Med school in the UK?

[brontehardyeliot]

I guess at this point I really need to look at what kind of financial assistance I would get. I don't know if I would be applying for U.S. loans or U.K. loans as an American at a U.K. school. Whichever I would apply for, I really need to find out when you start paying them back, how long you're given to pay them back, etc. If I was given an adequate amount of time to pay off the debt, it wouldn't bother me. I was just worried that with debt that's probably three or four times higher than the average U.K. med school graduate, I'd have these astonishingly high loan payments and I would not be able to make them.

I've been looking into scholarships, too, but some of the big ones like the Rhodes scholarship and the Marshall scholarship, I'm too old to apply for apparently. Oh well. Those are pretty tough to get anyway.

FionaS, I actually have The Insider's Guide to Medical Schools and I LOVE it! It was the first book about British medical schools that I stumbled upon when I started doing searches on amazon.co.uk, and it's given me so much information about individual schools! I find myself pulling it out at odd times, weighing the pros and cons of applying to this school as opposed to that school. And I'm going to get So You Want to Be a Brain Surgeon. After I've read it, I'll probably have tons more questions about the postgrad process, but now I know so little, that I'm not even sure what to ask.

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[miscalculated]

Hello Thewonderer, yep you're right that British surgeons are called "Mr" instead of "Dr" and here's some info I got off a website for you:

Surgeon Titles: Dr. vs. Mr.
By Mr. Rodney Croft

While surgeons carry the appellation ?Dr.? in the USA and other parts of the world, in the UK they are referred to as ?Mr.? How has this anomaly arisen?

Academically, in order to be called ?Dr.? one must hold a doctoral degree (the highest academic degree in any field of knowledge), such as Doctor of Medicine, M.D., or Doctor of any other discipline. In the USA, an M.D. is a licensing qualification to practice medicine, whereas in Britain, an M.D. is a postgraduate thesis degree. In order to practice medicine in Britain, students must attain a Bachelor of Medicine and a Bachelor of Surgery degree (MB and BS). Therefore they are not, in the strictest sense, ?doctors.? However, once graduated in Britain, all graduates are referred to as Doctor, as are consultant and trainee physicians and other specialists??all except surgeons.

The word ?doctor? is derived from the Latin doctor-oris, meaning teacher or instructor, and in Middle English (c. 1150-1500) it became used for any learned man or medical practitioner. The title ?Mr.? is a 16th century English variant of Master, derived from the Latin Magister, which means master or teacher.

Following the fall of the Roman Empire, most surgery in Europe was performed in monasteries by monks and their assistants, the barbers. As well as cutting hair and shaving, barbers helped with blood-letting.

The Medieval Universities were founded to teach subjects, including medicine, which had no place in the ecclesiastical curriculum. Salerno was one of the first medical schools and was established by the middle of the 11th century. Courses were initially available to physicians and surgeons, but not to apothecaries.

In 1123 CE, Pope Calistas II decreed that monks must not shed blood, and it was this ruling that resulted in the teaching of surgeons being forbidden in church-dominated universities. Surgeons, therefore, served an apprenticeship, whilst physicians spent four years at university, leading to a Bachelor of Medicine degree and a possible further thesis leading to a Doctorate. The Pope?s ruling also resulted in a great boost to the barbers, who now performed dental extractions and fracture treatments as well as blood-letting. Because of their increased role, they became known as the barber-surgeons, and monks then administered only to the spiritual needs of patients.

At this time, true surgeons also developed. They were more skilled than the barber-surgeons, but were apprenticed and not university trained, and therefore could not style themselves as ?doctors.?

In 1493 English surgeons decided to enter a working agreement with the barber-surgeons, and this association was given Royal assent in 1540 when Henry VIII, by Act of Parliament, united the two groups under the name of ?Masters, Governors of the Mystery and Commonalty of Barbers and Surgery of London.? From this time, by Royal edict the barbers could only perform barbery and extraction of teeth, and the surgeons had to refrain from cutting hair and shaving people! King Henry VIII gave each member of this newly formed group the right to be addressed as ?Master,? and in time ?Master? was pronounced ?Mr.? So when a British Surgeon is addressed as ?Mr.? he is actually being honoured, as in reality he is being called ?Master.? Female surgeons are called Miss, Ms. or Mrs.

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So basically Mike the medstudent spends all his life wishing to earn the right to be called Dr and once he's reached this level he yearns to be called Mr again, weird huh?!

I'm willing to help any guys interested in applying to UK medical schools, just ask!!

miscalculated

 

[FionaS]

I know - Dr vs Mr - It always seems odd to me that surgeons in the Us are called Dr, I always assume they're still in training... And then I remember Like Miscalculated (hi there by the way!) says, surgeons used to train separately etc and not get the MD so they didn't call themselves Dr. Yes, you are likely to upset a surgeon if you constantly call them Dr, unless they've done a PhD in which case they might forgive you

After private practice most consultant physicians (outside of London) can expect to earn about 90-100k (pounds) and most consultant surgeons can expect about 120-150k with private practice. You aren't allowed to practice privately (in any substantial manner) until you are a consultant. Just for comparison the average UK household income is 30k - so marry another doc and you do quite well really...

BHE - probably best off with a UK loan, though since I don't know the US system I can't really say. Maybe you could talk to some banks over here? Barclays, Lloyds TSB, HSBC and Natwest are the main banks. Natwest has the biggest student market I believe, personally I bank with Barclays and they are fine with me - they keep on offering me loans and I haven't yet asked for one You could try investigating the Student Loans Company (www.slc.co.uk I think, if not try .com on the end) to see if they do anything for international students.

