Why do medical students choose St Mary's Hospital Medical School?BMJ 1996; 313 doi: http://dx.doi.org/10.1136/bmj.313.7072.1646 (Published 21 December 1996) Cite this as: BMJ 1996;313:1646
- J H Baron, retired consultant physician and subdeana
For many years St Mary's Hospital Medical School in London has had the highest number of applicants per place in Britain. For entry in October 1996 there were 2700 applicants for 100 places. St Mary's has published extensive data of its audit of admission1 2 3 and in 1990 inquired which of 22 factors influenced the 5872 applicants to the 28 British medical schools to make their five choices on the form from the Universities' Central Council on Admissions (UCCA).4 St Mary's was rated high on friendliness, but is this a continuing perception?
Subjects, methods, and results
From 1971 until my retirement in 1996 I asked 344 men and 301 women who had chosen St Mary's one question “Why St Mary's?” at interview for entry and when students began on my firm or applied to be my house physician. For simplicity the category “friendly” included the following answers: caring, character, close knit, community, cosy, enjoyable, everyone knows each other, fun place, kind, lovely, nice, open, outside activities, small, stress free, supportive, taking interest, warm, and welcoming. “Adviser” might be a relative, teacher or tutor, or family doctor. “Academic” included the quality of teaching and research and adequacy of patient numbers for clinical experience. “Low grades” meant that students knew that St Mary's might interview them even if it was placed low on their UCCA form and that they might be accepted if they were out-standing at interview even if they achieved less than the minimum grades or if they had to retake their A level examinations (see table 1).
Most people gave one reason why they had chosen St Mary's, which was scored 1, but a few gave two or three reasons, which were scored a half or a third. Thus there were 779 answers from 645 students divided by sex and by date of entry (1971–82 (258) and 1983–4 (387)) (table 1). Over the 25 years choice made on friendliness increased from 52% to 70% while choice by an adviser fell from 29% to 6% (table 1). Those citing academic reputation trebled from 2% to 7%, but four chose St Mary's for the opposite opinion: “not too much pressure, not an academic hot house, not high powered.” Sport was cited by 7% of the men but only 3% of the women, and music was mentioned by 2%. Those choosing St Mary's because of its prospectus decreased from 7% to 2%. St Mary's location in London (west central) was cited by 2% and a similar proportion had been impressed by St Mary's willingness to consider low UCCA ranking or low retaken A grades.
Miscellaneous answers included liking the research (AIDS, tropical diseases, cystic fibrosis) or researchers (Fleming or Almroth Wright), the name (“my school,” “my middle name”), the dean's annual book (Learning Medicine), the buildings (“so old,” “so new”), the residential accommodation, and acceptability of mature students. One had been a patient, and another was impressed by royal patients. One chose randomly, another because of its Welsh connection, one by the sixth form conference, one by the television programme Doctor to Be, and one appreciated the bar and the beer.
Advice from older people is no longer important. St Mary's is increasingly chosen because it is regarded as small and friendly. By the end of the 1990s, 12 London medical schools will have been (sub)merged into four multifaculty colleges of London University, Imperial (Charing Cross, St Mary's, Westminster), King's (Guy's, King's, St Thomas's), Queen Mary's Westfield (St Bartholomew's, the Royal London), and University College (Middlesex, Royal Free, University College Hospital), leaving St George's standing alone. It will be interesting to see what criteria applicants will choose in deciding whether to apply for these medical schools.
Conflict of interest Formerly consultant physician and subdean at St Mary's.