India has progressed to a point in time at which an MBBS degree is only a gateway to the medical profession and post-graduation (PG) or super specialisation is needed to achieve career growth. So, anyone considering to enter into the medical profession as a doctor should have foresight on how it would be possible to complete PG / super specialisation to create a long and fulfilling career ahead. Admission for PG on merit basis in India is as competitive (if not more) as getting a merit seat for MBBS. If a student does not get a merit seat for PG in India, although qualified in the entrance examination, then she/he has the option either to join in a private medical college by paying a hefty fee or go abroad for specialist training. This is where studying MBBS in the United Kingdom (UK) offers many advantageous.

In India the number of PG seats available are significantly less than the number of MBBS pass outs. But in the UK, as of 2018 statistics, almost all of the interested medical graduates from the UK universities are absorbed by the National Health Service (NHS), most of the hospitals and clinics are run by the NHS in the UK, for work as well as for specialist training (in other words, all the eligible and interested candidates got admission for specialist training). Whereas an MBBS graduate from India go through the uncertainty and unpredictability of obtaining high ranks in the PG and later on super speciality entrance examinations. Or else the candidate should have the financial background to pay huge fee for PG / super specialisation courses if he/she merely qualified in the concerned entrance examination. However, most of the successful MBBS students from the UK universities straightaway gets well paid job and opportunity for training to achieve MRCP / MRCS / MRCPH to become a specialist and eventually other qualifications to become a super specialist. The beauty of this route is that the graduates are pursuing their higher qualifications while simultaneously earning from their work. The options are also open for the interested candidates to obtain Permanent Residency (PR) and eventually the UK citizenship.

Admission into many of the medical colleges in China, Russia, Philippines, Georgia etc. are largely dependent on the financial capacity of the student to pay whereas in the UK it’s primarily on merit basis. There is no shortcut to pursue medicine, popularly known as MBBS/MBChB, in the UK and each candidate will be selected purely on individual case to case basis by fulfilling set criteria. Each university has their own admission criteria, well explained on their websites, which may differ slightly from university to university. Universities are also generally prompt at responding to emails and queries related to admission process. Hence, the role of agents is almost nil in the UK medical admissions and it’s advisable to do it directly with the help of experienced relatives, friends or social educationalists.

The UK universities do not take NEET score into account; qualifying in NEET is mandatory only for students who plan to come back and practice in India. However, the Foreign Medical Graduate Exam (FMGE) is not required for returning medical graduates to practice in India who have obtained a degree from five countries; US, UK, Canada, Australia and New Zealand as per Medical Council of India (MCI) in 2018. One must check the latest norms as rules are changing very rapidly these days. In all case, it is advisable to qualify NEET examination. When it comes to studying medicine in Canada and the US, a basic undergraduate degree like B.Sc is required which makes it difficult and time consuming for Indian students. Whereas in Australia and New Zealand, getting admission into medical colleges for international (and even for local) students is extremely difficult with cut off marks for plus two in the range of 95%-99% depending on the university, along with high performance in the entrance examination and fulfilling other criteria.

There are only two categories through which one can gain admission into medical schools in the UK. The first category is for local students with lesser fee (nearly 85% of total seats are allocated for local students). Foreign students will fall under the international students’ category and those who are meritorious and can afford to pay the fee of around IRs.35 lakhs per annum (plus living expenses of around IRs.10 lakhs per annum), as of 2019, may be able to look into the option of studying medicine in the UK. No major scholarships are available for international students for medicine. However, some Indian state governments like Karnataka are reimbursing a portion of the fee (up to IRs. 20 lakhs per annum) for students who fall under certain socially backward categories and continue to reimburse them every year provided that they maintain prescribed high academic grades. Therefore, studying medicine in the UK is a good option for high performing students, rather than joining for MBBS under Management or NRI quota in Indian private medical colleges by paying a similar fee.

In a nutshell, though the overall cost of studying MBBS in the UK is slightly more expensive than studying at a good private medical college in India in the said quotas, the extra cost will be compensated by getting a well-paid house officer job immediately after graduation, followed by similarly well-paid specialist training jobs. Indian doctors are paid the same salary scale as UK doctors for the same grade and it ranges from £2500-£4500 per month during the training period. Unlike in India, there is no tuition fee for post graduate training in the UK. Doctors simply pay the exam fee for qualifications like MRCP, MRCS etc.

