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.
Academic preparation
🔬 Core sciences (Biology, Chemistry and Physics)
It can be difficult as a pre-med to understand the importance and relevance of core sciences as a pre-requisite. The mindset of the majority of my cohort was that A-Level sciences felt like a waste of time or felt infantilising especially to those who have come from a healthcare background. However, as someone who has actually completed the course and successfully completed half of my degree, I can certainly attest that the core sciences I learned throughout my access course has resurfaced throughout my entire degree, without it, I would have failed all of my summative exams (that is how relevant the access course is to medicine!). Anyone coming into an access course should come into it with the mindset of it preparing you for medicine and not that it is a waste of time or irrelevant.
Fortunately, the knowledge taught during my access course (unlike A-Levels) was tailored to medicine. The lecturers made every effort to tie each concept in every subject to medicine, whether it was a pathology, physiological process, condition or presentation – this made it incredibly easy to learn the information from my lecture slides in medical school as they were near identical. Every concept I learned during my access course was hugely built upon during my degree. Simple concepts such as pH and buffers were hugely built upon because it is so relevant to the renal and respiratory systems, some of the A-Level equations are actually used in clinical practice (e.g. anion gap).
The subject that prepared me the most for medicine...
Most people think that biology would be the subject that prepares you the most for medicine because of its obvious connection to anatomy. While you should aim for distinction in all domains, chemistry is the one module you should invest time and energy into mastering for medical school. Biology is essential for learning anatomy but that is as far as it takes you.
I would say the greatest return on investment for a successful journey in medicine is mastering your chemistry knowledge. Chemistry sits at the heart of the medical curriculum – physiology of systems, pharmacology, equations, acid-base balance in respiratory, renal or metabolic disease(s). You may think chemistry is only relevant for pre-clinical medicine but it will be the foundation of your entire career. In my summative exams (and on placement) I was asked to use the Henderson-Hasselbach equation for cardiovascular patients, Dalton’s law, V/Q and metabolic acidosis/alkalosis equations for respiratory patients and anion gaps for renal medicine, not to mention pharmacology and all of my prescribing modules (e.g. oxygen and antibiotic prescribing in my first year). It plays a hugely important role in medicine and I advocate for access students to take it seriously.
✍🏼 Essay writing
We had an ungraded module (still pass/fail) during the access course that required me to write an essay on a medical ethics topic of my choosing. I was expected to write it and reference to a university standard. My first instinct was that because this module was ungraded, it wouldn’t bare much value to my medical degree.
I later noticed its value when I was tasked with writing a graded essay on Sickle Cell Disease during medical school. I quickly noticed how seriously medical schools (and universities in general) take academic writing. Every word, sentence, paragraph and reference is heavily scrutinised and I was given four paragraphs worth of positive feedback. I have definitely gotten used to academic writing over this time but the value of the essay writing module during my access course was the exposure it gave me to academic writing in general, 1:1 support with referencing and the confidence in my ability to write – making my first essay a smoother experience.
🔍 Research Project (the most valuable module)
Unfortunately, not all access providers offer the research project as a module but if you asked me which access course module continues to pay dividends throughout medical school, I would say this one.
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, I formulated my own research question, assigned a named supervisor I met with once a week (even a statistician was available), learned to write scientifically, taught clinical statistics including how to navigate the SPSS software which my medical school currently uses.
For many reasons, this was my favourite module. Firstly, at any given point throughout my schooling, I had exposure to core sciences and essay writing, so the access course primarily focused on building on prior knowledge. However, as a mature student who had not completed a prior degree, the research project was entirely new to me and provided me the springboard and foundational understanding I needed for medical school research projects. Depending on how research obsessed your university is, there will be some opportunities to get involved in research during the degree. 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 an advantageous position with benefits extending into external opportunities.
Secondly, 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 sooner and what better opportunity than before medical school even starts.
📄 Exams, assignments and academic stamina
I felt that the access course realistically resembled the speed, volume and demands that medical school placed on me.
