Medicine

Each year, 7,000 students with lots of As in sciences at A-level sign up for five years of unpaid training. Once qualified, they earn £18,000 for a 56-hour week. They make life and death decisions with little supervision and there's a high risk of suicide, drug addiction or alcoholism, with potential for high earnings after 20 years. Yet each year, more than 10,000 of the UK's finest 18-year-old minds decide this is the career for them, leaving Britain's medical schools oversubscribed and able to pick and choose the creme de la creme of the applicants. These applicants know that, despite the pitfalls, medicine can be a uniquely rewarding profession, offering the opportunity to be resourceful and imaginative, and impact practically and emotionally on people's lives in a way that only doctors can.

The medical school business is booming (applicants for courses beginning in 2004 were up around 22% compared to 2003), with new schools launched and established places enrolling mature and even former arts degree students (the horror...) in response both to demand and to the perception of medics as white and middle-class (though 60% female).

So with all this competition, it'll certainly help if you're good - the institutions are looking for candidates who are ready for a world of pain (their own as well as their patients'), who are aware of the daily crises that make up the NHS, have the inner robustness and a sense of personal responsibility that means they won't go to pieces at the first sight of blood. Someone who, in other words, isn't trying to be a doctor simply to make their parents happy.

One medical school used to list several attributes that it sees as ensuring successful applicants are "excellent in every respect": students needed to have been a school prefect or head of school, played at least two musical instruments, be fluent in at least two languages, played for their country or county, and held a number of Duke of Edinburgh awards. This is, of course, in addition to basic entry requirements: at a minimum, candidates need three very strong A-levels, which must include chemistry and biology, and a strong GCSE back-ground, again in the sciences. While you don't really have to worry about whether you're a school prefect or not, it does push home the message that standards are high.

Once there, medical courses are changing. Typically it involves five years of academic work, with an optional intercalated year (studying a science course fbr 12 months before returning to medicine). In the early 1990s, medical schools attracted criticism from the General Medical Council fbr spending too long on lectures, and, in response, every medical school changed its curriculum to put more emphasis on communication skills, understanding cultural issues and more patient interaction. In addition, the teaching emphasis was changed so that instead of learning the latest advances in medical science, you'll be picking up specific skills of use to you as a doctor in the environment you'll be working in. In TV terms, it's more Casualty than Tomorrow's World. The exact methods of getting this across via pre-clinical and clinical training, lectures, problem-based learning and other new-fangled teaching methods (some use actors to improve communication skills, so it's just like Casualty) varies between the institutions, so make sure you investigate these before you apply.