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The Business Around Getting Into Medical School: Are We Getting Fooled?

This post is for you if you are an aspiring medic applying to Medicine, or if you care about Widening Participation. Aspiring medics, whip out your pen + paper and start taking notes, because you will have your minds blown.


Quick links to skip to specific sections:

Introduction

Getting into medical school can be an expensive business. A simple search on Google reveals a plethora of companies offering services for Medicine applicants. These include arranging work experience, advising on the application/course, doing interview practice and admissions test prep. One company even says that “a practicing surgeon who sits on the admissions panel of a London medical school” will do interview practice with you if you pay for their service.


So, what’s the problem with this? One could argue that these companies are filling a demand that has been created by the increasing competition associated with getting into Medicine. To illustrate my point, the number of UCAS applicants for medical schools in England in the 2021 application cycle has increased by 12% compared to the 2020 cycle. The trend is similar for Scottish and Welsh medical schools. (1) It is even more competitive to get into Medicine in the UK if you are an international student, with the number of available places being lower than for UK Home students.


The problem is that there are companies out there profiting through unethical means. Take this real-life example about Eilidh, a current 3rd year Graduate Entry Medicine student at Nottingham. One company took her image without permission to create a fake persona called Gemma who had apparently received offers to study at 4 medical schools. Eilidh never applied to these medical schools.


This is a  real-life example about Eilidh, a current 3rd year Graduate Entry Medicine student at Nottingham. One company took her image without permission to create a fake persona called Gemma who had apparently received offers to study at 4 medical schools. Eilidh never applied to these medical schools.

I came across Eilidh’s story on Instagram (@thegraduatemedic) and reached out to her to hear more about it. Thank you very much to Eilidh for speaking to me and agreeing to have her image included in this post. Her full experience written by herself is available below and she has given some valuable advice to anyone considering paying for services like this, check it out towards the end of the post!


Eilidh’s Full Experience

Written by Eilidh

“I reached out to one company in 2015 because I had tried the UCAT previously and despite a score of 667, failed to get interviews with it. I knew I needed to get at least 730 to have a shot at getting into my first choice uni. I saw a course online that was reduced from £195 down to £50 and it felt like a no brainer.


I spent £30 return on a train, and so by that point I was spending £80. I got there and spent the first hour confused. They were spending a lot of time just telling me what the UCAT was. I knew all of this, it was all available on the website you book the UCAT on. I thought the day would get better but it went on telling me the sections and tips that I already knew that were widely available for free online - for instance eliminating answers and strong language use in verbal reasoning. I got quite agitated and asked the woman running the course what her UCAT score was. She said she didn’t know, she took the BMAT and was a Cambridge medic. She was just reeling off information without having taken the exam, or any experience of sitting the new section.


I was ready to leave at this point but the course was reduced because a film crew was present. They told me they would give me free books if I gave a review. I decided at the very least I wanted to get something out of the money I wasted. They told me what to say. I didn’t think any more of it.


I had written down my address to get the free books… they never came. A year later I got a message ‘is this you?’. It was an advert of me by the same company. They had named me Gemma and stated I got four offers from universities I never applied to. It took me over a year to get the video taken down.


Recently, I decided to contact them again. I wanted to see how their prices were. I couldn’t see online, I had to give them my number. A woman rang me and told me she couldn’t give me the price, she was just trying to work out how many courses they could get me on, and said she would pass me to a ‘senior admissions advisor’ to give me quotes. I asked why she couldn’t give me the prices and she said it was part of the process. I told them I wasn’t interested. For days I was harassed with phone calls and emails, all persuading me. I told them that I was dissatisfied with their service and it fell on deaf ears.


If I had been more vulnerable I probably would have caved, especially if I was a young A-Level student with parents that wanted me to do well. These companies sound promising. But they do that because they lie, make up statistics, and get very high profit margins out of very little work. They prey on people’s desperation.


Since then, I have had contact from someone who paid in excess of £1000 to that company, and had equally awful reviews. I also have had contact from individuals that have spent monthly money on getting help, but the help is marketed as having help from a student that goes to one of your preferred unis, and also from a top doctor. If that student doesn’t get the grades to get in, the monthly money they’ve paid is already redundant. The advice the doctor and student offer really is peer support that you could get off a friend. All the information given is available online. There is no ‘insider info’. I also have experience of companies pretending to have interview questions for specific unis, and it is diabolical marketing.”


