Undergraduate Admissions Handbook 2011-12

2.6 Medicine and Veterinary Medicine

2.6.1 Introduction

It is a requirement of the Department of Health that the University admits students to Medicine in line with contract numbers (1). The number of Veterinary Medicine students is not externally constrained but needs similar careful management so that the numbers of students align with the Department of Veterinary Medicine's capacity to teach them. It is clearly difficult to foresee the actual numbers of students that will be successful in their studies over a six-year course, and evidently some students will not complete their course. Consequently the University has to estimate the numbers to be admitted for Medicine and Veterinary Medicine, to ensure that the right number of doctors/veterinarians qualify at the other end of their studies.

There are two Medicine courses at Cambridge. The main route involves students taking the Medical and Veterinary Sciences Tripos (MVST), before undertaking their Clinical Studies in Medicine after three years as an undergraduate. The second route is the Cambridge Graduate Course in Medicine (CGCM), a special course for UK/EU graduates. Admissions to these two courses are handled in markedly different ways.

Admissions to the CGCM are administered solely by three of the four ‘mature’ Colleges (Hughes Hall, Lucy Cavendish and Wolfson), and the numbers of students admitted to this course count against the University’s Funded Graduate Numbers.

Admissions to the MVST are conducted by nearly all Colleges, and students admitted by this route count against the Colleges’ Target Undergraduate Numbers.

This section of the handbook outlines the procedures and intercollegiate agreements that have been made concerning the arrangements for admissions to the Medical and Veterinary Sciences Tripos.

2.6.2 Number of places

The best estimate made to ensure that the correct number of students admitted to the MVST eventually qualify as doctors/veterinarians is that the University should admit, each year:

278 students to study Medicine, including 22 overseas students
70 students to study Veterinary Medicine.

The quality of Medicine applicants is particularly high, and the subject is one of the most competitive in the University. Being a relatively small subject, applications for Veterinary Medicine can often be very unevenly distributed across the Colleges, who have relatively little room for manoeuvre in the numbers of places they can offer. It is therefore particularly important that the procedures for admitting students in these subjects are closely monitored, not only to ensure that the correct number of students is admitted each year, but also to ensure that the best students from the gathered field of applicants are admitted across the Colleges.

In the interests of efficiency, it has been agreed that places for Medicine and Veterinary Medicine be divided amongst the Colleges through a Group system:

In Medicine the Colleges are divided into four Groups, and the number of Medicine places is shared amongst these Groups, while for Veterinary Medicine the Colleges are in a single Group.
In Medicine the membership of Groups I to III is determined by the Chair of the Medical Quota Committee each year in order to ensure that, as far as possible, the number of quota places allocated to each Group and the number of applicants competing for these places are the similar. The three mature Colleges that admit to the MVST make up Group IV.
Each Group agrees how places are allocated amongst their constituent Colleges. In practice, the nominal allocation to individual Colleges has become fairly fixed, but there is, in principle, room within the Groups for actual College numbers to be varied by negotiation and agreement in response to the number and quality of applications received.

Medicine

The table below shows the allocation of Colleges and places in Medicine across the four Groups in the 2010-11 admissions round. As explained above the membership of Groups I to III for the 2011-12 admissions round will be determined once application numbers are known.

Group I		Group II		Group III		Group IV
Gonville & Caius	25	Downing	16	Christ's	14	Lucy Cavendish	10
Corpus Christi	6	Jesus	11	Churchill	10	St Edmund’s
Clare	12	St Johns	17	St Catharine's	11	Wolfson
Fitzwilliam	11	Magdalene	11	Emmanuel	16
King's	8	Newnham	9	Girton	10
Murray Edwards	10	Pembroke	8	Murray Edwards	10
Queens'	11	Robinson	9	Trinity	12
Selwyn	8	Sidney Sussex	9	Trinity Hall	8
Totals	91		90		88		10

Veterinary Medicine

The provisional allocation of places amongst the Colleges is as follows:

Churchill	2	Jesus	3	St Catharine's	5	Lucy Cavendish	6
Clare	4	Magdalene	3	St John's	3	St Edmund’s
Downing	2	Murray Edwards	5	Selwyn	3	Wolfson
Emmanuel	4	Newnham	3	Sidney Sussex	2
Fitzwilliam	3	Pembroke	2	Trinity Hall	2
Girton	9	Queens'	3
Caius	2	Robinson	4

The allocation of places to Colleges may be varied by negotiation and agreement.

Colleges wishing to adjust their quota allocation should contact the Chair of the Medical Quota Committee, Mr Andrew Jefferies (Girton College).

Overseas students
Part of the requirements of the GMC is that not more than 7.5% of those students admitted to study Medicine should come from outside the European Union. Colleges will therefore need to note which applicants are overseas, and which are not. (Islands students should be included in the Overseas category for the purposes of managing admissions in Medicine.) Because of the level of competition, overseas applicants for Medicine should be considered together in separate gathered fields within Groups and in the context of the gathered field across Groups.

