their tuition fees.
4. Overseas students on the standard 5-year course:
  • These students are liable to pay their own tuition fees and living expenses.
5. Overseas students on the accelerated 4-year graduate entry course:
  • At the moment overseas students are ineligible for the graduate entry course.
The new system of Government student loans (from the Student Loans Company) provide enough support for most home students to survive comfortably. The interest on these loans is linked to the rate of inflation, meaning graduates pay back only what they've borrowed in real terms. Further information can be found on the Student Loans Company website.