All In or All Out?

It seems a lifetime ago since I withdrew my GEM application in October and the offers are already rolling out for September 2022. 

I haven’t been active and I’ve barely looked at my Instagram feed. At first it was resentment and shame; I was being left behind for another application cycle and on the outside looking in at the happy offer holders… Then life got busy. Like, super BUSY. Before I knew, I had not registered for the March GAMSAT, the sitting is over and did I miss it? No, I didn’t miss the torturous all-day testing, sat alongside peers, the competition, the months of waiting for results. I do miss being part of the community, everyone being in the same boat, sharing the weight, the comradery. 

So, do I want to sit on the bench and watch or do I want to be in the game too? Pretty sure I want to be in the game… My first application cycle was 2019/2020. I’ve missed the 2021/2022 cycle and the next cycle is 2022/2023. 3 years in-between! I’ve never really seen everything as being time sensitive but as I approach 30, still needing to get admission, then the intense 4-year course, 3 years of being a junior doctor, 3 years of training to become a GP – I could be pushing 40! Which is both a terrifying and heart-breaking realisation. 

Next steps:

UCAT, GAMSAT or both? Well, realistically, it’s going to have to be both. I would love to never, ever sit any aptitude/ medicine entry exams again and the lesser of two evils would be the UCAT. But of course! GAMSAT, my nemesis, we’re going to meet again. 

UCAT booking opens in June which gives a 3-month (+/-) testing window. Revision from today would give almost 6 months (if a September test date).

GAMSAT registration opens in mid-May. Revision from today, gives a 6month period.

Work Experience:
I’m extremely fortunate that my work experience – paid and voluntary, will mostly still be valid for 22/23 cycle, due to COVID. A little bit extra, wouldn’t hurt but my extensive employment as a HCA for the NHS and an agency HCA in the community are two solid, hands on care experiences that I’m forever thankful for. 

I know the hoops; I know I have to jump through them to meet interview selection. I’ve done it before… It just seems like SO much work to get back to that stage of an interview, just one! Feeling a bit like a one hit wonder. I need to be all in. 


Adding More Turns in The Road to Medicine

It’s all become a bit official so I can now fully share my plans for the next 6 months or so.

Firstly, I won’t be sitting the GAMSAT this year. Unfortunately my testing date has conflicted with some other life events which means that I can’t get to Liverpool, sit the exam and get back very easily. The additional cost of hotels and travel have just become more of a pain than a help. It’s money I’ve lost out on and I can’t get back (or defer) and that’s annoying but at this stage it’s not hugely important and to be honest, I don’t feel ready to sit it on the 9th September!

So, you’re probably thinking why on earth would I miss my GAMSAT exam and what could be SO important to take priority? Well.. I have been invited to work up in Shetland (most northernly islands in the UK) for the next 6 months due to their shortage of healthcare workers. The post will be working within Learning Disabilities and Autism (including challenging behaviour) but it based in rural community care and crisis management. The Shetland Islands do not have any Mental Health inpatient services and the closest are within the Grampian Trust (Aberdeen). The Mental Health/ Psychiatric services are extremely understaffed, similarly with their acute medicine services and community care teams.

As it has all been confirmed and starting to really take shape, I’m booked on the 19:00 sailing from Aberdeen on Friday the 10th September (hence GAMSAT). I’m relocating and so my life for the next 6 months will be packed into my car and we’ll be setting off on the 5hr car trip before the 12.5hr ferry (14hrs if it is a sailing that calls at Kirkwall, Orkney) to Lerwick.

I’m extremely fortunate that the team in Shetland seemed very keen to have me and that I had qualities and experience that they desired. I’m excited to learn in a more community setting (everyone in Shetland knows everyone)! I’m also very fortunate that for some, this opportunity would be a nightmare – the cold and often wild winters, the dark, the island life and being ‘cut-off’ from everyone and everything however, I was born in Shetland and grew up there for the early years of my life. I still have a very large group of family and friends in Shetland so it’s a sort of, homecoming, so to speak. The fact that it’s working through an agency and they’re paying me very, very well for the work, accommodation and travel is also a big plus!

