Take one step back, gather your thoughts and let me ask you one question: Are you sure that you want to be a doctor? Did you say 'yes' instantaneously, wave your hand in the air as high as you could tripping over yourself in the race for the front of the line? Yes? Then you are either: (a) Convinced by your life-time sense of vocation and by your need to help fellow men (/women). (b) Completely nuts. Why? Because medicine is not a subject decision to be taken lightly. You probably haven't yet lived two decades of the few that you have in life and are effectively going to be signing the rest away. If it sounds like I’m trying to put you off then you’ve guessed right, but that’s no reflection of the institution that I’m writing about, rather a caution over the subject as a whole. If you really think medicine is the subject for you then you’re not going to be put off by some random article on an internet site, but if you’re undecided I’d really consider doing lots of research into what you’re diving into. Go to open days and ask questions, and make sure you’ve done the work experience. Make sure you’ve heard first hand what it’s like to have been up for 24 hours on call earning peanuts working within a pressured NHS environment whilst your old university buddies are earning buckloads in the city. Right now I’m a fourth year medic on the six-year MBBS/BSc course, and I’ll be graduating in 2004 with a realistic debt of over £25,000 (student loan and bank overdraft). Meanwhile two of my non-medic flatmates from last year are now working in the city for over £30,000 a year. You go figure. And then there’s the good side. This is the bit that all those people that got turned off about 10 lines down won’t be reading. The good side consists mainly of this: human compassion. It’s that nice feeling in your bones to know that
your life is going to be worth something on a humanitarian level. The feeling that hundreds of people are going to have lives touched by you. And of course being challenged in your daily work and being a generally nice rounded human being. Ahhh. So enough about the subject, what about the course? Imperial College School of Medicine is one of the new merged medical schools in London consisting of the former St Mary’s medical school and the former Charing Cross & Westminster medical school. As such it finds itself located across the most part of west London which is where most teaching and hospital rotations will take place. In common with most medical schools other than the Oxbridge faculties, the course is no longer divided into a “pre-clinical” phase followed by a “clinical” phase. This older system relied on academic teaching in the basic sciences such as anatomy, physiology and biochemistry during the first preclinical phase (usually two years) followed by hospital based clinical teaching on the wards in the clinical phase (usually three years). Some students would do an intercalated BSc in between. On the whole only Oxford and Cambridge still teach in this traditional format, with a focus on the pure science. Many on these courses move to London or other cities to study their clinical phase. At most London colleges now, the courses have been restructured but still remain similar to the old preclinical/clinical design to a greater or lesser degree. At Imperial, for example, the first two years are still in the basic sciences, but not taught by subject (anatomy, physiology etc), but by body system (cardiovascular system, neurological system, gastrointestinal system etc). This difference reflects the fact that in hospital, medical teams are based around these same divisions (cardiologists, neurologists, gastroenterologists etc) so that when you do your hospital rotations things make more sense. This teaching is basica
lly in the form of lectures, which take place in the Sir Alexander Fleming building at South Kensington and at Charing Cross Hospital, Hammersmith. The lectures are supplemented by practicals, tutorials and new fangled inventions like PBL (problem based learning) and SDL (self directed learning) which are the mainstay of some other medical school courses. In addition there is some patient contact in the appropriately named Patient Contact Course whereby you’ll get to meet people like those you’ll see on the wards. Assessment during these two years of lectures is by end of year written exams and practical communication skills assessment (which will be videotaped...!) The two years of lectures is then followed by the real thing on the wards. This bit is common to all medical schools wherever you are and basically follows the same pattern. You’ll do about one year of general medicine and surgery, which is about four attachments. In hospital, the consultant is boss and all those under him are referred to as his “firm”. Next down are the specialist registrars (SpR), then senior house officers (SHO), then house officers (HO) and then you as students. You will be expected to see patients, ask them questions and examine them (known as “clerking”) and then present your findings to one of the more senior members of the firm. Teaching will be variable depending on how willing doctors on your firm are prepared to teach. The basic tenet is that you are there to experience the conditions you read about in real life and to learn some basics about whatever the firm does (eg medicine, surgery, whatever). Each firm will have some form of assessment. After having experienced the basic medicine and surgery and worked out which bit of the stethoscope goes in your ears you’ll be unleashed on the specialties (like psychiatry, neurology, obstetrics & gynaecology, A&E etc). This is the more complex stuff and assessments in these firms
will count toward your overall degree. The other big difference in the Imperial course is that all students must read for a BSc degree in addition to the MBBS degree. This means that the Imperial course is six years instead of five. The BSc is modular and work for it continues throughout the course culminating in a year out from medical teaching either in the fifth or sixth year. This means taking a year out during the “specialty” rotations but means something nice to put on your CV (especially if you get a first, since the MBBS is an unclassified degree so your BSc may be the only indicator of your intellectual prowess). Finally having completed this you’ll be in the sixth year with final exams. During this you will have written as well as clinical exams in a hospital setting with real patients... And then you’ll be able to call yourself doctor. Easy. So what about Imperial as a place? Well if you want to come to a nice area of London it doesn’t really get much better than Kensington and Chelsea, although your student budget might not stretch very long... The medical school tends to segregate itself from the rest of the college and can really be considered as a separate entity although the benefits of the main college societies and union are all available to medics. On the social side, Imperial doesn’t have a particularly good reputation due to the 70:30 M:F statistic, but looking wider, London is one of the best cities in the world whatever you’re into – from high culture to hedonistic pleasure. Academically Imperial has an excellent research reputation and has arguably the best postgraduate centre in London which helps when you’re looking for training post once qualified. It also has a huge hospital base headed by three big London hospitals: St Mary’s, Paddington; Charing Cross, Hammersmith; and Chelsea & Westminster, Fulham. On the down side the wide hospital base means lots
of travelling around, and a decentralised medical school community. The merger has left the medical school without a single focus, although has opened it to the wider environment of Imperial College. The course itself is also still evolving as we speak since I joined in the first year of the new merged school. Things change year to year, but not really very significantly. The major problems had in our first year have generally been sorted for successive years below. So, I’ve ended my little spiel. Let me say this to you again: Think hard about medicine before you apply. On a more profound scale, work out what you want from life. Take a year out. Do whatever it takes, but think about it seriously. As for Imperial, it’s a nice place to be – but not the only nice place you could be to study medicine. But don’t take my word for it. If you’re serious about medicine do the open day, see what it’s like, make up your own mind... And myself? Well, when I grow up I’m going to be a lawyer...
I have just completed my first year of medical school at Imperial College and have absolutely loved it! Medicine at Imperial concentrates very much on the 'peoplely' side of medicine - we spend quite a lot of time learning communication skills and meeting and talking with patients. This emphasis is very much reflected in the kind of skills and experiences that Imperial seem to look for on a UCAS form - my predicted grades were poor, but I had an awful lot of community work, so I can only surmise that I was accepted on this basis! Being a student in London is also a great experience - there is everything for everyone, whether you like theatre or clubbing.