Asif Rajah

“The more we look after the delight of other people, the greater our own sense of wellbeing becomes.” The Medicine of Altruism: Dalai Lama


the essential mission of any medical school would be to select those individuals who contain the characteristics and personality traits suitable to becoming an excellent doctor. The initial section of this article takes a critical consider how great britain (UK) medical schools select physicians, which could vary dramatically, and asks whether it may be enhanced. The characteristics would have to be an excellent medical practitioner are discussed and asks whether work experience illustrates about some of those individual qualities and really should consequently be an essential prerequisite for deciding on medical school. Such experience helps the pupil to make an educated career option and exploring it at meeting can reflect student inspiration to examine medicine. My experience in Ghana gave me the chance to learn in the beginning hand basically had what it takes to become a physician. The trip ended up being completely inspirational. It made me realise that medicine is more than being master of most sciences. In Ghana We saw many of the characteristics one needs to be a health care provider, how this contrasts with all the current selection criteria into the UK, making me personally wonder if the British system offers our society the most effective training available.

review of British medical school selection

signing up to medical college is becoming increasingly competitive. Selection into medical schools is not an exact science but one assumes that most useful available proof is being utilized. The current system almost certainly turns away pupils that would make good physicians and takes some who are mediocre or poor and even drop from medicine completely. The choice criteria for entry into medicine have to be accurate. However, no system is fool evidence therefore the wide range of drop-outs in British training appears at 6.8 – 12%.1,2,3 In my opinion that better selection requirements would reduce steadily the drop-out rate and save individual stress those types of who made an unwise choice. This makes economic feeling. There was extensive contract that people should select medical students on wider requirements than ratings of scholastic success,4, 5 though used numerous medical schools have valued scholastic scores at the cost of other considerations.6, 7 A Levels alone shouldn't be sufficient to achieve someplace at medical college. True communication calls for some shared life experiences and empathy with others. In my opinion that pupils who're totally consumed within their studies to your exclusion of almost anything else are less inclined to make good health practitioners. In one study, a ten-year follow-up after entry into medical school showed no correlation between educational rating at entry and drop-out price, but significant correlation between low meeting scores and soon after drop-out.8 Known reasons for drop-out were a variety of individual reasons including not enough inspiration for research or even for medication. In a medical school that carefully evaluates applicants, empathy and inspiration to be physicians had been discovered to be specially essential in predicting both clinical and educational success.9

Another major study, taking a look at the dropping out from medical schools in britain over a ten year duration (1990-2000), 10 showed that drop-out prices increased during this time period and concluded that the probability of dropping from medical college is 20percent reduced for pupils with a moms and dad that is a physician. The writers remark that this may be the result of greater commitment or better preparation and insight prior to starting the program. Cultural background of students ended up being recorded only between 1998-2000. The study discovered that Indian females had been around 1.9% less likely to want to drop out in contrast to white females, whereas Indian males had been no distinctive from white males. Other ethnic groups had been less likely to drop-out by around 0.8%. A concerning reality inside paper was the amount that drop-out prices diverse between various medical schools. No research currently was done to obtain the known reasons for these distinctions. Surely prospective applicants must be conscious of these outcomes. The distinctions might be accounted for by variable selection processes one of the medical schools.11 Some medical schools shortlist for interview just on predicted educational performance or the number of A* GCSEs or decide by the UK Clinical Aptitude Test (UKCAT) / BioMedical Admissions Test (BMAT) scores. Some usage information presented in candidate’s personal statement and referee’s report while others ignore this due to concern over bias. Sometimes candidates complete a supplementary questionnaire. Interviews differ with regards to length, panel structure, framework, content, and scoring techniques. Some schools do not interview.

the most typical reasons cited in lots of papers for dropping away from medical school had been because it is maybe not for them, they discovered it boring, they would not like clients, the task environment wasn't what they desire to spend their time on, or they failed to like responsibility.12 Essentially that they had realised far too late that Medicine wasn't for them. That they had didn't uncover what these were permitting by themselves in for before using additionally the medical school had didn't pick this up. There is certainly a very good argument for pooling resources so applicants get one good assessment instead of four poor ones.