My Thoughts and Experience

Eilidh’s story reminded me of my own experiences with these companies. As I was the only person applying to Medicine at my college at the time, I felt like I had to do something to help my application. I paid for two services: one for “BMAT prep” and one for interview prep. The BMAT prep cost over 10 thousand Ringgit Malaysia (that is at least £1600). It was shocking to discover that some of the teachers didn't even bother preparing for their sessions. When I first signed up for the classes, I was told that any unused hours that I paid for could be refunded. Yet when I requested a refund, said company did not refund the full sum that was due, claiming that they used a package where the hourly rate is higher to calculate the amount, instead of the original package that I paid for where the hourly rate is lower.


This was a big company outside the UK that claimed to be very reputable. Looking back at my experience, I regret paying for that BMAT prep so so much. I lacked the ability to discern how legitimate that company was and felt pressured to complete the sessions, due to the cost and fear that not continuing would affect my application. In reality, the sessions didn’t even help me. I scored so badly on the BMAT to the point where I am embarrassed to recall what score I got.


This leads me onto the next point. How true are the good success rates and reviews that some companies claim to have? Eilidh’s experience highlights this. The companies I paid definitely did not ask me about the outcomes of my application/BMAT so I wonder where all the data to back those claims come from.


A common leverage is claiming that the courses are run by doctors and medical students, particularly from Oxbridge and London. But there isn’t any evidence to back that claim. Even if these people study in Oxbridge or London, so what? They are unlikely to have experience working in admissions. Them getting into Oxbridge or a London medical school does not mean that they will be able to get you in as well.


A major issue with paying to get into medical school is the disparity it creates between applicants from higher and lower socioeconomic backgrounds. Only the wealthy can benefit from this. There are companies that claim that they focus on widening access, but I do not see how organising one free webinar while charging a premium price for all other resources/courses is widening access. Producing resources marketed as part of a company’s social responsibility initiatives, while charging a fee for them, however small, is not “widening access”.


There is evidence that paid prep may not help you get into Medicine. When writing a literature review on student selection in Medicine, I came across papers that indicated these services did not actually improve applicant performance at MMI interviews.


One paper published by Griffin et al. found that self-reported coaching did not improve MMI scores, with coached candidates having a significantly lower score for 1 of the 9 stations. Candidates who repeated the MMI improved their scores in stations that were reused/similar to those used in their previous attempt, so the findings of this paper indicate that coaching does not improve MMI performance and MMI practice can improve scores, only if candidates have done the same/similar station before. (2) Another paper by Moshinsky et al. found that self-reported coaching, retaking an MMI and reusing MMI items did not affect MMI scores. (3)


I don’t object to medical students and doctors offering paid services like this, since this provides an income source for them. Perhaps there is a need for applicants to be more selective with which companies they end up paying for. Those offering individual training need to ensure that they charge at an ethical level. I have heard stories about medical students charging over £50 to check applicants’ personal statements and that pricing is exorbitant.


Beyond Applying to Medical School

This challenge has seeped into postgraduate training. As the Events Director for the local medical research society, I have organised Specialised Foundation Programme (SFP) events and mentoring completely free of charge. In contrast, I have noticed a number of paid courses using the same strategies as medical admissions companies. This is not only for academic programmes such as the SFP and the Academic Clinical Fellowship, but also for specialty applications e.g. Core Surgical Training.


I can see why this is happening, because these applications are becoming a chase for points. There aren’t enough positions available relative to the number of people applying so competition is already tough, and even more so after accounting for everyone trying to add to their portfolio at an earlier stage to boost their chances.


Conclusion

As an international applicant, you might feel the pressure to pay for services like this, especially if you don’t know about the free resources that are already out there, but there are lots! I’ve included a short list here. Lots of societies and organisations offer free events and support; a lot of medical students and doctors are also very happy to help if you approach them nicely.


I wanted to raise awareness and shed light on these bad practices by writing this post. I spoke to someone about this topic and what they said about it really stuck with me; there are two reasons why you would fall for this: because it's competitive to get in and there is a fear of not getting in.


I hope no one ever ends up learning the hard way like me with that BMAT prep company. If you would like some support from me, please do get in touch! I can be found on LinkedIn, Twitter, or you can contact me through my website’s contact page.


Some Free Resources/Sources of Information

  • We Are Medics: a Widening Participation organisation who have produced completely free resources including those for the personal statement, interviews, UCAT prep and interview practice. I wish I had this when I was applying!