Maybe you should try becoming a British citizen?!

 

[brontehardyeliot]

Actually, FionaS, that's exactly what my husband and I had hoped to do eventually: become British citizens I mean. I hadn't looked seriously at all that becoming a British citizen entails as of yet because I assumed that I would have to live in the UK several years before I'd be allowed to go through the process. But all things considered, it does seem like something I should be thinking about right now, however long it might take me. Do you think I might be able to find something on the British Council Web site about it, or is there another site anyone can suggest?

 

[Stephen Ewen]

For anyone "in the know" about the medical culture in the UK, I am wondering how docs from non-UK medical schools, but the ones that carry full GMC approval (e.g., University of west Indies, Jamiaca), are viewed by other docs and patients. Thanks.

 

[The Pill Counter]

BrontyHardyEliot: Just a few words of caution: The route to consultancy is like the splenic artery, long and tortuous. (I know bad joke, I'm revising anatomy at the moment)
You are not making that kind of money for about ten years on average postgrad. Let's take a medium-competitive medicine specialty, like rheumatology. It would take 1 year pre-reg, 2-4 years senior house officer, all the while making yourself attractive to obtain a National Training Number (NTN). Most likely you wouldn't get this with only 2 years of house officer years. Let's say it takes you 3 years of SHO, so now 4 years out of med school you're blessed with an NTN. The training period could be anywhere from 4-6 years before you get your CCST (Certificate of Completion of Specialist Training) in Rheumatology. But you're still not a consultant. It is recommended to you that doing a year out to write an MD thesis to make yourself more attractive. With 10-20 new consultants named per year, your competition is other registrars with a CCST in rheumatology. So say a year later you're appointed a consultant - about ten years later. AND! the government is considering restricting how much private practice a new consultant can do, although I don't know if that would apply to someone who funded their own degree. I'm British-born doing a GMC recognised degree in Australia so it is an option in my mind, but to be honest if say, rheumatology was the thing, the US option is three-year internal med, 2 year rheumatology fellowship and there you go: 5 years postgrad you are completely independent with much greater earning power.
By the way, say rheumatology wasn't your thing, but cards, or GI, add a couple of years to compensate for the much more intense competition.

 

[miscalculated]

Firstly, there is no such thing as the term "FMG/IMG" in the UK. Doctors are so scarce in some parts of the country that people would be pleased to see a doctor no matter where s/he trained! I really don't think there is any stigma. (Fiona, (hi by the way!!) can you expand on this?) There are many doctors from Asia in Britain because British medical schools have to take overseas applicants and they usually take students from countries that used to be part of the British Empire.
I really think it doesn't matter a bit to the patient where the doctor trained because doctors are held in such high regard here anyway.

 

[geezer]

Pill Counter, the MD is actually two years of full time research not one as you have stated, plus it is generally done during the registrat years, and sometimes even before you become a registrar hence ist is completed before the CCST. Once the CCST is completed though, you it should not be too difficult these days to obtain a consultant post provided you are not too fussy about where you work. The reason why NTN's were introduced was to try and match registrar appointments with predicted upcoming consultant posts.

I would agree with you that only very good graduates, or very lucky ones, can become consultants within 11 years of graduating. Now if money is your thing, then you should consider becoming a GP, as it only take 4 years post graduation to achieve full GP status, plus GPs can earn a lot of money (> ?100, 000 in some cases).

 

[The Pill Counter]

Geezer, my cousin, a graduate of your school might disagree with the lofty numbers you've stated for GP's. They'd have to be doing a lot of private work to get it up that high. But after speaking with him, and seeing his surgery running, I'm not even going to pretend to understand the scheme by which GP's are renumerated in Britain!

 

[lola]

Where did you find info about GKT? I went to King's for my Junior Year and am interested in finding out if they have a 4 year graduate entry program but haven't had much success looking on their website.

 

[brontehardyeliot]

Lola, I found a lot of my info about GKT from a book a mentioned in an earlier post, The Insiders' Guide to Medical Schools (UK version), which I ordered from amazon.co.uk. There's also a place on GKT's Web site to order a prospectus. I think you just go to "Prospective Students" and then to "undergraduate" or "graduate" study. I know they have a premed program, but I don't know if I remember anything about a graduate one.

Pill Counter, I'm almost afraid to ask where hematology/oncolgy ranks on the scale of competitiveness in the UK, but I think I will, just to know where I stand.

Can anyone tell me some of the areas of the UK where doctors are scarce? If I do opt to train in America instead of Britain, then I'm guessing that my best bet for getting a job over there eventually would be to plan to move to one of these areas. Just want to look over all my options very carefully.

 

[miscalculated]

Hello brontyhardyeliot!

Drs are especially scarce in the rural areas of the country (Cornwall, Devon) and "up north" as we call it (Cumbria, Northumberland) and in Wales. Here's a link from the British Medical Association website (20th Aug 2002) about the shortage of Drs in Wales:
http://www.bma.org.uk/ap.nsf/Conten...ng+picture+for+general+practice+-+20+Aug+2002

But Drs are also shying away from working in big cities and there are now cash incentives available to GPs who work in innercity surgeries.

