CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK
First published in print format
ISBN-13 978-0-521-70967-5
ISBN-13 978-0-511-37868-3
© P. Richards, S. Stockill, R. Foster and E. Ingall 2008
Every effort has been made in preparing this publication to provide accurate and up-to-
date information which is in accord with accepted standards and practice at the time
ofpublication.Although case histories are drawn from actual cases,every effort has been
made to disguise the identities ofthe individuals involved.Nevertheless,the authors, editors,
and publishers can make no warranties that the information contained herein is totally
free from error,not least because clinical standards are constantly changing through
research and regulation.The authors,editors,and publishers therefore disclaim all liability
for direct or consequential damages resulting from the use ofmaterial contained in this
publication.Readers are strongly advised to pay careful attention to information provided
by the manufacturer ofany drugs or equipment that they plan to use.
2007
Information on this title: www.cambridge.org/9780521709675
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without the written
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Published in the United States of America by Cambridge University Press, New York
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eBook (NetLibrary)
paperback
To spirited students, dedicated doctors, and courageous and
forbearing patients – all of whom have helped us to learn medicine.
With our special thanks to all those (students of several medical schools, a patient, and
a BBC TV producer) who have each contributed their piece to this book – Tom Alport,
Chloe-Maryse Baxter, Michael Brady, Sarah Cooper, Sarah Edwards, Adam Harrison,
Farhad Islam, Liz James, Grace Robinson, Susan Spindler, Brenda Strachan, Helena
Watson, Lynne Harris, David Carter, Sarah Vepers – and particularly to the late Larry,
who most generously breathed life into a “worthy cause”, and to his widow, who has
not only kindly given us permission to continue to use the original cartoons but also to
use some not previously included. We also gratefully acknowledge the assistance of
Dr Aneil Malhotra in the updating of this 18th edition.
v
Contents
Foreword page ix
Preface xi
1 Why medicine and why not? 1
2 Opportunity and reality 13
3 Requirements for entry 27
4 Choosing a medical school 49
5 Application and selection 66
6 Interviews 76
7 Medical school: the early years 83
8 Medical school: the later years 101
9 Doubts 122
10 The new doctor 130
11 Developing your career 143
12 Career opportunities 156
13 Privileges and responsibilities: avoiding the pitfalls 175
Postscript 211
Appendices 215
Index 227
vii
Foreword
By Sir Roger Bannister,
CBE DM FRCP
The authors between them have more or less seen it all. This book gives a
vivid, and fair picture of medical student life and what is involved in becom-
ing a doctor. There is fun and esprit de corps; hard work and even drudgery.
It is also about what it means to be a doctor: the privileges and responsi-
bilities; and about career options and pathways.
If, after carefully considering the issues raised here, you choose medicine
and if you are successful in getting a place at medical school, you will be on
the threshold of one profession, above all others, acknowledged all over the
world to have brought the greatest advances and the greatest benefits to
mankind. Medicine has fascination; it has diversity.
For 40 years I have been a neurologist and have never for one day lost the
feeling of exhilaration of solving a new clinical problem. Medicine has hap-
pily been the core of my life. Study and reflect on this book and medicine
might, or might not, become the core of yours too.
ix
If you choose to represent the various parts in life by holes upon a table, of different
shapes – some circular, some square, some oblong – and the persons acting these parts
by bits of wood of similar shapes, we shall generally find that the triangular person has
got into the square hole, the oblong in the triangular, and a square person has squeezed
himself into the round hole. The officer and the office, the doer and the thing done, sel-
dom fit so exactly that we can say they were almost made for each other.
SYDNEY SMITH 1804
If we offend, it is with good will,
That you should think we come not to offend,
but with good will
A Midsummer Night’s Dream
SHAKESPEARE
x Foreword
Preface
For 25 years this book, regularly updated, has assisted many people like
yourself, to make your own informed decision as to whether, or not, medi-
cine is the right career for you.
However, this book has a much wider purpose. It charts the various med-
ical school courses, explains the Foundation years, and outlines the wide
range of medical specialty choices.
Further, through its consideration of the legal consequences of the privi-
lege and responsibility of being a doctor, it gives food for thought and reflec-
tion throughout your career in convenient bedside reading!
It also provides a readable source of information for patients and the pub-
lic, about what it takes to become and remain a good doctor.
With the ever-increasing radical changes to medical education and med-
ical practice, Medicine continues to go through difficult times, but patients
will always need good doctors.
Medicine is not just another job: it is a way of life. Most doctors are highly
regarded by their patients. Medicine is a tremendous career for the right people.
You will need to consider all the personal and professional implications of
a life dedicated to putting patients and patient safety first.
We celebrate our 25th anniversary by sub-titling this book “How to become
and remain a good doctor”, to reflect its now much wider scope.
The authors
xi
xii Preface
1
Why medicine and why not?
1
So you are thinking of becoming a doctor? But are you quite sure that
you know what you are letting yourself in for? You need to look at
yourself and look at the job. Working conditions and the training
itself are improving, but medicine remains a harder taskmaster than
most occupations. Doctors have also never been under greater pres-
sure nor been more concerned for the future of the National Health
Service (NHS).
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