OLD SEDBERGHIAN: Clare Carney talks about Medicine, but not really about Medicine at all

On her pathway to medicine, Clare Carney, formerly of Robertson House (2002 – 2009), has taken the most-winding route possible. She left Sedbergh and completed a Bachelor of Arts (BA) in Politics and International Relations at Oxford Brookes University. By the time she completed her undergraduate degree Clare had realised that whilst she was ‘good at’ these subjects and loved her degree, she simply wasn’t motivated by any of the career paths available to her. What followed was several years in diverse jobs – including Assistant roles within the NHS. During this time a passion for medicine was ignited. The next steps took commitment and hard work; Clare had to rebuild her science knowledge (un-used since her GCSEs) to the level needed to sit the GAMSAT exam for entry into Graduate Medicine. Multiple applications and interviews later Clare successfully applied to the University of Swansea Graduate Programme and in 2024 she will graduate with a Bachelor of Medicine, Bachelor of Surgery – MBBS, Medicine. A doctor.

We were privileged to host Clare at Queens’ Hall for the very first in our series of 2024 Pathways talks to our pupils. Clare’s openness, relatability and facts-driven presentation kept our audience spellbound; there were several invaluable lessons that she wanted to stress in her presentation.

I did my first degree, I went to Oxford Brooks and I studied politics and international relations and I loved it, but I kind of knew in my second year that I didn’t really want to do anything to do with it.

I thought, oh, maybe I actually have made quite a big mistake here and maybe I think I’d be quite a good doctor, but I hadn’t studied A-level sciences, hadn’t done any relevant work experience, and my parents thought I’d lost the plot.

I’m going to talk about medicine, I promise, but I’m also not going to talk about medicine because I think that’s quite important too for reasons that I’ll explain as I go through.

if you think that you are friends at school are not going to be in your life for the rest of your life, think again because they will be.

I really enjoyed my time at Sedbergh; I had a good academic career, I did really well at GCSE, but I wasn’t quite sure what I wanted to do for a-level. So, I did what quite a lot of 16 year olds would do and pick the subjects that they did best in. And if I could give you one piece of advice, it would be do not do that. Pick what you enjoy the most because take it from someone who has done five A levels and two degrees that what you are interested in is what is easiest to learn. You’ll get most out of a career that you enjoy doing, not something that you just think that you are good at.

I remember sitting down in lower six when we were doing our UCAS and looking at the computer and thinking, what am I going to do with these subjects? I was reading all these course descriptions based on what I was doing A levels in and not really knowing what I wanted to do but thinking, ‘Oh, it’ll be all right; I’ll just pick something that sounds interesting and I’ll get on a graduate entry scheme somewhere and I’ll do something and in the end it’ll all be all right.’ This is what I thought my career might look like; I’ll go to university and then I’ll just work my way up and eventually I’ll get to be the boss at something and it’ll be fun. That is not what my career has ended up looking like.

Instead, my career looks a bit like a squiggly path and I’m 32 years old and I’m still at university. But I’m going to tell you that if this is what your career ends up looking like, that’s okay. I’m going to graduate this year. I’m going to be 33 and I’ll have 40 years in a career as a doctor, which I don’t think is too shabby, so don’t panic if you don’t figure it out. Being 18 is tough and there’s a lot of pressure on you to make some really big decisions really early on. You don’t have to make big decisions now and it’s all right if you don’t know what to do. There’s all sorts of careers that you will never have heard of. Apparently you can get paid to rob banks professionally, that’s a thing. I found a course online that’s called Entertainment Engineering where you basically design things like theme parks and casinos.

I’m in my final year now I’ve got six months until I graduate. As part of your university course as a medical student, you get sent to all sorts of hospitals on placement. My days are very varied. All courses vary a little bit, but most courses will start off with the majority of your time in the classroom in lecture theatres learning about anatomy, physiology, biochemistry. As you go through, you spend more and more time with patient contact, so you’re on placement either in GP or you’re in the hospital.

From where you are sitting now, there are a number of ways that you can get into medicine. The traditional route would be the undergraduate route. The route that I did is the graduate route. So, you are going to need good GCSEs and A levels. Most universities will want biology and chemistry, some also want maths and physics. That is going to depend on what university you apply to. And then most medical schools are going to ask you to sit some sort of aptitude test – these are the UCAT exam and the BMAT exams and different universities prefer different tests and there will be a cutoff score. Some universities place more weight on this exam than others. Some are more interested in what you’ve got at a level, some are more interested in what you get in this aptitude exam. You’re going to have to do your own research and see what different universities say about what they want. Once you’ve sat these exams then you put all this information into your UCAS applications.