Basically, England is crying out for doctors! It's well-known there aren't enough of them here, junior doctors get stretched to their limits etc, though this should change with the introduction of the 48 hour max week. (I don't want to put you off altogether!)

And regarding GKT, well I'm going to be starting there on Sept 23rd and they *are* planning on introducing a 4 year grad programme. Email [email protected] for more info.

When are you guys applying?

 

[miscalculated]

ok, so that link doesn't work. Here's the entire article instead!

welsh recruitment survey paints a depressing picture for general practice
Press release date: Tuesday, 20 Aug 2002 (BMA Wales)
The results of a recruitment survey by the British Medical Association in Wales paints a gloomy picture across the whole of the country.

Family doctors practices from the four corners of Wales are reporting a sharp drop in applications for vacant posts with several unable to retain at all.


One medical practice in mid Wales has finally filled a vacancy which was open for 3 years highlighting a staff shortage which led to the practice having to close the list and publicise the problem to their patients, Low pay and stressful on-call system are quoted as the reason for the low uptake in applications.


The picture is the same across whole swathes of mid Wales. "Response to advertisements was very poor and gave partners a small number of applicants from which to recruit," reports one GP.

The northern valleys of Gwent have experiences such problems for many years with several practices having to close their lists temporarily in order to limit the workload. One practice had one applicant to their initial advertisement and he did not return for a second interview. They are now very selective about new patients and have advised some patients to consider finding another GP.

Chairman of Gwent Local Medical Committee, Dr David Bailey said:"Our principal problems in the Gwent valleys are the highest proportion of GPs in the UK aged 55 and over, and areas of high deprivation and morbidity. This is leading to vacancies with high workload and poor infrastructure, which is bad news in a buyers market. The situation may be helped by the new contract, providing there is agreement on patient allocations, but unless we become self sufficient in training GPs throughout Wales, I fear we will continue to fight a losing battle."


The valleys of Rhondda Cynon Taf, Bridgend and Merthyr Tydfil are also experiencing grave difficulties in recruitment with several practices reporting long-term vacancies despite placing several advertisements over a period of several months. Some practices have had to close their list to new patients.

Chairman of Bro Taf Local Medical Committee, Dr Susan Pierrepoint said:"Parts of Bro Taf - particularly the valleys - are already recruitment blackspots, with many GPs due for retirement. Even Cardiff is now developing recruitment difficulties -particularly in areas of deprivation.

"Practices which have extensive new development within their boundaries are taking a hard look at offlisting patients who move out of the area."

The comments reported by practice managers and GPs are depressingly similar from all corners of Wales:

"Four candidates have visited the practice, but only one application was suitable. However, they pulled out in the end."

"We have 3,450 patients and only two GPs at present. We have not closed our lists, but the work rota has been rearranged and surgeries extended."

"We are a rural area and the on-call is every other night at present. I feel that this is why we are unable to recruit."

North Wales has not escaped the crisis with vast finding recruitment a problem as well:

One practice reports:"At one point last year we had great difficulty in recruiting two new partners (one full-time, one part-time). We advertised in all the medical newspapers - twice - and even advertised in Ireland. We only received one applicant who is now working part-time. We managed to recruit our full-time partner through one of our part-time GPs who works at the general hospital in Bangor.

"We organised a trip to Northern Ireland with our local health group to talk to newly qualified doctors. We offered free travel and accommodation for two nights, again nothing forthcoming.

"Currently our 2 new partners have extended their probationary period and we are not sure whether they will stay or not. They have asked for a further 2 months to make a decision.

"If they decide not to stay I fear it will mean the end of this practice. Two other partners have changed from full-time to part-time and if our two new partners decide to leave there will be so much pressure on our other full-time GP I am sure he will leave also.

"At one point when we were short of doctors, we had to close our list for about 3 months.

"There is a big problem in north Wales recruiting GPs and we know of another practice in a nearly town who were recruiting the same time as this practice. They have not had one single applicant and are now desperate. They have a GP retiring next year and it could mean the end of the practice."


Chairman of the BMA's Welsh General Practitioners Committee, Dr Andrew Dearden said: "The problem is that not enough has been done by the National Assembly to encourage GPs to enter general practice in Wales over the past 5 to 7 years. The GPC Wales has been warning the then Welsh Office and latterly the Assembly of the impending recruitment problems for at least that long, but with little success. Funding to primary care and general practice has been siphoned away to meet spurious short term targets set by politicians, mostly in the hospitals, instead of investing resources in long term funding needs, for example having more GPs seeing patients at the "coal face".

"Recently there has been some progress in setting up incentives to attract new doctors into general practice and encouraging older doctors to remain in practice, but much more needs to be done.

"The new contract for GPs will go a long way to helping to increase the numbers of doctors entering general practice but only if it is accompanied by significant new funding. This will be the true measure of the government's and Assembly's commitment to developing general practice."


Contacts:

Dr RD Spring and Dr CT Whitfield, Presteigne Medical Practice (01544 267 985)
Dr Geoff Graham, Pontypool
Calfaria Surgery, Treorchy (01443 773595)
Laraine McEnhill (Practice Manager) Cambria Surgery, Holyhead.
Dr Alan Rogers, Llyfni Surgery, Maesteg
Dr HS Evans, Cwmbran (01633 4841)

 

[lola]

Right now I'm only applying to Oxford. I know it's unlikely I'll get in, but I've decided to try anyway (if I can figure out how to fill out this UCAS application!) I can't really find any other programs that are 4 years that will take foreign students.