During my access course, I had 15 exams/assignments within nine months (averaging 1-2 per month), the volume and speed in which the content was delivered was difficult to grasp. This directly mirrored medical school, although I only had one exam and one assignment at the end of the year, the lectures, tutorials, workshops and dissections each day were voluminous (sometimes up to 8 x 1-2hr lectures a day for months). For someone as organised as myself, I found it completely unattainable to stay ontop of medical school content and fell behind within two months of starting. I do think that exposure to fast-paced content delivery during my access course helped me during this period of transition to medical school, without it, I probably would have stressed much more when falling behind.
Not only was the content delivery similar but the exam format was too. When completing GCSEs and A-Levels, I remember the exam/question style to be more recall based. However, access course examination questions were based on application of knowledge as opposed to recall, this is directly comparable to medical school in which there are often 2-3 stems/parts of the question and the answer can only be derived if you are able to first recall and then apply your knowledge to an unknown.
During my first and second year, a large proportion of my cohort failed because they had been guided by other medical students to only use Anki; using Anki as the only method of studying is highly flawed because it only tests your ability to recall and memorise information you have learned, it does not give you the ability or skill to apply that knowledge to unknown scenarios. This is why I believe my access course prepared me better for my examinations than most of my cohort fresh out of A-Levels, the pass/merit questions were ‘recall’ based and the distinction questions were ones that made me apply knowledge to unknown scenarios; by the time I reached King’s, I had already sat over 10 exams directly comparable to medical school exams.
Clinical and professional preparation
🗣️ Medical school interviews
Many (aspiring and current) access students have tunnel vision when it comes to access courses; often viewing it as just an academic stepping stone to medicine and forget about the periphery. But getting into medicine encompasses so much more than just academics – UCAT, interviews and clinical exposure make up a large proportion of your journey so it is important to choose an access course that can deliver this support, as well as academics.
While long-distance access courses do serve to support those who struggle with work or life commitments, I will always advocate for in-person access courses; the reason is simple – community. We all know that 90% of communication is through body language, so how can we build community online sufficiently? As someone who works from home, there is an undeniable disconnect between functional working relationships between colleagues when compared to working physically together – the same applies to access courses.
The journey into medicine is arduous and can be isolating. Leaning on your access community (e.g. lecturers, peers) can make an unbearable journey, bearable. For medical school interview practice especially, I was able to practice both online and in-person panel and MMI circuits. If I was preparing for my interviews on my own, I would have never been able to lean on professors who had over fifteen years of experience getting students into medicine, a clinical skills tutor who sat on the medicine admissions board who regularly interviewed aspiring medical students or my access peers who I practiced with day and night. As well as the multitude of resources given to me such as prior access students from varying universities sharing their interview experience (e.g. topics that came up for them, interview format).
Each of these exposures gave me the confidence I needed (e.g. body language, posture, professional language and knowledge) to perform exceptionally well during my interviews. I believe that the support I received from my access community led me to score in the highest percentile in all of my interviews.
🩺 Clinical Skills and OSCE Familiarity (my favourite module)
College of West Anglia is the only access provider to deliver clinical skills. This was not a graded or ungraded module but rather, was introduced into the curriculum as enrichment to provide a real sense of how medical school will be structured (and for fun).
We were introduced to the concept of OSCEs (the practical examination component of medicine) early on. I was fortunate to be taught by an entirely passionate lecturer whose one of many hats was to examine nursing and medical students during their OSCE stations. During these sessions, we learned five years worth of clinical skills (e.g. deteriorating patient, management of haemorrhaging, airway management, GP style consultation, nasogastric insertions, lumbar puncture, ECG interpretations); thus I felt more than well prepared during my clinical placements and exams.
To conclude...
Overall, I felt extremely prepared for the application to and the journey of medicine; the access course laid bare the expectations and realities of medical school to a high quality, that’s 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 this 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 (e.g. QAA-accredited, face to face delivery).