You are also going to need some relevant work experience and this is really important. Every medical school is going to want you to have RELEVANT work experience. It’s something that comes up in interviews which you are also going to have to apply for medical school. Relevant work experience means being able to show that you understand the healthcare system, that you understand what being a doctor looks like on a day-to-day basis. You need to know why you want to be a doctor and not a nurse or a physiotherapist. RELEVANT also means that you didn’t just go and spend three weeks in a medical technology company developing robotic arms or prosthetic limbs. Wonderful, great that you did that. Not helpful for medical school. I can tell you this because I sit on the interview board at the University of Swansea and I have done since I started medical school. The amount of people who really shine in their interviews but have got no relevant experience that tells me they know what they are signing up for is huge. Don’t be one of those people. Make sure and you can tell the interviewer or whatever medical school you are applying to that you are sure. Once you’ve done an interview, let’s say you’re all fabulous and you get a place, you’re going to have five years of medical school, maybe six.

One way that you would have six years (instead of 5) is if you do something called intercalate which is basically where some universities give you the opportunity to effectively do an extra degree – a bit like a master’s in one year – and you would do that in the middle of your medical school degree. It’s always optional but it adds an extra year – although you get an extra degree. It’s going to be something to do with medicine or science pharmacology. Some universities offer it, some don’t.

The other way that it might be six years is … don’t worry if you don’t get As and A*s at A levels, at some universities all is not lost. Some universities will offer you a place at medicine on what’s called a foundation course, which means that your medical degree becomes six years because you start with what’s called a foundation year that’s basically to get your sciences and everything that you need up to scratch to then join the standard undergraduate course. Those are not available at every medical school and it’s an option if you don’t quite make it but you are really determined that it’s what you want to do or you do it my way and you figure this out later. And then you don’t have the right A levels necessarily. Some universities offer a graduate course where you have a degree in something, some like you to have a degree in a science based undergrad. Some graduate courses will accept you if you don’t have a science based undergrad. But if you are like me and you don’t have a science-based undergraduate degree then what they would like you to do is sit something called the GAMSAT exam, which is horrible but everyone does it. It’s basically a six hour long exam with a three hour long science section to make sure that they know that you are not going to struggle when you get to university. So it does take some studying. There’s also a little essay section in it and verbal reasoning.

Okay, so yeah, medical school interviews are slightly terrifying. This is probably going to be the first time that you’ve been in this sort of a formal setting for an interview and it can be quite intimidating. Medical school interviews come in two forms. The old traditional form of interviewing at medical school is something called a panel interview. So it’s you and there’ll be some people (between two and six) sat opposite you. Some of them might be doctors, some of them might be people that work in the medical school. Some of them might be just lay people and some of them might be medical students themselves. Some are more of an informal chat and some are very formal and structured. If you go to Oxbridge or you are applying to Oxbridge – whatever degree you are applying for – this is the kind of interview they’re going to expect you to sit. It usually lasts about 20 or 30 minutes. Sometimes you might change panels halfway through, sometimes might stick with the same panel for the whole thing.

Some of the questions that I got asked were things like, ‘Tell me about a bit of interesting research that you’ve read about lately’. ‘Tell me about a bit of research that’s led to an interesting policy change in public health’. ‘Why don’t you want to be a nurse’, is a popular question. ‘Why do you want to come to university here particularly’, is quite popular. There’s lots of information about what sort of questions come up at different universities online.

The newer interview type – and more popular – is something called an MMI (multiple mini interview). You are basically in a round; there’ll be lots of different stations (up to about 8). They last about five minutes each and then you have a minute in between before you move to the next one. It’s very quick and the stations are really varied. Some stations might be like having a panel interview where it’s just one person that wants to ask you specific questions. One thing I got asked was, ‘Do you think doctors should be allowed on dating sites?’ Quite rogue! Then some stations might be very practical things. At one station I had the picture diagram instructions for how to build a Lego car and the person sat opposite me had all the pieces and I had to explain to this person how to build a Lego car. Some stations might be with actors. They want to see how you handle difficult situations, so they will vary dramatically. Different universities have different styles and different things they like to focus on. As long as you are prepared, you will be absolutely fine.