 

[brontehardyeliot]

Hi, Miscalculated. I won't be applying until next year (still have some science classes to finish up). I'll probably apply to four places, although I'm not sure which ones yet. I do have it down to seven though: Oxford, Sheffield, GKT, Newcastle, Leicester, Dundee, and Birmingham.

 

[The Pill Counter]

Lola: The Warwick/Leicester School

 

[lola]

Hey thanks Pill Counter. I'm actually not eligible, because my degree is in Chemistry and not a Biological or Health Science. Oxford includes Chemistry as one of their eligible degrees, but it looks like Warwick/Leicester doesn't. I also have a Master's Degree in Epidemiologiy, but they don't regard it as a Health Science. Oh well

 

[Thewonderer]

I am so glad that my inquiry about Dr. v.s. Mr. got clarified. I did a year abroad at UK in college but I never hanged out with the medics, so I have a few questions that never got answered.

If you guys don't mind,

1) Which are considered more competitive med schools? When I was there, I thought the general concensus is that Cambridge was beating Oxford in all areas of sciences. How about other med schools?

2) I am curious about all the terms being thrown here.

In US, after 4 years of med schools, you get your MD and you become residents (enter so called "residency training"). Your post-grad training then last from 3 years at a minimum (family practice or GP in UK, pediatrics, internal medicine) to 10+ years (cardiothoracic surgery, etc.) depending on your area of specializations and residency + fellowship time.

I assume from reading here that, in UK

The first step is to graduate with a Bachelor's degree after 3 years of university-level sciences courses (same length as all the other degrees in history, philosophy, etc.).

The second step is to find a program that will take you and give you 2 (@ at places except) to 2.5 (only @ Oxbridge) years of clinical experience/education, and that will give you a Master's degree (which is equivalent to US MD). I heard that finding a program after getting your bachelor's is no big deal since many more spots are open than the number of applicants.

The 3rd step is for post-grad training where you are called house officers (=residents in US terms) for either 4 years to become a GP or how many ever years it takes to get an NTN and receive advanced training (= fellowships in the US). And after you finish your advanced training, you are blessed with a CCST and there, you become a consultant (=specialist in the US).

Am I wrong in my understanding?

How about surgery trainings?

What do they call people who are being trained with NTN? In the US, they are called fellows.

What is a registrar? Is that basically = fellow in the US?

Also, who does research for 2 years to get an MD? Why would anyone do that? What is an MD in UK's term?

Lastly, is there such a thing as the match in UK? Or do med school graduates simply sign contracts with different programs to obtain house officer training?


Thanks!


As for my input in this issue, you can actually do a FAST-track in rheumatology in the US. My resident was interested in it so he told me. Basically instead of 3 years of internal medicine residency and then 2-3 years of rheumatology fellowship (some do research and hence the extra year, but that's not required), you can instead shave 1 year off your internal medicine training, so you will, at its shortest, get a total of 4 years of post-graduate training before becoming a certified rheumatologist.

Allergy/rheumatology is a fairly easy fellowship to obtain in the US. Heme-onc is okay hard to get, while both cardio and GI are very competitive (similar to the UK).

 

[Thewonderer]

Originally posted by The Pill Counter
I understand the point you're making geezer, except the fact that the academic record most English schools require is equal to or greater than what is competitive in North America. It is by no way an easy alternative. Some schools won't even consider students who don't have English qualifications. My North American degree was insufficient for Manchester and Liverpool, both demanded degrees from English Universities.

I am getting hooked on this thread a bit, so just reading some of the previous posts more in details.

To Pill Counter and Geezer,
Similar to the thread I started on putting Canadian schools on some people' map, does anyone really know how competitive it is to get into certain UK or Canadian med schools as internationals? Say, (just pulling out a number) 10-20 spots for internatonals might not sound a lot but it wholly depends on how many applicants actually apply and depends on their credentials. And I am sure they offer much more than 20 acceptances to make the yield worthwhile. But I am sure that nobody knows the answers to all of the above. Furthermore, in the US, there are many schools that receive 1500-3000 applications for 150 spots. And proportionally, do these UK and Canadian med schools necessarily get 200-400 international applicants for 20 spots? It would be good if someone can dig up the numbers for us.

Also, people often forget that US application can be quite different from UK application. In UK, they probably look at your highschool grades as well, and they will care less about your Medical College Admissions Test scores. These can work to some applicants' advantage. So I still do not agree that if you can get into an UK school, you would necessarily be competitive enough for an US school in the first place.


To Bronte,
I can understand the romanticism that Americans have toward UK in genearl (and in particular Oxford). But the actual thing is usually not as good as you imagined. And honestly, I could not stand the weather (more grey sky than I ever imagined) and the expense during my year in England. The US as a whole also embraces technoolgies much faster than UK does (with the exception of the mobile/cell phones!). I know that you will apply to Texas schools along with some overseas. But you should think this over carefully. There is always the option of getting accepted in the US and then take a year off (if you get accepted early enough, most schools will let you defer your acceptance for whichever reason you can think of because they always have the waitlists to fall back on) and just backpack across Europe for a whole year (while you are at it, why don't you add Australia too)! In terms of time spent in medical training and finance, you might come out on top with the latter plan. Or alternatively, you can study part-time in London and explore Europe with your husband for one whole year. either way, you don't have to spend 4 years there and have to deal with IMG status (unless, of course, as you mentioned before, you might even stay in UK for House Officer training, etc. etc.).