Benefits of studying medicine in the UK

1. Pioneer in allopathic medicine: UK medical schools offers some of the best and well-structured learning methods (problem-based learning (PBL), lecture-based learning (LBL) or a combination of both) and many medical schools have more than a century’s worth of experience in teaching medicine.
2. Value: A UK medical graduate is well respected across the world, especially in the Gulf countries. Within the UK, it does not matter much from which UK university one has graduated, because the standard of education in all medical schools can said to be consistent throughout, whether it’s Cambridge, Newcastle or any other medical school.
3. A strong regulatory body: A nation-wide independent governing body, General Medical Council (GMC), regulates the medical schools and they closely monitor the standards of all the medical schools. Even students have a say in the ranking process of universities done by other independent agencies.
4. Limited seats: As of 2019 intake, 7,500 total seats are available in the entire UK per year and approximately 15% (i.e. 1,125 seats) are designated for international students. Countrywide annual demand for doctors is more and therefore, due to the shortage of medical graduates, the country gives opportunity for the MBBS graduates from abroad to work in the NHS hospitals once they clear the PLAB (Professional and Linguistic Assessment Board) test. For medical graduates in the UK, both local and international students, there is no need to attend PLAB.
5. Job immediately after graduation: Upon successful completion of medical graduation, almost all of the interested students are generally absorbed by the NHS hospitals with reasonable salary. A new exit exam is proposed recently for both local and international outgoing students alike which may be implemented from 2020 onwards.
6. Centralized admission process: All admission processes are through a central body called the Universities and Colleges Admissions Service (www.UCAS.com). The role of agents is very limited and even discouraged at times. Very few medical colleges like University of Central Lancashire (UCLAN) offers admission directly (no need to apply through UCAS).
7. Fee is at par with NRI fee in Indian medical colleges: The fee for NRI seats in good medical colleges in India and the fee for international students in the UK do not differ greatly (for e.g. the fee at MS Ramaiah Medical College, Bangalore for NRI seat is IRs.40 Lakhs in 2019. On the other hand, an average UK medical school fee comes around IRs. 35 Lakhs). The difference in amount spent arises only when it comes to cost of living.
8. Respect: Indian doctors are well respected in the UK and a good percentage of doctors within the country are from Indian subcontinent.
9. Specialisation: This may be one of the major attractions for studying MBBS in the UK. A student completing MBBS in the UK is much more likely to get the opportunity to specialise/super specialise in the UK, compared to someone who has done MBBS in India or elsewhere.
10. No tuition fee or entrance examination for PG: Unlike in India, there is no tuition fee or entrance examination for post-graduation and super specialisation training in the UK.

Which board is ideal, which combination of subjects to study for plus two and what are the minimum marks required?

For Indian students, CBSE/ICSE has better weightage than the state boards and the students have to score a minimum of 85% in plus two in the core subjects namely Chemistry, Biology, Physics, English, and Maths (if Maths is not opted as one of the electives, then it can be any other subjects like Home Science, Psychology, IT etc.). For state boards, the minimum cut off marks to be scored is either 85% or 90%, depending on which university the student is applying. IGCSE is a better option with AAB grades in the core subjects as cited above.

The eligibility criteria of a few universities demand Maths as one of the core subjects to be studied for plus two. In addition, most of the universities give preference to Chemistry compared to Biology. Very few universities do not accept any of the Indian qualifications (CBSE/ICSE/State Board) at all (e.g. we got a reply from Leicester University in 2018 that they do not accept any Indian qualifications).

The most ideal combination to choose for plus two is both Biology and Mathematics along with Chemistry, Physics and English for the above said reason. Mathematics is mandatary for medical and many other courses in Canada, US etc. It is not a good idea to change Boards (IGCSE/CBSE/State), especially in the higher classes, as the philosophy and approach towards learning is different in many ways and moving to another board may adversely affect the performance of the student.

When to start the preparations?

The earlier the better. Ideally, the best time to start the preparation is from 9th standard, since many universities consider 10th standard marks/grades for medical admission.

Is there any entrance test?

Yes, but the entrance test is entirely different from Indian NEET and it is only one of the many parameters for admission. There are two types of entrance exams; UKCAT (UK Clinical Aptitude Test) and the BMAT (Bio-Medical Admissions Test). It’s important to know which universities accepts UKCAT and which universities accepts BMAT. A candidate who scores very high in the entrance exam will not be ensured admission, until he/she scores more than 85% for plus two and meets all other admission criteria mentioned further.