The provisional allocation of offers to overseas applicants within the Medicine quota is as follows: Colleges with 14 or more places may make two offers to overseas applicants; Colleges with 13 or fewer places may make one offer to an overseas applicant. If a College wishes to make fewer than its allocation of overseas offers, another College or other Colleges within the same Group can, with the agreement of the Group, increase their overseas offers correspondingly. The overseas applicants nominated for offers within each Group, and those who were close to nomination, are moderated in a single gathered field at a meeting of the Medical Quota Committee.

Affiliated and Mature students
It is an agreement of the Colleges that affiliated students in Medicine and Veterinary Medicine should be admitted by the Group IV Colleges (Lucy Cavendish, St Edmund’s, Wolfson) only. Colleges should therefore direct all would-be applicants of this type to these Colleges. All Colleges may, if they wish, consider and admit mature applicants in these subjects. Please note that all affiliated students must apply via UCAS.

Degraded students
As with any other subject at Cambridge, some students in Medicine and Veterinary Medicine degrade. When (and if) they return into residence, they count against the number of places for the year in which they return. This may seem an unfair system of double-counting, in that such students counted when they were originally admitted, and then again when they return into residence. However, the calculations that arrive at the target admissions figures of 278 and 70 for Medicine and Veterinary Medicine respectively take into account some degree of fall-out of students, and the number of students degrading is factored into those calculations. Consequently, when such students return into residence, they must be added back in again. This procedure also has the advantage of simplicity, in that all students starting MVST Part IA in any particular year are counted, and it is not necessary to try to keep track of returning students, and which year’s intake they are to be set against. However, since the matter of degrading students is rarely a responsibility of College Admissions Offices, it is important for Admissions Tutors to receive detailed information from their Senior Tutors concerning their College’s degraded students in Medicine/Veterinary Medicine.

Deferred entry applicants
Applicants for deferred entry will need to be monitored in the same way as are applicants for direct entry. However, it is unlikely that the number of deferred entry applicants will reach a level to threaten a Group’s exceeding its number of places in the following year, and so there is less pressure in this area. However, to be fair to the applicants in the following admissions round, Colleges should not normally admit more deferred entry applicants than a third of their nominal number of places.

Transfer applicants – Medicine
It was agreed in 2007 to discontinue the Transfer route into Medicine. Any undergraduate expressing interest in changing to Medicine should be encouraged to complete their current degree and seek a place on one of the graduate-entry medical courses now available.

Transfer applicants - Veterinary Medicine
Although rare, it is not unknown for students studying Natural Sciences (and occasionally other Triposes) to wish to transfer to Veterinary Medicine. Ideally a student should declare an intention to transfer by the December prior to when they would want to commence their Veterinary Medicine studies. Should the College support the transfer they can present the student to the December Group Meeting as a Transfer applicant. Provided that the Group approves, the Transfer applicant may then change subject. However, although the Transfer applicant will be counted as (effectively) an unconditional offer holder, it is expected that the College will require that student to obtain First Class Honours, or at the very least a high Upper Second, as a condition of transfer.

In many cases, however, a student does not declare their interest until after December. As there are formally no Veterinary Medicine places reserved for Transfer applicants, Colleges should inform the Director of Admissions of the names and relevant information concerning such students – examination history and other circumstances. There is a Veterinary Medicine Transfer Application Form for the purpose (see Forms and letters).

The cases of would-be Transfer applicants will be considered (by the Director of Admissions and the Subject Convenor) at the Summer Pool in competition with the ‘near-miss’ applicants for any places remaining, once those who have met their offers (including any Open–Offer–holders) have been accounted for.

It is important to note that there are sometimes problems with Transfer applicants meeting the University’s pre-medical requirements. It is the College’s responsibility to ensure that their Transfer applicants will satisfy the University’s pre-medical requirements, and the College should provide the Director of Admissions with an assurance that this is the case before such an applicant can be approved for a place. Colleges should consult with Dr Fiona Russell, Secretary of the Pre-medical Requirements Committee, Faculty of Biology, for advice on this matter.

2.6.3 The BioMedical Admissions Test (BMAT)

This is a common test for all applicants to the University wishing to study either Medicine or Veterinary Medicine, and is taken by applicants in very late October or early November. (Applicants for the Cambridge Graduate Course in Medicine are not required to take the BMAT, but can opt to do so as a means of fulfilling the pre-medical requirements.) This test comes in three sections: the first being a test of aptitude and skills, the second being a basic test of scientific knowledge and application in the main science subjects, and the third offering more open-ended essay-style questions. The intention of the BMAT is to provide some degree of standardisation across the Colleges, providing a framework with which to assess (to some extent) the relative quality of applicants in the various Colleges. It is also hoped, of course, that Colleges will find their applicants’ performance in the BMAT a useful indicator of ability when deciding which applicants should receive offers.

All three sections of the BMAT are marked centrally by Cambridge Assessment. The scripts for Section 3 will be distributed to Colleges for reading, and applicants are informed that what they wrote for Section 3 may be discussed with them at interview. Applicants will be informed by Cambridge Assessment of their marks in each section of the BMAT before they attend for interview.

