Interview Series #3: Knowledge for Interviews

A brief overview of background knowledge that is likely to be of use in medical school interviews.

December 2020
Dhillon Hirani (Blogger)
Queen Mary UoL - 4th Year Medical Student

N.B. This is an extensive list of resources and information and by no means must you know everything or contrarily, feel limited by only this.

Away from asking questions about yourself, your experiences, and your opinions, interviewers can get a sense of your interest in medicine from your knowledge of health and healthcare systems. We will therefore try to cover a few topics here that will help put you in good stead to ace any knowledge questions you may be asked. We can broadly split this into Medical and Non-Medical knowledge:

1. Medical Knowledge for Interviews

This is a comprehensive topic and so it is way beyond the scope of this blog to discuss everything you should know. Instead,we will divide this into themes and suggest some useful free resources to aid your preparation:

Human body:

This is more relevant for Oxbridge applications where extra science is more likely to be tested. A great resource (slight overkill) would be to become familiar with the topics/information found here in the free Human Biology unit course offered by Khan Academy.

Current Health News:

Health is all the news is about right now and it is very difficult to get away from no matter how hard you try (trust me, I have) but it makes for interesting conversation at an interview. It’s important to have a rough gauge of recent medical news stories and a good way to keep up with this is to read through ‘Health’ sections from News organisations such as BBC (or even the designated ‘Coronavirus’ sections they can have) or for more breadth, try the BBC Medicine section.

Background:

As well as knowing the most recent news, it’s also important to have some background knowledge of the most significant medical advancements. The BMJ made a great publication where they analysed the biggest milestones since the 1840s here. Whilst it is important to consider the past, we should also begin thinking about the future. An interesting way to learn about exciting, recent, and upcoming health technology is to listen to TED Talks such as this playlist on the ‘Future of Medicine’.

 

2. Non-Medical Knowledge

Structure of the NHS

Graduates of UK medical schools will in all likelihood, begin their clinical career in the NHS. And therefore, medical schools are fond of asking about students’ understanding of the NHS so they have an idea of what they are entering. Bit of history first (yes!), following the Beveridge report; when Aneurin Bevan became Health minister in 1945, he was set on building a National Health Service which was built upon three key values which still stand today: the NHS must help everyone regardless of class, it will be free at the point of delivery, and care would be provided based on your need and not the money in your pocket. It was on the 5thJuly 1948 that Aneurin Bevan deemed the new “National Health Service” open for service.

Since its inauguration, the NHS has altered its structure continuously. Currently, the NHS is not controlled centrally by Westminster but divided by country in the UK, which act as individual headquarters. Each NHS HQ (e.g. NHS England) oversees their country’s NHS and funds CCG’s (Clinical Commissioning Groups), which plan services for individual, small areas in the country. The CCG’s are then able to filter their payments into services that provide care such as trusts. These are made up of hospitals, ambulances, GP’s, and other social and primary care services in that area. Alongside the NHS HQ’s there are organisations like NHS improvement and Care Quality Commission (CQC) which overlook trusts to make sure they are cost-efficient and are effective (like OFSTED for schools). There are also other organisations like Public Health, NHS Digital, MHRA, and Healthwatch which also play a role but having so many organisations can confuse things as their roles often overlap.

Despite the many changes that have occurred, the NHS is guided by 7 key principles from its constitution which can be found here. The principles are underpinned by 6 core values that ensure optimum care for patients, these include:

We can divide care in the NHS into primary, secondary, and tertiary levels of care:

Primary care: this is commonly the first point of contact and is delivered by General Practitioners, dentists, and pharmacists  

Secondary care: this is provided by specialists and can be referred to as ‘hospital and community care’ – including A&E, outpatient routine clinics, and mental and maternity health access

Tertiary care: this is highly specialised treatment provided in specialised hospitals, patients are referred to these services from secondary care.

NHS Hot Topics

Students should have a broad idea of the issues in the NHS. The most pressing issue is funding with the budget commissioned by the government being unable to keep up with the increasing cost of taking care of an ageing population with increasingly complex healthcare needs. Spending in the 2000s increased at a rate of 6%, but under the Conservative government, in the 2010s it has only increased by 1.4% a year. This has resulted in the NHS becoming more and more stretched, needing more capacity and staff. Other issues in the NHS and healthcare that are worth thinking about are:

To improve upon a few of these issues, in 2019 the Government created the ‘NHS Long Term Plan’ to improve NHS care over the future decade. This included:

To read a summary download the document here.

Medical Careers

Before embarking on your medical career, although many students (and doctors too!) don’t have a fixed plan in their head of what career path to take, it is still important to have an understanding of the routes so you have an idea of what you are signing up for. We will therefore briefly discuss clinician career paths in the NHS.

Post medical school, graduates undertake a two-year general training foundation year program (FY1 and FY2). After the foundation year program, doctors continue training in a specialist area of medicine or general practice. The length of each specialty training program varies, with GP training lasting three years and other specialties lasting 5-8 years (assuming no breaks are taken within the training). These are either run through (apply once at the beginning) or uncoupled (apply for core training for a few years then apply again for higher specialty training). Therefore, consultancy positions are usually reached at least 7 years after medical school graduation. The pathway is nicely summarised below and you can find a list of specialties to learn about each specific pathway here:

To conclude...

The variety of knowledge tested at interview can vary between medical schools, and so it is worth trying to do a bit of research on what is commonly asked. However, if you can drop a bit of knowledge anywhere in the interview (even if it is not to directly answer a question), it is very impressive and shows that you are a keen, competent aspiring medical student.

Author: Dillon Hirani

Editor: Allegra Wisking

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