 

[miscalculated]

Thewonderer, I'm afraid you are wrong in some of your understandings. Allow me to clarify...

Medicine is an undergraduate degree lasting 5 years. The first two years are the preclinical years and consist of university-level science illustrated with clinical examples. Medical students at most British universities are allocated to a GP's surgery in the first semester so there is patient contact very early on.

Medical cirricula must adhere to GMC (General Medical Council, in case you didn't know) guidelines so it's pretty much the same at every medical school but some have more PBL than others. Most of the learning in the first 2 years is "systems based" which means you learn about body systems and their associated diseases. The first and second year cirriculum at GKT also contains sociology, psychology, public health medicine, ethics and epidemiology.

At the end of the 2nd year some students choose to intercalate a BSc, extending their studies by one year. The first two years of the medical degree make up the first two years of the intercalated bachelor's degree. After the BSc, students can study for an additional year to get a masters degree and it's also possible (e.g. at GKT) to do a PhD but only students who want to go into research do this.

Years 3, 4 & 5 are the clinical years. You said we must find a programme to take us after the preclinical years so we can complete our masters. That is incorrect. The clinical teaching is automatically part of the degree course so we do not go out and "find" a programme. After the 5 years students have the right to call themselves "Doctor" and the degree they have is MB BS (Bachelor of Medicine, Bachelor of Surgery) but different medical schools have different forms of this, e.g. MBChB but it means exactly the same (the "Ch" comes from the Latin for "surgery"). The medical schools of the University of London award the MB BS.

After the 5 years of med school you become a PRHO (Preregistration House Officer) for one year. You work 6 months in medicine and 6 in surgery. After the completion of this year you register with the GMC and then you are licenced to practise. After the PRHO year you are an SHO (Senior House Officer) and this lasts 3 years and is equivalent to resident in the US. Then comes registrar, senior registrar and finally consultant.
A registrar is a doctor who is working in their chosen speciality and is working towards becoming a consultant.

Re the match, here grads are allocated positions in the hospitals to which the med school is connected with (although is it possible to transfer to a different part of the country if you wish, e.g. a PRHO who graduated from Manchester was working at the hospital I was working in, which was in the south-west of England).

I hope I have been of some help, Thewonderer.

 

[13538]

I think Thewonder is also getting the general system of medical training in the UK mixed up with the system at Oxford.

Medical students at Oxford spend the first 3 years of pre-clinical training working towards a BA (usually in physiological sciences). Students then must apply to clinical schools in either Oxford, Cambridge or London to do their clinical training leading towards the Bachelors in Medicine and Surgery.

Also, Oxford, Cambridge and Dublin (Trinity College) BA graduates are entitled to an MA 3 years after their BA was conferred. The Oxon/Cantab/Dubl MA is part of the tradition of these universities and is not awarded for the completion of a period of research or course work.

 

[brontehardyeliot]

Hi, Thewonderer. I know England's pretty grey, but after Texas, I'm actually sick of the sun. The most practical thing to do if I really want to live in the UK eventually (and I promise I am considering practical things) would be to go to school somewhere in Texas and then move to the UK to practice since my debt would be low to nonexistent. I am considering it as a perfectly valid and logical option. Just not my favorite option.

 

[The Pill Counter]

Before I headed off to Australia a few friends of mine gave me a piece of advice, "Debt will kill you" Now, this was my last option, so I had to take it. But, I really don't understand anyone who would purposely go into debt when they could arrive at the same place by taking a less costy route. So BHE, remember, "Debt will kill you!"

 

[Thewonderer]

Originally posted by miscalculated
After the 5 years of med school you become a PRHO (Preregistration House Officer) for one year. You work 6 months in medicine and 6 in surgery. After the completion of this year you register with the GMC and then you are licenced to practise. After the PRHO year you are an SHO (Senior House Officer) and this lasts 3 years and is equivalent to resident in the US. Then comes registrar, senior registrar and finally consultant.
A registrar is a doctor who is working in their chosen speciality and is working towards becoming a consultant.

Re the match, here grads are allocated positions in the hospitals to which the med school is connected with (although is it possible to transfer to a different part of the country if you wish, e.g. a PRHO who graduated from Manchester was working at the hospital I was working in, which was in the south-west of England).

I hope I have been of some help, Thewonderer.

Yeah, I think that I got the oxbridge system mixed up with the rest. All of these are pretty interesting....

So if oxbridge kids spend 3 years to get BA (all preclinical), then their clinical training is 2 1/2 years only? so they go to school for 5 1/2 years to be called doctors?

And since people tend to do their PRHO and SHO in the hospitals affiliated with their med schools, do people in UK care less about their school/hospital's reputation and more focused on where they wanna live for the next 9-10 years?

So in order to become a certified GP, kids in UK would have done 3 years of clinical in med school, 1 year of PRHO and 3 years of SHO. In the US, one would only have done 2 years of clinical in med school and 3 years of residency before becoming a certified family doc (=GP). In Canada, it is even shorter, because FP residency is only 2 years long! I don't know if I can trust my FP's in N. America anymore

Cheers!

