The subject that gets sacrificed for medicine

Most of the students we teach want to do something with science: medicine, dentistry, veterinary work, pharmacy or engineering. They know those courses are hard to get into. So they put their hours where the degree seems to be: maths, biology and chemistry. English becomes the subject to get out of the way. The universities’ own published rules do not agree with that plan.

Suppose your son is one of them. He wants to be a dentist, he has only so many evenings in a week, and he cannot give every subject the same time. Which subject would you tell him to leave alone? Most families would choose English. The logic is easy to follow, because if the degree is a science degree, science looks like the thing being judged.

Before you decide, look at what the universities themselves publish. Start with the entry requirements. The English grade also turns up in a second place, where most families never look.

The entry requirements name English

Start with Medicine at the University of Manchester. Its published entry requirements ask for at least seven GCSEs at grade 7 or above, and then name the subjects that must reach a minimum of grade 6: English Language, Mathematics, and at least two sciences.^[1]

Dentistry is stricter in places. The Dental Schools Council publishes a table of every UK dental school’s requirements. In it, the University of Birmingham asks for grade 7 or above in English Language, alongside grade 7 or above in Mathematics. The University of Sheffield asks for six GCSEs at grade 7 including English. Manchester’s dental school asks for seven GCSEs at grade 7 or above, with English Language named, while King’s College London asks for grade 6 in both English Language and Mathematics.^[2]

Does every competitive university want a 7 in English, then? It does not. In that same official table, several dental schools ask only for grade 4 in English, and one asks for three GCSEs at grade 4 including English.^[2] The requirements vary a great deal, so a parent should look up the specific course, in the year their child will apply, rather than trust a general rule.

So far, then, the picture is a list of minimum grades. A student who clears the one on his chosen course might think the English question was settled. The minimum, however, is only half of the picture, and the other half matters more.

The English grade is scored, not just checked

Queen’s University Belfast’s dental school does something different with the grades. Instead of simply checking whether an applicant clears a minimum, it converts the whole GCSE record into a number. In its own published words: “GCSE performance in the best 9 subjects will be scored with 4 points awarded for an A* (grade 9), 3 points for an A (grades 7 and 8), 2 points for a B (grade 6) and 1 point for a C*/C (grades 4 and 5).”^[2]

Now go back to your son. He wants to be a dentist, he has worked relentlessly at chemistry and biology, and he decided some time ago that English was the one to leave alone. He clears the minimum with a grade 6.

In that scoring system a grade 6 is worth 2 points and a grade 9 is worth 4, while English is counted in exactly the same way as chemistry. So the evenings he took away from English cost him more than a subject he did not care about. They cost him two points in a ranked competition, before a single person has read his personal statement.

Nobody will ever tell him that this happened, because nobody sends applicants the arithmetic.

What a university accepts and who it admits

The gap between what a university will accept and what it actually admits sounds like something that only insiders whisper about. Yet at least one of the most competitive universities in the country publishes the mechanism openly.

The University of Cambridge produces what it calls an “adjusted GCSE score” for every applicant. Its own description reads: “this is most often a simple count of their A*/8/9 grades at GCSE, but for pupils from schools where the mean ‘sum of best 8 GCSE score’ is below 40, 7/A grades are also taken into account.”^[3]

Which grades does that count include? Grade 8 and grade 9 are counted, while a grade 7 is counted only if the student’s school is a lower-performing one. For most applicants, a 7 contributes nothing to that particular number, and a 6 contributes nothing at all.

Cambridge’s Faculty of Economics is more direct still. In its guide for applicants it states that there are around eight to ten applicants for every place, and that “the typical successful UK applicant has at least 6 grades 8 or 9 at GCSE, and often a lot more.”^[4]

Cambridge sets no formal GCSE requirement at all. A family reading only the entry requirements would conclude that GCSEs did not matter there, while the university’s own published policy says something quite different.

Language is named, Literature depends on the school

Parents often ask whether English Literature will do instead. The answer depends on the medical school, and both answers are published.

The University of Liverpool’s medical school addresses the question directly in its admissions questions: “English Language GCSE is a requirement and one of the core subjects; it therefore must be offered at a minimum of Grade 6 or B. We cannot consider an English Literature GCSE grade in place of this.”^[5] Manchester says the same thing about its medicine course, where English Literature will not be accepted in place of English Language.^[1]

Brighton and Sussex Medical School takes the opposite view, and asks for “English (Language or Literature) and Maths GCSEs at grades 5/C or above.”^[6]

So why would one medical school refuse Literature while another accepts it? We think the reason has little to do with the subject itself. A medical school is setting a minimum standard of everyday communication for a clinical job. That means writing a patient record, taking a history and being understood under pressure. English Language is the qualification that certifies that standard, and every applicant in the country has to sit it. English Literature is not taken by every student, so it cannot serve as that shared minimum, even where it teaches more demanding thinking.

Nor does the evidence show that universities value Literature less. Cambridge’s adjusted score counts grade 8s and 9s in any subject at all, so a grade 9 in English Literature is worth precisely what a grade 9 in Chemistry is worth.

The two subjects simply do different jobs. English Language is the gate, and English Literature is a good part of the training that gets a student through it.

Hours are limited, and English should keep its share

Go back to the evenings at the start, when your son could not give every subject the same time and English looked like the obvious subject to let go. The instinct behind that choice is that hours are limited, so English must lose. We would argue the opposite.

A grade 9 in Chemistry cannot be exchanged for the English grade. On these courses the English grade is named separately, and at Queen’s Belfast it is scored separately too. There is no arrangement where the sciences can cover for it.

English also happens to be the subject where a determined student moves fastest, because most of what separates a 6 from an 8 is method rather than more content. We have made that argument throughout this series: nearly every mark in GCSE English is awarded for how well the student writes, so improving the writing improves the whole subject at once.

The boy we imagined at the start did nothing lazy. He worked extremely hard on the subjects he believed were being judged, and he was partly wrong about which subjects those were. A mistake like his is much easier to correct in Year 9 than in the spring of Year 11.

Three things to do this week

None of the three below takes hours away from science.

1. Look up the real requirement. Find the specific course, at the specific universities, for the year your child will apply. Then look at whether each university scores GCSEs or only checks them, because that changes what a grade 6 costs.

2. Check whether English Literature counts there. Literature counts at some universities and not at others, and each university publishes its rule, so you do not have to rely on anybody’s opinion.

3. Treat the English grade as part of the medicine plan, not separate from it. A student who arrives in Year 11 with English still at a 5 has usually decided, without meaning to, that the application will rest on everything except the one subject the university named.

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