Back to Medicine… I have pushed my UCAT back to the 31st August due to being on a nightshift prior to my UCAT date on the 26th. I will still apply with my UCAT score (if good enough) and aim for solely Warwick. I will aim to take the GAMSAT in both March and September next year and have the full force of testing behind me when I apply for 2023. It’s maybe a bit of a longer journey than I originally intended but there are some opportunities that you simply can’t miss. This is one of them!

Be prepared for posts on island life. How sad it is that I can’t get a McDonald’s or Costa Coffee anytime soon or food from JustEat! Let’s just pray for a smooth sailing to Lerwick on the 10th!

The Application

Where to Apply to This Year?

Last year, I applied to Nottingham, St George’s, Swansea and Warwick. All these programmes were the graduate entry, 4 year route (A101).

I’m starting to think about whether I would change my approach this year. It’s still early days and some medical schools have yet to finalise their 2022 entry requirements.

Nottingham A101:
2020 entry cut off: 55
2021 entry cut off: 58 (Rounded up the Notts scoring method)

St George’s A101:
2020 entry cut off: 58
2021 entry cut off: 60

Swansea A101:
2020 entry cut off: 60
2021 entry cut off: 62

Warwick A101:
2020 entry cut off: 2570
2021 entry cut off: 2720 (+/- depending on what you read and where…)

As you can see, there’s been some increases in admission exam cut offs. This is where the difference of an overall score point, makes all the difference and let’s not talk about Warwick’s huge, 150 point increase for their UCAT cut off this year.. I know a lot of people told me that an application will never be a waste but coming straight off the 2020 entry and into 2021 applications made me feel depressed. I knew there was a strong chance of increased cut offs and this is exactly what’s happened this year. I doubt that I would have been interviewed by any of these universities had I applied again for this year – hindsight is a wonderful thing.

Do I apply for the same places?

I’m still considering all 4 year, GEM programmes. As Warwick require the UCAT and the results are given on the day, if I score less than 2750/2800, then I risk being too low for Warwick, meaning it’s a wasted application. So.. Step up Ulster University! They’re in the process of interviewing for 2021, which is their first ever cohort for their graduate programme. Reading through threads and research, the GAMSAT cut off for 2021 was 55/56. A very obtainable score, similar to Nottingham, making them a really suitable place.

If I score high enough for Warwick, I will still consider exchanging Swansea (historically high GAMSAT cut offs) or St George’s (London living expenses), for Ulster. Ulster have become quite a favourite for me whilst researching the campus, the course and the location of Northern Ireland!

Why Ulster?

Ulster are a brand new medical school and 2021 will be their first cohort. A lot of people would see a new medical school as a bad thing however, it’s far from negative.

Their GAMSAT cut off has been amongst the lowest for graduate entry (similar to Nottingham).

The course is overseen and linked with St George’s in London. If on the rare occasion that Ulster do not get accreditation from the GMC, then you will receive a degree from St George’s University London instead. Essentially, the worst case scenario, is a degree from a university I would have applied for anyway. It’s the same course, qualification but without the London living costs.

Location-wise, Northern Ireland is a bit of a change but by no means impossible. Other than the initial moving fees, Derry/Londonderry is affordable and a beautiful place to live! If I have to relocate around the country anyway, why not Northern Ireland?

Will this change?

Probably! Let’s face it, UCAS opens next month, GAMSAT registration opens next month and UCAT registration opens in June. The deadline for UCAS is October (usually the 15th). That’s a long time off just yet!

The Application

Application Timeline for 2022 Entry

Explaining the timeline for Graduate Entry Medicine can sometimes be confusing – a lot of work happens the year/s before!