 

[miscalculated]

AFAIK Oxbridge students still have to complete three clinical years after their BA. They either stay at Oxbridge or transfer to London. One of my friends got bored of Oxford and went to GKT in London. It is possible to do it the other way round, i.e. for London students to do their clinical years in Oxford/Cambridge but I'd doubt you'd get bored in London! The course at Oxford is 6 years and at Cambridge it's 5 so cambridge students don't get the BA as part of their course, they get it if they choose to intercalate for an extra year.

Of course some students are concerned about reputation and amongst the five medical schools in London there is a dividing line between the "best" and the rest and I won't name any particular schools in case I offend anyone but it is actually entirely due to the college of the University of London to which the medical school is linked rather than the individual medical schools themselves. Generally medical students become very proud of their school and the basic truth is that all medical schools in the UK are excellent so it does really boil down to where you want to live.

 

[FionaS]

Whoops, back on the net again, and hello all! Just feeling sunny (and the sun was indeed shining all day today - it's not all grey!)

Anyway, can't remember all the questions asked which were relevant to me, so I'll just ramble...

All undergraduate medical degrees (the majority) last 5 years, going up to 6 years. All UK medical schools (except Oxbridge (= Oxford & Cambridge)) once they have accepted you onto the course are obliged (?sp) to provide preclinical and clinical training. Most degrees are 'integrated' - this essentially means that while you still have a preclin/clinical divide, you get to do some clinical stuff in your first 2 preclin years. Most are also systems based - neuro, musc, cardio, digestive, endocrine etc. Oxbridge is subject based ie pharm, physiology, anatomy etc.

I am doing an integrated systems based 5 year undergrad degree in medicine and will graduate in 2006 with an MBChB (Bach of Med MB, Bach of Surgery ChB). The reason I am taking 6 years is because I am intercalating a BMedSc (Bach of Medical Science) between my preclin and clinical years. The fist 2 years of medicine and extra year I am doing now lead to a full BMedSc which is an honours degree in its own right. I've confused myself now!

As to rep... Well, there is the old rivalry between Oxbridge and the rest (Oxbridge says we have tradition and v clever people, rest say we have moved with the times and have up to date courses; London says we are more cosmopolitan and have more interesting disease, provinces say we are cheaper and there are fewer students to each patient; No doubt Scotland looks down on the rest of the UK and so on and so forth ) I'm sure you have competition between schools in the US as well, but in the UK it really is pointless, all the schools really are pretty much equal, and they certainly get pretty mcuh the same scores in league tables. Of course some schools have special points, for instance B'ham is getting very well known for producing excellent GPs (pity I don't want to be a GP then!)

Further training: The vast majority of PRHOs stay in the area they trained. SHOs tend to move around a lot more. However, if you are a training SHO (there are nontraining ones, but we'll leave them out for now) what you do is get on a rotation in a region, for instance the South West surgery rotation takes in Plymouth, Truro, Barnstaple, Exeter and sometimes extends up to Taunton and Bristol.

For instance, if I decided I wanted to become an Orthopod in the Southwest, what I would do is:
2006 Finish medical degree at University of Birmingham
2007 Complete 1 year as a PRHO in the B'ham area, doing 6 months surgery and 6 months medicine.
2008-2011+ Complete 3 years minimum as a surgical SHO on the southwest rotation, doing 6 month rotations in general surgery, plastics, ITU, A&E, Orthopaedics, cardithoracics, neurosurgery etc. Also need to pass MRCS part I (see www.rcseng.ac.uk - have to check that link; It's the Royal College of Surgeons of England)
2011+ - 2014+ Complete 3 years minimum as a specialist registrar in orthopaedics, pass MRCS part II (can't remember if there's a part III as well, but if there is, pass that as well).
2015 onwards Get myself a consultant post and start building up that private practice!

The bottlenecks are at getting on the right SHO rotation for what you eventually want to be (which is where non training SHOs come in - they are working, getting experience and can often be taking their exams but aren't on an official rotation), and getting an SpR post after SHO (this is where many people take those 2 years to get a research MD, making them more impressive on interview etc), and in some specialities there is also a bottleneck after SpR training to get a consultant post (some people also end up taking time out to do another degree type thing here).

As for overseas trained doctors, in the Orthopaedic dept I am working in at the moment there are:
11 Consultants, 2 of whom are Egyptian
2 Staff Grades (between SpR and Cons, another grade of doctor, don't worry), 1 is Ghanain (I think, somewhere in Africa), and the other Egyptian.
8 SpRs, 1 Egyptian, 1 Italian
10 SHOs, 1 South African, 1 Egyptian, 1 Australian
There aren't any PRHOs at the moment

We quite often have more egyptians (very strong links to Egypt at my local hospital), but I should stress that Plymouth is perhaps one of the least cosmopolitan areas of the UK - people think it's too far away from London. I'd be quite surprised in London if there aren't quite a lot of deapartments with more overseas trained docs than UK ones. Basically if the GMC recognise your qualification, you're in!

There's my missive for the moment, and now I really must go to sleep for it is 1am (BST) and I have to be at work bright and early tomorrow!

 

[Tevelin]

Graduate entry to UK Med. schools, is in my experience, very difficult even for us. I applied to 5 UK med schools after writing to most (except Oxford & Cambridge due to the high college fees) to determine if they would consider accepting graduates. In addition as a graduate of the University of Wales I applied to the College of Medicine in Cardiff directly.

I have a BSc (First) in Biological Sciences, came top in my class and received the annual prize. I also worked as a hospital volunteer for a long time. I felt very optimistic after graduating and was quietly confident that I would have a chance of finding a place (surely this is the only way to be - you have to believe it is possible).

