Is it time to rethink Medical School selection? A GP Mum and Daughter’s Perspective.

Since 2009, the government has reduced spending on the health service[1][i]. There is talk of bringing in more health professionals and resources, but we are still lacking, and often vacancies can’t be filled for which there are funds. There have also been concerns that when medical students are trained, they will go abroad and not give ongoing service to the NHS, leading to discussion of compulsory NHS service in England for 5 years.[2]

The recent coronavirus outbreak has highlighted the value of a good health service. But how do we encourage more young people with the motivation, compassion and endurance required for years of training and the capacity to work for decades in an overstretched service, without giving up or going abroad?

I am a GP and my husband, is a Child Psychiatrist. We have both worked in the NHS for over 20 years and our four children have witnessed the satisfaction, but also extreme stress and all-consuming nature of our work. Despite all this our eldest daughter has decided to apply to medical school. She attends an ‘outstanding’ state school and wonders why none of her friends want to apply to medical school. This is her story.

Medical school application.

What initially comes to mind? We envisage compassionate, dedicated individuals with a love of science and intellectual challenge. We need new doctors, as well as nurses, paramedics, therapists etc. more than ever with the 2020 COVID-19 outbreak. These workers are not only on the front line of care for those infected with this disease – but also for those with every other disease. They are literally the beacon of hope to which we hold on to.

That’s why we seem to be clapping randomly for them every Thursday.

They therefore do not need the additional pressures from lack of NHS funding. In December 2019, there were 106,000 job vacancies across the NHS[3] – marking an increase from the previous year and causing further stress and burnout to current employees. By April 2020, approximately 35,000 retired doctors have come back into service, and many of whom are elderly and most susceptible to the coronavirus anyway.[4] We appreciate all their support, but this is far from ideal.

Why then do so few of my schoolmates want to work for the NHS? Why has medical school application still become ever increasingly competitive and grade orientated?

I’m in (or used to be in) the canteen with my mates, talking about ‘post-18’ options. ‘The NHS is going under -why would you wanna to work for them?’ ‘You have to be a genius to be a doctor,’ ‘Doctors have no social life,’ they say. I first wanted to be a doctor when I made some primary school friends with genetic disorders – becoming obsessed by the science of what makes an ill person and how to cure them. This was developed by my love of human biology at A Level and hospital work experience where I enjoyed chatting to patients.

Schools should tell their students that doctors need have good people skills as well as being academically minded. They shouldn’t scare kids out of applying because they won’t get A*A*A*A*A*………More Sixth Form colleges need an encouraging action plan for getting kids the key work placements they want – alongside teaching A Level content. Also, without teachers freely showing passion for their subjects, how can they inspire our future doctors? No more mere mark scheme drilling.

In this Coronavirus pandemic, should we be looking again at how we train and encourage people to work in our NHS? We need to be listening to the young people at this difficult time. Not only do they have to contend with the usual difficulties of studying, exams, and applications for courses, but they are having to do this in a new climate of uncertainty and fear, learning new ways of remote working. General Practice was re-imagined very quickly at the start of the pandemic and is continuing to be re-invented into a “new normal”. Similar innovative changes have been made by our colleagues in secondary care.

Surely, we can do something similar for the recruitment and retention of our young people, so that they can be fully equipped for the many challenges that are still to come. We argue that the grade boundaries for medical school and nursing are relaxed and the selection process looks a lot more at the personal qualities needed for entry at 18 years, 21 years and up to the age of 30 years, implying a need to tap into an even higher intake from the graduate community, who have had more life experience.We need to think again about how to attract to our worthwhile profession.


[1] https://www.bbc.co.uk/news/health-50290033

[2] https://www.independent.co.uk/news/health/junior-doctors-nhs-quit-training-costs-repay-pay-back-health-department-medics-medical-school-a8172141.html

[3]  https://www.unison.org.uk/news/2019/12/nhs-staff-shortages-increase/

[4] https://www.bma.org.uk/advice-and-support/covid-19/returning-to-the-nhs-or-starting-a-new-role/covid-19-retired-doctors-returning-to-work


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