Real-life story - Adam Peckham-Cooper
Adam Peckham-Cooper explains why as a graduate he chose the five-year course in medicine.
Making the decision to pursue a medical degree as a post-graduate is a significant life choice and one that generates more questions and concerns than definitive answers: Can I afford to continue as a student for a further four or five years? Should I do a graduate-entry programme (GEP) course or the traditional five-year course? Do I want to move locations? Is this really what I want to do?
Having gone through this conundrum myself, I hope that sharing my story will help you to address the difficult questions that you are currently facing. We all have our individual reasons for choosing to study medicine, but collectively we enter believing that the short-term sacrifices will be balanced out by longer-term gains – but will they? For the majority now facing sky-high tuition fees and career-long debt, this once difficult decision has suddenly now become virtually impossible without the aid of a crystal ball!
However, now that I am on the other side, with a National Training Number in Surgery, I can genuinely say that I love what I do. Nonetheless, the journey was long; there are many factors to consider and one must enter into a career in medicine with their eyes open. I will try to explain why I made the decisions I did, how these may have affected my medical career and answer the pertinent question - would I do it all again?
My experience before entering medicine
Having been unsuccessful at gaining a place in medical school direct from sixth form, South Africa became my destination. I took a gap-year in Durban during which time I taught English, played rugby and reflected on my options. I returned to the UK in autumn 1998 to read Pharmacology at Liverpool University.
To this day, my thought process at this time remains unclear. I didn’t really know what Pharmacology involved and had never been to Liverpool prior to moving into Halls of Residence! Fortunately, the gamble worked in my favour and I thoroughly enjoyed my four-year degree. After my second year of study, I re-located to Kent for a year of training in industry, and worked for Pfizer exploring the pharmacological characterisation of the female rat urethra!
Indeed, it was not until I returned to Liverpool for my final year of study that my thoughts moved back to a career in medicine, where by coincidence, I moved into shared accommodation with a group of final-year medical students. Their influence undoubtedly reignited my subconscious desire to study medicine and ultimately pursue a career in surgery.
Why I chose medicine
Choosing medicine wasn’t an easy decision to make. Considering studying medicine as a post-graduate raised several questions, many of which remained to some extent unanswered until later in my journey. My primary concern was financial – how would I be able to support myself through four or five further years of university? As the eldest of seven children, and with four of us at university at the same time, I was not in the position to call upon parental support.
You may therefore think that the four-year course would have been the most desirable option for me. However, when I took time to look at the two courses in detail, I actually found that the five-year course was much better suited to my circumstances. The longer holidays and less-intensive structure allowed time to take on part-time work, and work for longer in the summer holidays. Working in term-time did not distract from my studies - I was fortunate to find work summarising patient notes for General Practice surgeries on a flexible basis and this helped considerably in funding my personal and university expenses as well as providing valuable exposure to the medical world.
Why I chose the 5 year course
It is worth noting that when I was looking to apply in 2002, GEP courses were very much in their infancy. Leicester/Warwick and St. Georges Medical Schools had introduced fast-track graduate-entry training in 2001. 2002 saw the introduction of courses in Newcastle, Cambridge and Oxford. The popular press at the time slandered these courses, claiming they were ‘dumbing-down medicine’ and there was significant debate surrounding the quality of graduates that these ‘new courses’ would produce. At that time, a GEP degree in Medicine in the UK was unchartered waters - it was yet to produce its first cohort of doctors and divided both professional and lay opinion. As a potential candidate, it was impossible to not be affected by this and my final shortlist of four medical schools clearly reflected this concern.
But times have changed. GEP courses and graduates from these institutions are now ingratiated into our modern medical training system and extensive research demonstrates that GEP medics differ little in their knowledge, practical skills and communication abilities from graduates on the traditional five-year programme. It is difficult to say had such knowledge been available to me at the time, how my decision process would have been affected.
Location was also something to which I gave a considerable amount of thought. Having studied in Liverpool for four years, I felt settled, had a network of supportive friends and therefore had no strong desire to relocate to a new city. The Liverpool GEP course was due to accept its first student cohort in 2003, which posed a further dilemma. If I were to choose Liverpool as my preferred course, it did not seem to make sense to postpone entry for twelve months to undertake a four-year course, when I could immediately enter the five-year course and graduate in the same year. The only benefit I could determine in delaying application by a year was the opportunity to work and save some money to assist me in paying fees in later years.
After considerable research and procrastination, I decided to apply for entry in 2002. Still somewhat undecided about the credentials of the GEP course, I sat on the fence, applying for traditional courses at Liverpool and Nottingham Universities, and GEP courses at Leicester/Warwick and Newcastle Universities. My first choice was clearly Liverpool – in addition to not needing to relocate, the more self-directed, problem-based learning structure appealed to me, having already completed a heavily science-based BSc (Hons) degree in Pharmacology.
In the end, all worked out well. I received offers of a place to read Medicine at the Universities of Nottingham, Leicester/Warwick… and Liverpool. I accepted the latter, and proudly graduated in 2007.
The decision to read medicine as a post-graduate is not inconsequential. The real cost to the individual is high – one must take into account loss of potential earnings, the rising cost of tuition fees and high living costs. Once graduated, medics have to pay considerable sums of money for professional memberships and indemnity, in addition to self-funding courses and post-graduate examinations.
Throughout the process however, I genuinely had no doubt that I wanted to pursue a career in medicine, and now five years on from graduation, I really do have no regrets. But choosing post-graduate study is simply a "yes" or "no" decision - one size certainly does not fit all. Personal circumstances, family background, financial support and dependants, preferred learning styles, and the ability to relocate must be considered in great depth to determine which course and University is right for you.
Research into each potential course is of paramount importance - speak to current students and consider how you learn. Are you sufficiently motivated and disciplined to undertake a course with a self-directed approach, or do you prefer a more didactic educational style?
In the end, a decision such as this will always be, to some extent, a gamble. Weigh up all the pros and cons, and if it seems right for you, then just go for it! A career in medicine can be hard work, expensive and at times frustrating, but conversely I fail to think of another career as variable, sociable and challenging as medicine. So would I do it again? You bet I would!