I did not receive a single offer indeed I was not interviewed by any of the colleges I applied to. The worse part really was not knowing the reasons for being rejected, especially when you didn't get interviewed - at least it could then be put it down to your personal failings at the interview stage.

I subsequently went to Cambridge and studied for a PhD (probably a displacement activity but it kept the momentum going and perhaps helped avoid despondency - just keep studying!). Having completed that and having saved like crazy for several years to be able to afford the fees, I'm now applying to International Medical schools.

To train to be a doctor, as a UK graduate, is a difficult challenge and requires endless determination to overcome the obstacles.

It is still obvious that much importance is placed on your having attended the right school and that you have the correct socio-economic background. We still have a long way to go here in dissolving social barriers and overcoming the vestiges of our class system. Many med students here are from medical families and are from the more affluent areas. If admissions were purely related to academic ability and potential etc. these biases would not be as apparant in the student body as they are.

At my secondary modern school, we had no opportunity to take A levels (required for undergraduate entry to university here). Chemistry and Biology were not even on the curriculum so couldn't be taken at Ordinary level. But that is just life - nothing is perfect - you try to make the most of the opportunities you do have. Academic success, a belief in your abilities and the will to achieve your dream is only the beginning - the open, non-predjudicial admissions policies of many International and US Med schools would be very welcome here .

 

[14931]

is anyone considering applying to UK schools this year? and for those there, how is it? (that is if anyone sees this thread)

 

[rgerwin]

The first part of this message is to everyone who says the cost of living is higher in the uk than the us. I'm confused, and maybe this is b/c I've lived in Boston and Manhattan. In my research, housing, cost of schooling, and cost of healthcare are much lower in the uk. Forexample, the mortgage interest rates are at least half. You can get a university degree for a fraction of the cost. The cost of getting an undergraduate medical degree is ~5500 pounds or so, I've found, in the uk. Correct me if I am wrong. However, in the us, 4 years of private college is about 82000 pounds, and private med school is another 100,000, with room and board. Plus, healthcare is a nightmare I won't even begin to detail. What am I missing?

Another couple fo questions:

1. If I were to get a primary, WHO recognized medical degree from a docotr of osteopathy school, but did an allopathic internal medicine residency, could I get a job/training posts in the uk?

2. If I entered the uk as an SHO with 100,000 pounds of american med school debt, and became a private practice GP, could I pay it off in 8-10years and still have money ever year to live resepctably (nothing fancy)?

Any and all help would be greatly appreciated! My fiance and I desperately want to live permanatly in the uk.

 

[FionaS]

Cost of living is higher in the UK - it's one of the highest in Europe at the moment, on par with Switzerland apparently.

The cost you quote (~?5500) for an undergrad degree would be about right (a little low actually, closer to ?6000) in terms of tuition fees for a UK home student, but not for overseas, who have to pay about ?15000 for the first 2 years and ?25000 for the final 3 years. Starts getting expensive! I'm expecting to graduate ~?35000 in debt.

Rent as a student is cheap - if you're outside London. Prices in London are insane. My rent at the moment is ?49/week including water bills. For that I get a (large) room in a shared house with shared kitchen and bathroom. I share with 5 other people. My rent is on the cheap end of the scale, most people in Birmingham pay ?50-?60/week. Gas and electricity is extra.

Healthcare is cheap - I'm not sure how it works as an international student, but I think you are entitled to NHS healthcare, in which case it's free!

The things that make it expensive are everything else! For instance, to run my car, it costs me 79.9p per litre to fill it up with petrol, ?1000 pa to insure myself to drive it (it's a Peogeot 306, 1.4cc - ie not fast, and I have a 5 year clean licence. Insurance hurts!). Car tax is about ?100 pa, and you have to put it through it's MOT every year (test to make sure it's roadworthy) which can be as cheap as ?30 but if you need work...

My food bills are ?30/week, nothing exotic in there, no alcohol either (expensive). I could live on ?20/week food, but that would be exceedingly boring and no meat. Pint of beer in London costs ?3, elsewhere about ?1.80-2.40.

I'll stop putting you off now!! The UK is a great place to live, especially if you want to see the rest of Europe, but don't speak the lingos good enough to live there I don't think of it as expensive, because this is how mush stuff has always cost to me.

About your questions:

1. No one really seems to know, the GMS seem to be doing DOs on a case-by-case basis, so your best bet would be to ask them. I've heard anecdotal reports of DOs working in the UK, but I've never personally met any.

2. There are very very few private practise GPs in the UK. In fact, I'm not sure they exist. You can be an NHS GP and do Medicolegal work (basically reports on health of patients on your list) for which you are paid by report, and this is the private work most GPs refer to. You'll earn about ?65000 pa (I think - it might be more now) before tax (tax is 40%) without private work. The GP contract is in the process of being changed at the moment (there should be some stuff about this on the BMA website) so that you won't have to do oncall - you opt in to do call for extra money (quite where the government thinks it's going to get GPs to do call is the question at the moment - most want to opt out)

That's a mammoth post. I'll stop now!

 

[rgerwin]

Fiona,

Thanyou so much for your reply. It's been one of the most helpful yet. Are there private practices for other consultant level specialties, such as psychiatry or rheumatology? Or only governemnt work? If there are , what the salary difference be?