How and when to apply?

www.UCAS.com is the website to apply for all university admissions, including medical. A student can apply for a maximum of five courses, under which one can choose a maximum of only four MBBS in different medical schools and a fifth choice in any other course (this choice is optional and may leave it blank, if not interested). Thorough research has to be conducted prior to filling the four medical options.

For example, consider the scenario of an Indian plus two Physics, Chemistry, Biology, Home Science (PCBH) combination student with 91% marks and high UKCAT score who applies for the following four universities and the results of these applications would be:

1. Leicester University (Rejected, reason: Any of the Indian plus two qualifications are not accepted)
2. University of Manchester (Rejected, reason: Maths not studied for plus two, or less than 95% grades in case Maths not studied)
3. Cambridge University (Rejected, reason: This university accepts only BMAT and do not accept UKCAT)
4. Lancaster University (Very little chance of getting admission: Limited intake, only around 5 seats for international students in 2019. Applying to universities with more intakes per year has better chance of getting admission. For e.g. University of Manchester has got the highest intake in the UK, and the international student intake in 2019 is around 60).

In the above narrative, the student is left with Lancaster University where only five seats are available for international students. Here is the importance of choosing smartly. Therefore, selecting the right four medical schools/universities is the key. It need not be Oxford or Cambridge, but a university where more seats are available and is relatively easy to get admission due to its geographical and other factors.

Generally, every year, the deadline to apply is 5PM on 15th of October and it would be best to try to submit applications at least two days in advance to avoid any last-minute technical glitch.

While applying through UCAS, please do not choose a medical school like University of Central Lancashire (UCLAN) where applying direct is possible. In other words, by choosing this University, a candidate is losing a precious chance to apply for one more university through UCAS.

What are the overall requirements?

1. At least 85% or more in Chemistry, Biology, Physics, English and elective (maths, home science etc.)
2. Good score in 10th examination.
3. A valid score of 7.5 and above in IELTS with minimum 7.0 in each parameter.
4. Preferably 2,200 or more score in UKCAT. In case of BMAT, it has to be taken after September. UKCAT can be written at the British Council in all the Gulf cities, Indian metro cities and at VIT (Vellore Institute of Technology).
5. Two referral letters from teachers of previous institution he/she has studied at.
6. Shadowing a doctor or engagements with a care home or palliative for 2 weeks (this is the most beneficial aspect of the UK medical admission requirements since the candidate will have first-hand knowledge about what he/she will be required to do for the rest of his/her life and can decide prior to admission whether he/she really wants to become a doctor).
7. Predicted marks in plus two from the class teacher (since students will be applying while she/he is studying in 12th standard, a predicted score will be considered for initial screening and to call for interview)
8. One of the key elements for selection is producing a well-articulated Statement of Purpose (SoP) written by the student. A student who has gone through shadowing might have better insight on what to write. SoP should be genuine, and any plagiarism can be detected using purpose-made software.
9. Once all the above criteria are met, each university generally will call for interview. Each university has their own interview methods for international students (e.g. Newcastle University might have Skype interview, UCLAN conducts interview in Dubai and/or in their UK campus, Birmingham University usually conducts MMI (Mini Multiple Interviews) in their UK campus etc.). Candidates are not supposed to reveal details of these interviews.
10. Many universities look into other outstanding achievements of students, especially in the fields of charity, sports and healthcare.

An outstanding interview performance is very important for admission. A few private institutions in UK provide online training for MMIs. However, students’ own preparation with the help of relevant internet sites will be of great help.

The candidate should be well aware that while a great amount of concentration is to be exerted on fulfilling the above long list of admission criteria, one also has to focus on plus two final exams where a minimum of 85% or 90%, as the case may be, is mandatory.

Despite all your earnest attempts, if you could not find a place in any medical schools in the UK, the doors are still open for you to attain an MBBS degree from any good medical college in India or elsewhere, where the culture of appearing for PLAB (or any US, Australia, Canada, New Zealand entry exams) prevails. You will still be able to work at UK NHS hospitals, do specialisation and post specialisation training and continue your wonderful journey of serving humanity while living a quality life.

Good luck!

Contributed By Muhammed Firoz C M & Fiza Firoz

(Disclaimer: This article is prepared in 2019 based on research and email communication made with various UK university medical admission departments and personal visits made to many universities during 2018. Data and figures may change according to each year. Each university has its own eligibility criteria and fee structure. Interested candidates/parents are requested to make their own research and prior visits to various medical schools to achieve the maximum probability to get admission. Although all efforts have been made to prepare this article as accurate as possible, the authors or publisher shall not be held responsible or liable for any loss or grievance by anyone).