  • Other free UCAT practice sources such as Passmedicine and Medic Mind *note that Medic Mind’s free questions are a taster to their full question bank*

  • Master list of interview practice resources on Progress with Jess *note that some of these are not free*

  • Medical students and doctors on social media

I am currently compiling a resource list for international Medicine applicants. If you have suggestions for what to include, please get in touch!


For anyone considering paid medical admissions services

  • PLEASE PLEASE PLEASE PLEASE PLEASE check out all your options first, you should look at what free options are available and what other companies provide the same services. Compare everything. In fact, I would go as far to say that you should consider whether you even need these paid services in the first place.

  • Some companies will paywall their services, meaning you can only access them if you’ve paid. I think this is a red flag sign and you need to be very careful when dealing with them.

  • Don’t get talked into providing your personal and payment details, and don’t get talked into paying on your first encounter with someone from a company. Take a step back and give yourself time to consider.

  • If a company claims they’ll get you into a specific medical school, think again.

  • CHECK THE REFUND POLICY. It is your way out if the service proves to not be of value to you. Don’t hesitate to get out if needed.

Eilidh’s Advice

  • If the marketing is excessive, it is probably because the profit margins are very high. If the profit margins are very high it is likely you are dealing with one of these companies that employ people specifically to squeeze money out of you.

  • If the price isn’t available, it is usually because they will try to get contact details out of you so they can try and persuade you.

  • If it’s admissions test advice - remember there is no magic secret to doing well in the UCAT. There are tips that are all available online. No one is going to offer you any advice that isn’t already out there. The only way you will get better is practice. That’s why I recommend using a resource like Medify because it has the largest question bank and has all of the tips you need.

  • It is best to use ‘people’ rather than companies. If you really must pay to have someone help you with the interview or UCAT prep, then pay a well qualified individual - someone who can prove they’ve done well at the UCAT or in an interview, and will personally tutor you.

  • Always always be wary of the stats and reviews. Even if the reviews are honest, some people give credit all to a UCAT or interview course when really it was their own hard work that got them through. When they get through they’re so happy they just want to share it and usually will share it straight with the company because they’re understandably proud.

  • Finally I’d just say don’t pay any extortionate amounts, you can always check for resources on the internet or within the Instagram community for free.

TLDR

There's been an increase in paid services targeted towards Medicine applicants that profit unethically off their desire to get into medical school. Learn how to discern if such services will actually provide value to you and protect your wallet!


Glossary

  1. UCAS: short for Universities and Colleges Admissions Service, almost all applicants who want to go to university in the UK will submit their applications via UCAS.

  2. Widening Participation/Access: encouraging underrepresented groups to enter Higher Education (4)

  3. UCAT: one of the admissions tests that UK Medicine applicants may be required to take as part of their application. The UCAT is a computer-based test. Which test an applicant has to take is determined by which medical schools they apply to.

  4. BMAT: another one of the admissions tests that UK Medicine applicants may be required to take as part of their application. The BMAT is usually a paper-based test

  5. MMI: an interview style where an applicant rotates around a number of stations that are assessed by independent interviewers. In each station, the applicant will complete different tasks including answering questions and roleplay scenarios.

  6. SFP: one of the Foundation training pathways that UK medical students can apply to upon graduation. The SFP gives trainees protected time to pursue a project either in Research, Education, or Leadership during their Foundation Years (first 2 years of being a doctor in the UK after graduating from medical school).

References

1. 2021 cycle applicant figures – 15 October deadline [Internet]. UCAS. 2021 [cited 15 August 2021]. Available from: https://www.ucas.com/data-and-analysis/undergraduate-statistics-and-reports/ucas-undergraduate-releases/applicant-releases-2021/2021-cycle-applicant-figures-15-october-deadline


2. Griffin B, Harding D, Wilson I, Yeomans N. Does practice make perfect? The effect of coaching and retesting on selection tests used for admission to an Australian medical school. Medical Journal of Australia. 2008;189(5):270-273.


3. Moshinsky A, Ziegler D, Gafni N. Multiple Mini-Interviews in the Age of the Internet: Does Preparation Help Applicants to Medical School?. International Journal of Testing. 2017;17(3):253-268.


4. 4. Cleland J, Patterson F, Dowell J, Nicholson S. How can greater consistency in selection between medical schools be encouraged? A mixed-methods programme of research that examines and develops the evidence base [Internet]. 2014 [cited 18 August 2021]. Available from: https://www.medschools.ac.uk/media/2447/selecting-for-excellence-research-professor-jen-cleland-et-al.pdf


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