As of now (March 2021) this will be my (rough based on last year) timeline:

May 2021 – GAMSAT registration opens for September 2021 testing.

June 2021 – UCAT registration opens for 2021 testing (July – October).

July 2021 – UCAT testing begins.

September 2021 – GAMSAT testing.

October 2021 – UCAS deadline for Medicine & Dentistry applicants. UCAT testing ends.

November 2021 – UCAT results sent to universities. GAMSAT results released to September candidates.

December 2021 – Communication from Universities – Interview invites, pre-interview rejections and work experience evidence.

January 2022 – Interviews begin. GAMSAT registration for March 2022 opens.

February 2022 – Student Finance applications open for new students. Deadline is roughly the end of May 2022.

March 2022 – Offers and waiting lists begin being allocated. GAMSAT testing.

July 2022 – Most offers/ rejections sent out. Waiting lists still operate.

September 2022 – Waiting lists close and courses start for 2022.

Exceptions or other time constraints – work experience must be completed by the October 2021 UCAS application deadline to be counted towards your application total (e.g. Warwick University).

Some universities send correspondence throughout the application cycle, others operate under radio silence.


Rebrand/ New Logo

I’ve now branched out onto just about all social media. It’s spurred me on to have a bit more of a professional image/ logo so, here it is!

Work Experience

HCA Interviews – What Will They Ask Me?

Recently, my temporary contract (from my redeployment) came to an end. My Trust and manager informed me that there would be permanent band 3 HCA posts being advertised shortly. In January, the posts were advertised on the NHS Jobs website. These were open to both internal and external applicants. They were also a different number of positions for all the wards, not only mine.

I filled in an application and sent it off. It took about 4 weeks before I was shortlisted and invited to interview.

There were some HR related issues and my interview was cancelled on the morning it was due and I was offered the permanent role by my manager instead. Which was very convenient for me.

However, I was able to find out some of the questions I would have been asked. All candidates that were going to be interviewed would have been asked the same questions and their interview performance assessed by people they did not know or work with. This meant there was a very real chance that if I had interviewed poorly, I might not have gotten the job I have been doing for the last 11 months. A really scary possibility and something my manager was not informed of either. (She was interviewing too but kept away from our interview panels. It would have been better for the ward managers to interview the candidates for their own wards, to know who would be a good fit for their team and patients.)

Regardless, HCA work is deemed the ‘gold-standard’ of work experience. It’s invaluable. It’s hands-on, patient care. It’s patient centred and the chance to work as part of a multi-disciplinary team. It really sets you up for all aspect of working within the NHS.


Will I need one?

Yes, you will. Every band and role requires an interview.

Who will interview me?

This depends. For my interview it was a Clinical Lead Occupational Therapist, a Nurse Consultant from another ward, and a Ward Manager from another ward. Sometimes there will be HR involved or people who already do the job. Usually it will be a Ward Manager or Team Leader for the ward/ department.

Will the interview be in person or online?

I’ve know of interviews being held in both formats but mine was offered online via Microsoft Teams.

How long will it be?

Mine was scheduled for 30 minutes.


All the way through an NHS interview there will be questions that should allow you to showcase your skills and why you are best suited to the job.


For a HCA role, you’ll be prompted to draw on your precious experiences to demonstrate you’re a good fit and can do the job. For example: I had the experience from doing the job previously but they would still look for the aspects of being caring, compassionate and competent. Have you done a caring job before? Do you teach or mentor? All really transferable skills!


So, the NHS/ Healthcare LOVE these. I find they’re often easier to answer as you can put yourself in that situation and explain what you’d do. You don’t have to necessarily find appropriate examples of previous skills.


This is quite a common question. A patient makes a request for something that you don’t know what to do with. How do you handle not knowing something?

Refer to their care plan. It’ll detail if they’re on any restrictions or special dietary requirements.

Check their food and fluid chart – they may have missed a meal or been a significant amount of time since they’ve had a drink/ low on hydration.