an amounts, used for medical selection, do not suggest any character attributes associated with candidate and they are affected by socio-economic bias. The UKCAT had been introduced to level the playing fields. This test doesn’t examine acquired knowledge and applicants can’t be coached to pass through, so the theory is that it will offer a fairer evaluation of aptitude than an even grades. It was also thought your various the different parts of the UKCAT, namely spoken thinking, quantitative thinking, abstract thinking, and decision creating, may help to choose the students with the character features to help make good medical practioners. Regrettably, a current paper implies that the UKCAT cannot offer more assessment of aptitude than A levels.13 But an inherent favourable bias towards students from well-off backgrounds or from sentence structure and independent schools ended up being also discovered. Moreover the test does not compensate for skilled candidates whoever education happens to be affected by going to an unhealthy college. Another paper looked at the predictive validity of UKCAT.14 This revealed that UKCAT scores did not predict 12 months 1 performance at two medical schools. Although early prediction is not the main aim of the UKCAT, there is certainly some cause for concern your test failed to show even the small-to-moderate predictive power demonstrated by comparable admission tools.

there's absolutely no question that prospective physicians need enough intellectual ability to complete the work nevertheless they should possess other important faculties (Table 1):

Table 1: Personality faculties potential physicians should possess Concern for individuals Committed to self-learning feeling of obligation Emotionally stable Professionalism Good judgement and perception Good interaction abilities Good listener extremely inspired An enquiring brain Honesty Well organised Integrity Patience capability to handle stress Mental strength Confident Resilience Determination Respect for other individuals Perseverance Respect for confidentiality Decisiveness Tolerance Conscientious hardworking Team player an open brain Leadership qualities a logical approach to problems Humility Critical thinking Flexible and adaptable to change individual essential points from detail Logical thinking Recognise limitations of expert competence

What patients rate extremely on the list of characteristics of a great physician are high degrees of empathy and social skills.15 Personality characteristics such as conscientiousness were absolutely related to pre-clinical performance.16

The requirements used progressively by admission tutors are the candidate’s insight into medication including as evidenced from work experience.17Surprisingly, hardly any has been written on work experience and value placed on it differs considerably between medical schools. Numerous would treat this experience as a prerequisite for entry into medical college. It allows a student to see initially hand what she or he is permitting him/herself set for. Some get the experience fascinating and challenging although some could find it is really not for them. Work experience should not be seen as a hurdle to climb, but part of the decision-making procedure in determining whether medicine in fact is for you personally. We fear that another adding element to your escalation in drop-out prices from medical schools could be the increasing difficulty in getting work experience. Gone are the times when pupils could join theatre staff watching an exciting operation or shadow medical practioners in Accident and Emergency (A&E). Helpful work experience is so important and it is becoming harder and harder getting, it is nevertheless possible. For that reason considerable desire, commitment and inspiration by the student are required to get it. The work doesn't have become clinically related, but work experience in any care environment is vital. These placements could be used to illustrate at least a number of the individual qualities which can be popular in an excellent medical practitioner including: admiration regarding the interaction skills required of a health care provider; an intensive understanding of the realities of medicine and also the National wellness Service (NHS); a knowledge of teamwork; an ability to balance commitments; and observation of caring and compassionate nature for the doctors. Furthermore, as demonstrated generally speaking training,18 individual experiences can have an extremely good influence on an individual’s attitude to a particular speciality. Encouraging college students to experience general training would consequently not just increase their knowing of the life to which they have been planning to commit, but could aid recruitment to basic training as a speciality.

My Ghana Experience

I made the decision that, as an element of my work experience, I would personally head to Ghana with a charity organisation (Motec UK lifetime). The reason wasn't to impress medical admissions tutors, but to learn if I had the required steps to become a doctor. We realised how easily we inhabit our little bubble, with small admiration of how are you affected inside remaining portion of the globe. Ghana is a third globe country, which not merely has great poverty and malnutrition but additionally has its own life-threatening conditions including Acquired Immunodeficiency Syndrome (AIDS)/Human Immunodeficiency Virus (HIV), malaria, hepatitis, typhoid and sickle mobile illness. My journey ended up being demanding when I ended up being stripped of my luxuries and taken from my rut, but it assisted me personally to comprehend the real values in life through assisting the absolute most needy and vulnerable individuals. I felt the suffering and discomfort they went through, day in and outing, but knew that making even the slightest distinction for their life motivated me and enabled me personally to persevere through my time here.

one of many hospitals we stayedwas Nkawkaw, that was in the center of a shantytown with houses manufactured from metal sheets. Yet, regardless of the existence of good poverty and condition, I didn't find a single individual who was simply maybe not very type and inviting and always smiling. It made me consider the contrasting situation home in the united kingdom where people were fairly well off, and yet therefore unhappy. I talked to as many people that you can, not realising that I happened to be developing my people- and communication-skills. We played soccer utilizing the kiddies and made them smile. I happened to be in a position to go to the AIDS/HIV hospital and gained a first-hand account of how this devastating illness was managed and dealt with in a third-world nation. The pain, grief and suffering were immense and tough to comprehend unless one was really there witnessing it. AIDS right here hurts every person, but kids will always many vulnerable. The kids were created with HIV from their moms, or contaminated through breast milk, or before infected by unsafe medical options. These were frequently orphaned and destitute, having to build unique domiciles, grow their own food, and take care of younger friends and family. That's the cruel truth.