I think you're right on the individual basis. Technically, all American DO schools are on the list of WHO accepted primary qualifications, which is what the GMC (GMS?) seems to follow. I'm going to ask them, but I feel if I did the DO degree and did my entire residency here so I was a board certified whatever, that it would be equivalent and accepted. The thing is, the only real difference between MD and DO seems to a 4 week osteopathic clerkship. Big deal. I push for it, b/c my fiance is going to school, and the only medical school nearby is an osteopathic one, which I like very much, and I wouldn't be getting much older. Plus, since it's a post-grad degree, I qualify for more subsidized federal loans (yahoo!) than an undergraduate overseas degree.

So far, outside of London fo course, I haven't heard of any living costs that make me falter in our decision., Thanks for some current numbers.
So, would you have any insight on getting a CCST qualification into the specialist registrar with a US residency?


End of my monster reply.
Roslyn

 

[FionaS]

I meant GMC! (Not GMS)

Most surgeons have large private practices - a lot of them work part time for the NHS, and the rest privately. Usually plastics, Cardiothoracic & Orthopaedics. On the medical side of things, Anaesthetists can make a nice pocket looking after all those private plastics etc pxs when they have their op. Medical Consultants do have private practices, but they tend to be smaller in terms of money.

Currently the absolute minimum you'll make as a Consultant is about ?60k. Surgeons in private practice usually double this easily. It's quite rare even for those who work solely in the NHS to earn just the ?60k too - there are various awards and whatnot to sweeten the salary.

I don't think you'll have any problems with having a DO degree, it's just that they're so rare outside the US that the GMC don't really seem to have a policy on it. I know when I first started posting here I was like, they let Osteopaths practice as doctors?! But then I found the DO is basically the same as an MD (despite the snobbery you see around!). It makes sense for you to get your degree in the US from what you're saying.

I don't know anything about coming in as an SpR (Specialist Registrar) after US residency. I suspect it'll be a little more difficult than coming in at SHO level (purely based on numbers of posts etc) and I presume you'd have to take the Royal College exams whilst in the US (think something a little like the USMLE 3?).

Coming in as a GP registrar is something slightly different, and may be easier, but again it's not something that I'm an expert on.

Glad I helped!

 

[Miklos]

Originally posted by FionaS
I don't know anything about coming in as an SpR (Specialist Registrar) after US residency. I suspect it'll be a little more difficult than coming in at SHO level (purely based on numbers of posts etc) and I presume you'd have to take the Royal College exams whilst in the US (think something a little like the USMLE 3?).

Coming in as a GP registrar is something slightly different, and may be easier, but again it's not something that I'm an expert on.

So, what you are saying as that a US board certified specialist would need to do at least three or four more years of training as an SpR before becoming a consultant in the UK (or worse; would need to start as an SHO)?

(IMHO, nuts!)

 

[redshifteffect]

Originally posted by Miklos
So, what you are saying as that a US board certified specialist would need to do at least three or four more years of training as an SpR before becoming a consultant in the UK (or worse; would need to start as an SHO)?

(IMHO, nuts!)

What's so suprising about that? I see a lot of "arrogant" posts by american docs on this forum claiming us training as the gold standard, and "universally" accepted. But in truth, very few countries even partially recognise it.

Sorry to burst your bubble.

 

[rgerwin]

Just to add further info I found, incase it's helpful for anyone, I looked up what needs to be done for a board certified Psychiatrist to qualify for the Specialist registrar. Basically, all you need is a one year fellowship on top of that, and it should be accepted. I didn't have time to look up other specialities. So, it would take 5 years, I believe.

 

[Miklos]

Originally posted by redshifteffect
What's so suprising about that? I see a lot of "arrogant" posts by american docs on this forum claiming us training as the gold standard, and "universally" accepted. But in truth, very few countries even partially recognise it.

Sorry to burst your bubble.

Red,

I think that this topic has been discussed ad infinitum on this and other fora.

I'm not going to address the topic of which training is better or worse.

(My limited experience suggests that the North American training is much more intensive, organized and starts much earlier than the British one, as North American med students in the third and fourth years do things that Brits do during the PRHO year.)

I will however insist that all medical associations (or their equivalents) in all countries hate competition from doctors trained elsewhere and this is far more likely a reason for additional limitations. The exception to this rule is when a country faces avery acute physician shortage (especially if it is limited to certain specialties), then you'll see the rules relaxed. IMHO, this has far more to do with economics than with training.

Also, please do not forget that there is a net financial benefit in extending post graduate training in countries where healthcare is government sponsored, as postgraduate trainees are MUCH cheaper than specialists. The longer you have someone train, the more cheap labor they can provide for your underfunded system. This is especially true, if the hours you can work are limited; the European working time directive is a great example of this. (Hungary very recently changed the requirements for registration for these reason.)

Miklos

 

[Miklos]

Originally posted by rgerwin
Just to add further info I found, incase it's helpful for anyone, I looked up what needs to be done for a board certified Psychiatrist to qualify for the Specialist registrar. Basically, all you need is a one year fellowship on top of that, and it should be accepted. I didn't have time to look up other specialities. So, it would take 5 years, I believe.

I'm not sure that I understand.

You are saying that a US adult board certified Psychiatrist (4 year postgraduate training) would need an additional year of a fellowship in order to become a SpR? Then would need three or four years in addition as an SpR in order to become a consultant?

Or did I get this wrong?

 

[rgerwin]

nope, just the fours years and the fellowship to be a consultant. no further training