Most importantly – ask your team. You’re not completely on your own. The staff you work with may be experienced and able to guide you, that’s why we work as a team. It’s all about support. Always ask if you’re unsure. It may seem really simple such as someone is thirsty and wants a drink but I have previously worked with a patient who is on restricted fluids. They may also be restricted for medical reasons e.g. an upcoming appointment or due to medication.


Again, really common scenario. Linked with professional disagreement/ how to challenge professionally. You may be applying for a band 2 position or a band 8b, it doesn’t matter. Everyone should be able to work and communicate what is both safely and in the patient’s best interests.

You can professionally challenge ensuring you explain why you believe this is not in the best interests of the patient. Give examples, if you’ve worked with them before then that helps.

Suggest that this change be made temporarily or on a trial basis. This will show that you’re open to change but aren’t fixed to a permanent care plan change should it not work.



Deterioration is anything below the ‘normal’ or baseline presentation of your patient. If you have worked with them for a long time, you’ll know what is normal and what is not. How do you tell if you don’t work with them? PHYSICAL OBSERVATIONS/ PHYSICAL HEALTH! Check their BP, Pulse, O2, temperature. Make sure it’s written up in their NEWS chart and any scoring escalate to the NIC. If significant scoring, the on-call doctor will review, if life threatening, always call 999.

Little signs such as a patient not looking well – colour being off, sleeping a lot, not quite themselves are all signs of deterioration. THIS IS HOW I ESCALATED AND HELPED TO DIAGNOSE THAT MY PATIENT HAD COVID LAST YEAR.


A very common question.

Privacy and dignity can be anything from washing/ bathing/ dressing/ changing clothes or dressings and ensuring the patient is covered or kept away from an audience.

If breaking bad news to a patient, ensure they’re in a private or quiet area so that they can process this and display their emotions without fear of people watching.

In mental health, incidents requiring physical restraint are usually handled by ensuring the patient, staff and peers are safe, if this occurs somewhere communal/ busy, clear out the area of non-essential staff and patients that don’t need to observe someone at their worst.

These are only a few examples and not a complete copy and paste of the questions I was due to be asked but very similar.

Be sure of your skills, show how much you care, know the priorities and values of the NHS. Most of all RELAX AND BE YOU! If you don’t know something, be honest but explain what your steps would be to solve the situation, despite not knowing/ how you would expand your knowledge for next time. 30 minutes might seem like a long time but it’s definitely not long enough to sell yourself completely!


A Day in the Life of a Mental Health HCA

Recently I completed a story update which covered a day in the life of a mental health HCA/ my day at work. It wasn’t particularly eventful as our days go but it was nice to show what we do and how we handle situations and how much work we actually cover.

If you missed it or wanted a more detailed run down, here it is!

My working day starts at 7:30am for clinical handover. I’m usually at the hospital/ ward earlier so that I can get changed into my uniform and collect my keys and blick (personal alarm device).

Handover will usually be rather quick. It’s a rundown of how the patients have been recently and any significant information that the nursing team need to know. As we’ve had our patients for a while, we know a lot of the information already e.g. Legal Status, Section, Observation levels and immediate health concerns.
We would be told if anyone’s obs levels have changed e.g. from 1:1 to general observations or if they’ve been increased and why.

On a day shift, we usually hear how the patients have been over night and the days before. If you’re on a night shift, you hear how they have been during the day and the previous nights.

Handover usually takes 5-15 minutes, afterwards, the team are allocated to their observations so that the staff team who are currently on obs can swap and go home.
On a day shift, this would usually mean that the patients are all still in bed. We have patients who enjoy a lie in, it doesn’t mean that they will be asleep when you come in but it’s usually the case.
On a nightshift, patients are all awake and you can swap to begin engaging with the patients.