Equally heartbreaking ended up being seeing so many people into the HIV hospital whom could

perhaps not afford the anti-retroviral drug that could improve the quality and extent of life. This feeling of helplessness motivated me personally further to pursue a career in medicine to assist people at their many susceptible. With this trip I was greatly impressed by the dedication, commitment and professionalism shown by the doctors in difficult circumstances. I saw health practitioners using small guidance and little gear, and yet they seemed confident, well organised, and adapted on their own well on conditions. Their passion and compassion never ever waned despite working very long hours.

I saw various types of procedure being performed including joint replacements, hernia repairs and caesarean sections. On a single particular day, we observed the team performing numerous knee and hip joint replacements. The deformities of bones were a lot more serious than observed in the united kingdom. I enjoyed and appreciated the abilities of orthopaedic surgeons in carrying out these operations, which were being done under spinal anaesthesia, and so I surely could speak with the patients and convenience them. Each day, after seeing numerous operations, I didn't flinch or feel queasy at the sight, and this further encouraged me to think that i really could manage a vocation in medication. On viewing the caesarean parts, the excitement of bringing new lease of life in to the globe was overwhelming. Seeing another child being born with serious hydrocephalus marred this. No treatment facilities because of this condition had been available for a huge selection of miles and the child was too ill to be transmitted such a sizable distance. We witnessed the health practitioners conveying the heartbreaking news towards family with compassion. It became clear to me that we now have negative aspects to this job. There was significant amounts of feeling and anxiety to handle such circumstances but I believe that, given training, I would be mentally more powerful to take control of these situations.

I became constantly permitted to stick to the health practitioners on their ward rounds, and had been encouraged to inquire of questions and work out remarks, to make certain that we usually felt that I happened to be being treated as a medical pupil, which was strange in some methods but in addition really gratifying. On this journey I became involved with training plus in helping set up a workshop, which lasted for a whole day for medical practioners from all over Ghana. This involved lectures also showing the latest surgical and theater gear. I happened to be impressed by the teamwork and organisation shown by the group. The communication skills associated with team had to be associated with the finest quality in order to get the message across. I came across that teaching concerning the devastating effects of HIV, in a nearby school in Ghana, ended up being especially challenging as a number of the students before me had been victims and so I found it difficult to look them into the attention, comprehending that although they certainly were being shown the safety precautions, many did not have much of the next. This reinforced my feeling of helplessness but, even though this situation ended up being heartbreaking, we remained enthusiastic the kids, to help keep their morale saturated in order to get ready them with regards to their unavoidable future.


My trip ended up being totally inspirational. It made me personally realise that medication is much more than being a master of most sciences. In Ghana We noticed in doctors the true passion and drive needed for medicine plus other crucial characteristics I thought doctors required. This contrasts because of the present selection criteria in the united kingdom; unfortunately we're passing up on a lot of good medical practioners due to our obsession with grades instead of looking real qualities that will change lives to our patients.I discovered that seeing the enormous suffering, therefore the close bond of physicians and patients in an entirely different social and financial context, helped me to gauge and shape personal emotions and personal values. My inspiration in attempting to become a doctor has increased tremendously since this journey. My day at Ghana also inspired me personally to produce a medical log in my school as a fund-raising initiative. I brought together a team of fellow pupils to publish articles about common teenage dilemmas (teenage consuming, anorexia, obsessive compulsive condition (OCD), stress, smoking, sexually transmitted conditions (STDs)) in addition to articles on euthanasia and assisted suicide, stem cell research and the NHS. I penned about our experiences in Ghana as well as editing and publishing the college journal. All of the funds raised from the school medical journal are going to be visiting the HIV victims in Ghana.

Contending Interests
None declared
Author Details
ASIf RAJAH, Sixth Form Student, St Albans School, Abbey Gateway, St Albans, Hertfordshire, AL3 4HB.
CORRESPONDENCE: Asif Rajah, 41 Prospect Lane, Harpenden, Hertfordshire, AL5 2PL.


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