How well did my Access Course prepare me for Medicine?

One thing I have noticed about Access to Medicine discourse is not the absence of documented journeys but rather, leaving the most important question unanswered: how much do access courses actually prepare you for medicine and do they work? Fortunately, I have lived long enough on the other side to answer this question and why I felt better prepared than many of my peers.

Parts of the course that prepared me the most for medicine

🔬 Core sciences (Biology, Chemistry and Physics)

It can be difficult as a pre-med to understand the importance of core sciences a prerequisite. Biology becomes anatomy. Chemistry becomes pharmacology. Physics becomes physiology.

My access course taught the majority of core sciences with medicine in mind and framing mattered more than I realised at the time. Concepts were not presented in an A-Level centric way but rather as components of biological systems in medicine that would later be integrated clinically.

Much of what I learned during my course (e.g TCA cycle, amino acids, lipid metabolism) later resurfaced in medical school as the minimum knowledge required to even pass exams. I scored 90% in my Biochemistry exam outperforming students who were fresh out of A-Levels with a decade of studying.

✍🏼 Essay writing

We had an ungraded module (still pass/fail) that required us to write an essay on a medical ethics topic of our choosing. Writing an essay sounds easy, until there’s an expectation to do it properly and it becomes evidently clear it is not an innate, universal skill.

As someone whose only experience of essay writing was being coerced into analysing To Kill A Mockingbird during my GCSEs (some time ago), the most useful revelation was the difference in expectations between undergraduate and quite junior level writing.

If you were fortunate enough to attend a private school, you may have developed an intimate relationship with referencing systems (e.g APA, Vancouver) and written at least one hundred essays long before setting foot into university. For the rest of us, there is a good chance you arrive having never encountered this at all.

During my first term of medical school, we were required to write a graded essay on Sickle Cell Disease. I received a mark of 85%, which retrospectively evaluating, is actually quite rare. It is not that I became an academic writing sensation overnight, it is that early exposure to this style of writing during my access course prepared me much more than I thought it would.

🔍 Research Project (the most valuable module)

One could reasonably argue that core sciences offers the greatest advantage for medicine. In my opinion, they do, but their marginal returns diminish after about one year. If you asked me which access course module continues to pay dividends throughout medical school, I would say, the research project.

One should consider the long-game of medicine and to be a competitive candidate for speciality training one must unfortunately be embroiled in all things research. Medical schools have a pathological fixation on curating research portfolios with clear incentives for students to get aggressively involved early on. Assuming the reader hasn’t been preparing for their research portfolio in-utero, the suggestion is that you should begin to pursue it soon and what better opportunity than before medical school even starts.

Which leads me to the importance of this module and why I feel it benefited me the most. The research project was a graded 3,000 word paper not too dissimilar to an undergraduate dissertation. Everything remained near identical to a real medical research project: we formulated our own research question, learned to write scientifically, assigned a named supervisor and were taught clinical statistics (including how to navigate my medical schools SPSS software, helpfully).

Depending on how research obsessed your university is, there will be some level of opportunity to get involved during the degree. However, most students first dose of research isn’t until the Student Selected Component (SSC) module in Year 2. Fortunately, I had already gotten experience beforehand, placing me in a much well-received advantageous position. The benefits extended into external opportunities:

Presented my research project at the FIGO International Health Congress
Published my research project in an international journal
Landed a research role at Imperial College because of my prior research project
Assisted in two NHS England National Service Evaluations and audits

🩺 Clinical Skills and OSCE Familiarity

This was not a graded or ungraded module and was introduced into the curriculum as enrichment. After extensive research, I believe CWA is uniquely the only college to offer clinical skills in their access to medicine course at all.

We were introduced early to the concept of OSCEs and the expectations of medical students during these examinations. I was fortunate to be taught by an entirely passionate lecturer whose one of many hats was to examine nursing and medical students in OSCE stations.

By the time I reached King’s, I had not only observed but had been examined on every single clinical scenario that had resurfaced in my own clinical skills classes during medical school (e.g deteriorating patient, management of haemorrhaging, airway management, GP style consultation, nasogastric insertions, lumbar puncture, ECG interpretation). Thus I felt more than well equipped when exams boomeranged around.

Parts of the course I felt most underprepared

🪐 Physics. It's complicated.

Perhaps the downfall was that the subject was extremely conceptually difficult yet only loosely tethered to medicine during the entire course.

It does feel unfair to criticise because the lecturer was evidently enthused and very Brian Cox about it all. It’s also important to acknowledge that there is a national shortage of physics teachers and an even greater shortage of those willing to teach in rural King’s Lynn. The lecturer was brought in at short notice and whose sub-speciality was physics as physics, not physics as medicine.

As alluded to above, physics is a conceptual subject requiring the grasp of some very abstract ideas (e.g fields, energy or quantum sheets) often connecting mathematical formulae to counterintuitive realities. To relate this to medicine, the principles and equations (e.g Ohm’s Law, Poiseuille’s law) account for large swathes of physiology.

Every concept and equation from the access course annoyingly resurfaced in my physiology lecturers, with the slight caveat that not only had I not grasped any of the concepts or their relation to medicine, it placed me in the unfortunate position of retroactively inhaling medical physics approximately three weeks before my exam.

To conclude...

Why it works (and why it matters)...

The access course laid bare the expectations to a high quality, that I would later encounter as a medical student and that is ultimately, why it worked.

However, my experience is not universal and this is where a difficult but important distinction is to be made. It is a common rhetoric that any access course will “get you in” but in my opinion, it is inaccurate. Medical schools view access providers unequally (e.g Edinburgh and UCL only accepted students from College of West Anglia until 2025). Institutional credibility does matter therefore access courses only work if they’re good enough.

Pre-empting the reader “well, how do I know if my college is good enough?”. To answer that question, a decent starting point is to first search if your provider is QAA-accredited. If your provider isn’t regulated by QAA, it will not be recognised by any medical school. A bonus, is if the teaching mode is delivered face-to-face, the importance of which is explained here.

SAVI MED