Observations – If a patient is asleep, their observation levels may change e.g. 2:1 when awake but only 1:1 when asleep. You sit outside their room and note their breathing, any movement or use of the toilet. Basically anything of significance. On a nightshift when everyone is asleep, you swap around and spend most of the night doing this.

During the day, we usually spend 1hr observation periods with each patient. From the point of waking, we get patients organised and assist with personal care. All of our patients get up in the morning and either shower or take a bath. They’re very independant and don’t require a lot of help other that to wash their back or help with their hair washing. We have to ensure that patients do not remove or store their own toiletries and we also dispense shampoo/ shower gel for them. It’s not uncommon for our patients to ‘tip’ their toiletries or not use them at all.

Patients are given their medication and breakfast. HCAs are responsible for ensuring patients have adequate food and fluid throughout the day – this is also monitored and uploaded to their electronic records. We use plastic plates and cups and depending on the patient, they may not have access to metal cutlery e.g. they are risk assessed as being someone who may us a knife to harm staff.

In the hour we spend with the patient, we engage in activities they may enjoy. One patient enjoys colouring and so you can easily spend an hour colouring pictures together. Another patient has a stricter schedule for his day and certain activities are care planned for certain times e.g. walk at 10:30am. The day and activities are usually based on how the patient is presenting during the day and our staffing levels to complete these activities.

We used to eat with our patients at meal times as it’s a really successful and therapeutic activity, unfortunately COVID put a stop to this and we find it quite difficult to organise who gets breaks when and around the obs schedule.

Due to the nature of our patients we due often restrain. The ward has had a significant reduction in our restraints and I can’t remember the last time I was involved in full supine, PMVA holds. We are more likely (at the moment) to have to implement arm holds to escort a patient to a room for ‘time out’ or to secure them from attempting to harm staff.

We have a variety of jobs to do around the core job of patient care:
We complete temperature/ date and stock checks daily.
I try to attend the daily reviews – we have a daily meeting at 9am which discusses our patients with our team of clinicians. Any issues are raised and we get to discuss how we may move forward.
On Friday mornings, we have an MDT for one of our patients – this involves a full team, including clinicians and social care. We discuss possible care packages/ providers and their goal of discharge. Medication reviews are done and any alterations to their care e.g. obs level and S17 leave are discussed here.
We have a cleaning rota to complete (important due to COVID).
Laundry is completed – patients are encouraged to complete their own with the supervision of staff but staff have the overall responsibility.
We have to ensure that patients have sufficient funds/cash for the week and if needed, we withdraw this from the onsite bank facilities.

If a patient has S17 leave, this can either be for ground leave or area leave. We often take our patients out for walks around the site, to visit the hospital canteen or if care planned, they can be taken to a nearby supermarket or to visit nearby family. Each patient is unique in their leave plans. We have a ward car and this is utilised for patient transport. I’m usually driving!

We spend 12.5 hours a day with our patients and it’s long. We go to work in the dark and return in the dark. Dayshift is 7:30-20:00, nightshift is 19:30-8:00.

Whilst there are obvious challenges of the job – physical aggression and violence to staff, property and environmental damage, violence and aggression to peers, verbal abuse and the risk of absconding. I have been kicked, I’ve had a patient attempt to strangle me and grab at my throat, I’ve been hit and scratched but.. we also have some really enjoyable and rewarding work with our patients. As our longest patient has been with us for 2 years (nearly 3) we can build really good relationships with them. They know your name, what you’re like as a person, ask you if you’ve had your hair done and will remember when you’re next on shift. I can remember walking on to the ward and having a patient stood right at the doors to greet me, as I entered the patient cheered. They were cheering all the staff onto the ward!

We dance with our patients, we laugh, we feel their pain and frustrations, we are their family when theirs can’t be there.

I should be sad that I’m working all of Christmas but to be honest, I feel really lucky to spend it with those that need me. I truly love my job and the personalities of those I work with. It’s not for everyone but it’s definitely for me.