I thought we’d just talk a little bit about what your career might look like as a doctor. So let’s say you all did fantastically well and you’ve all got through medical school and you’ve all got your degree. You decided that you definitely wanted to be a doctor. Well now what do you do? So, medical school is anywhere between four and seven years if you do a degree like me beforehand. So that takes you up to the seven year part and then what you do when you graduate. So, what I’ll be doing come August is I’ll be starting my foundation program, which is two years as a junior doctor. So your first year you have your GMC registration but you don’t have your full medical license. You are protected by the people that you are working with in the hospital and the idea is that you are supervised quite heavily while you get to grips with the role and what you’re doing.

And then you get your full registration at your end of your first year and then you’ll do another year of being a foundation year doctor before you then go and choose exactly what you think you might like to do as part of your foundation years, you will do three different clinical rotations per year. You get some choice over what those are, but not total choice. You will apply to what’s called a deanery, which covers an area of the country and you will rank your preference of areas and then within those deanaries you will rank your preference of jobs and hospitals that those jobs come in.

Once you’ve finished your foundation two foundation years, you’ll have done six different clinical rotations. By the end of that, you then have a decision to make, do you want to apply for a training post? Do you know exactly what type of doctor you want to be and apply for training or do you want to take a year out or do you want to go GP training or do you want to do something called an F3 year, which is where you haven’t really figured out what you want to do and you haven’t got a training post. But you can keep working in the UK as a doctor and do something called locum work, which is where you don’t have a full-time position as a doctor attached to any one department. It’s a bit like they pool all of the spare shifts that need covering and you apply for those. You get paid very well for it, but you’re not within a training program so you’re not developing your career. If you decide to go into training, your career might look like this, the top two pathways that you can see. So you either decide that you want to be a medical doctor or you decide that you want to be a surgical doctor and you will follow the training pathway accordingly. If you take year out, go and have some fun in Australia, earn some money for a bit, no problem, you can then come back and apply for a training job just like you would’ve done at the end of your foundation program.

There are other options available. Things like academic training posts are available. So if you’re really into research, you can go and do that. If you are really into public health, there’s positions in public health. Developing policies alongside the government. Options are very varied. And being a doctor nowadays doesn’t just mean that you have to do the same thing Monday to Friday, Monday to Sunday for the rest of your life. Some of the consultants I work with, one of them is the crowd doctor for Brighton Sussex football stadium, one of them works in forensics with the police. Two days of the week, a couple of them fly up in the helicopters and go and rescue people. So there’s lots of options.

So what do doctors earn? Everyone always wants to know. If you want to be really wealthy, do not be a doctor. You are not ever going to be enormously wealthy. You will be comfortable, but you will never be rich unless you’re a private surgeon and you work seven days a week and then you might be quite rich.

It’s okay if you decide now that what you want is to earn a lot of money. This is also an important question. It’s one of the questions we didn’t get asked when I was 17. It’s actually some of the things you should be thinking about now is how many holidays do I want to have? What sort of car do I want to drive? Do I want to send my kids to private school? How important is money to me? They’re important questions. And it’s okay if the answer to how much money do you want to earn is a lot, that’s okay, but just don’t pick medicine.

The most important thing about being a doctor is about being a people person. This is just a bit of a plug for medicine, really. I wouldn’t be here if I didn’t love medicine. And yes, it has taken me a long time to get to this point, but I do love medicine. I love seeing patients. I love talking to patients. I like hearing their stories. I like helping people feel better. I like talking to their families and reassuring them and say, don’t worry, they’re going to be all right. If you don’t enjoy that side of it, you’re probably not going to enjoy being a doctor.

It is a huge privilege to be a doctor. There are probably few or no other professions in which somebody walks into your life for the first time and you can ask them pretty much any question. And there will probably for the most part give you an honest answer because they believe it’s in their benefit to do so. But with that level of trust comes responsibility and you have to want to honour that trust to be a good doctor. If you do decide to be a doctor, it’s going to be a little bit harder for you to keep that work-life balance than it might be for your friends who work in marketing or as investment bankers; you will miss things, weddings, birthdays, important occasions, holidays. You’ll probably form closer bonds with your colleagues in any other profession. You will meet people and probably have a greater impact on more people’s lives than any other profession, arguably.