Opinion
14 JULY 2023 ausdoc . com . au
Guest Editorial
My UCAT questions for medical school hopefuls
Reality can be far harder than a syllogism .
Dr Ruth Myers GP on the South Coast , NSW .
I
HAVE a 15-year-old who is a beautiful kid . Funny , hardworking , empathic and always challenging , he has proudly announced his intentions to get into medicine . I am both thrilled and terrified . I carry around a low level of anxiety most days , generally based on whatever the head of the WHO is worried about at the moment .
The rise of internet-connected , self-coding , psychologically manipulative AI and climate catastrophe are on high rotation at the moment , and like all parents , I wish there was a way to futureproof my children .
How do you choose a cohort who will embrace this work ?
But having worked in health for the better part of 25 years , I don ’ t know what careers are out there . Medicine seems as good as any .
So like any self-respecting wannabe tiger mum , I fired up the UCAT practice questions — “ All snoots are boots . Some dervishes are snoots . Are boots green ?” — and I realised that I would have absolutely no chance of getting into medicine today .
For those unaware , UCAT stands for the University Clinical Aptitude Test .
Previously known as UMAT , this is a computer-based admissions test used by medical and dental schools across the UK , Australia and New Zealand to assess your verbal reasoning , decision-making , quantitative
Dr Myers ’ UCAT alternatives
You are a junior doctor working in a small ED . You have called in the general surgeon , paediatrician and anaesthetist , who are working frantically to save a toddler with catastrophic head injuries . It is clear there is no hope . You realise you are standing next to the distraught mother .
Do you :
• Move away from her and attempt to glean learnings from the resuscitation effort , including paediatric intubation , intraosseous fluids and the one and only intracardiac adrenaline injection you will ever see
• Weep quietly
• Look for someone — anyone — more qualified than you to support the mother
• Wonder how long you will dream about this experience
• All of the above / none of the above
reasoning , abstract reasoning and situational judgement .
I ’ m not going to pretend that I have any alternative way of fairly selecting candidates .
But how do you choose a cohort who will embrace and love this work ,
It is 2am , and as a first-year junior doctor , you are asked to review a confused , vomiting , previously independent and cognitively intact 80-year-old on the ward .
She fell earlier in the evening and hit her head . You suspect an intracranial bleed and request permission from your senior doctor to arrange a CT scan . Your senior doctor declines your request .
Do you :
• Cancel the CT scan
• Discuss the case at length with a junior colleague and decide to review the patient again in a few hours
• Review the patient a few hours later and discover that she now has clinical signs that confirm your initial diagnosis , rearrange the CT scan , ask for urgent neurosurgical review and have to explain the four-hour delay to an angry registrar
who will thrive on building therapeutic relationships and providing service to their communities but will be able to protect themselves emotionally ?
‘ Back in my day ’, I sat the HSC , did well and started medicine in 1991 , a very naive and immature 17-year-old .
I had no clue who I was or what I stood for , but I had the advantages of youth — a flexible brain ready to thrive on new information and experiences .
It ’ s been a wild ride . I have no regrets even if the learning can be brutal .
• Call the family and explain that their mother has a large inoperable bleed and will be kept comfortable , perhaps leaving out the possible delay in diagnosis that might have changed the outcome
• All of the above / none of the above
You are a GP seeing a 45-year-old father of four . You have not had a chance to review his scans , and you pull up the pictures together with him in the room . Together you realise that his cancer is no longer in remission . It is everywhere .
Do you :
• Swear loudly
• Burst into tears
• Call for urgent oncology review
• Promise him that you will be with him every step of the way , and continue to provide palliative care home visits until his death less than 12 months later
• All of the above / none of the above
I wonder if the UCAT could be adapted to include the real-world questions that still keep me awake at night ?
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