For full details of the BMAT, and a specimen paper, consult the BMAT website: www.admissionstests.cambridgeassessment.org.uk/adt/bmat.

2.6.4 The offer-making process

The decisions made by each Medicine Group are co-ordinated by a Group Chair. Currently, the Chairs of the various Groups are:

Group I	Dr James Keeler (Selwyn)
Group II	Dr Geoff Parks (Jesus)
Group III	Dr Robert Henderson (Emmanuel)
Group IV	Dr Stephanie Ellington (Lucy Cavendish)

Additionally, the Group Chairs meet, as the Medical Quota Committee, to discuss matters of concern to all Groups, to moderate requests by individual Groups to increase or decrease the number of places they are allocated for a particular year, and to manage overall numbers and in particular the quota for overseas students. This meeting is chaired by a Senior Tutor (presently Mr Andrew Jefferies, Girton College).

The Subject Convenor for Veterinary Medicine, Dr Penny Watson (Emmanuel College), organises the single Group meeting in that subject. The meeting itself is chaired by the Director of Admissions.

The procedure for agreeing which applicants receive offers works as follows:

Applicants take the BMAT in late October/early November.
Applicants are interviewed (mostly) in December.
Colleges indicate to their respective Groups which applicants they wish to make offers to, and these Groups meet to agree the numbers of offers that can be made, and to whom those offers should be made.
Colleges make the agreed offers as usual in January.
To help achieve the necessary cover ratio, some Open Offers (offers of a place with the College yet to be determined) may be made for both Medicine and Veterinary Medicine in January.
When A Level (or other) results are declared in August, Colleges report the actual performance of their offer-holders to their Groups, and indicate which applicants' offers they wish to confirm. The Groups then meet or otherwise confer to agree which applicants should have their offers confirmed. Open–Offer–holders are allocated to Colleges at this stage through meetings held at the Summer Pool.

There are, then, basically four stages to the process as outlined in the table below.

October/November
In consultation with Colleges and Cambridge Assessment, CAO will create spreadsheets of all applicants for Medicine and Veterinary Medicine. These spreadsheets will include quantitative data from UCAS applications, Cambridge Online Preliminary Applications (for overseas applicants) and Supplementary Application Questionnaires. BMAT scores will be added when available. The spreadsheets are circulated to Admissions Tutors and Group Chairs (and thence to Directors of Studies) to assist moderation procedures, and will be used to check that all applicants have entered for, and sat, the BMAT.
December
Following the interviews, Colleges should produce lists detailing applicants they wish to make offers to and those they wish to place in the Winter Pool. This information should be sent to the relevant Group Chair. The Group Chair will convene a meeting of all the Colleges in that Group to agree: which applicants will receive offers the number of offers to be made from the Winter Pool the provisional overseas offers and the other overseas applicants to be considered at the meeting of Group Chairs which applicants should be pooled deferred entry offers Colleges should reserve at least the last 20% of their places, and be prepared to look at applicants from other Colleges within their Group (or from the Winter Pool), before finalising these last offers. At the Group Meetings in December, Colleges should bring the files of applicants in at least the bottom 20% of those to whom they wish to make offers, as well as all the files of applicants they intend to pool, for other Colleges in the Group to review. To ensure that applicants from overseas are treated fairly and considered as a gathered field for the limited number of places available, Colleges should also bring to the meeting the files of their first and second choice overseas applicants (if entitled to make one offer) and their first, second and third choice applicants (if entitled to make two offers). These files will go forward to a meeting of the Group Chairs to consider which overseas applicants are made offers. There will be the opportunity to add to the list of overseas applicants to be considered from the Group should a College entitled to make only one offer have three outstanding applicants. Colleges must not make offers to any applicants unless they have been agreed by their Group.
January
Following the Winter Pool, and before the end of January, Colleges should send their Group Chair a final list of those applicants to whom they have made offers. The Group Chairs will check that this data agrees with the outcomes of the Group Meetings in December, and pass this confirmed data on to the Chair of the Medical Quota Committee (Mr Jefferies). Again, Colleges may not make changes to their agreed admissions numbers without the explicit permission of their Group Chair. After Colleges have finalised their decisions in January, an appropriate number of Open Offers will be made to provide a suitable cover ratio in the two subjects. Any applicants to be made Open Offers will be selected from amongst those pooled by a panel consisting of: Medicine: the Chair of the Medical Quota Committee, the Chairs of the Medical Groups I-III, and representatives of the underwriting Colleges. Veterinary Medicine: the Director of Admissions, the Subject Convenor and the Directors of Studies in Veterinary Medicine at Clare, Girton and St Catharine's Colleges. Each Open Offer recipient is allocated to one of the underwriting Colleges to ensure that they receive the same communications as other offer-holders and are CRB-checked, as required. The offer letters are sent from CAO and signed by the Director of Admissions. The underwriting Colleges are currently: Medicine: Downing, Emmanuel, Gonville and Caius, and St John's Veterinary Medicine: Clare, Girton, Jesus, Murray Edwards, Queens', St Catharine's and St Edmund's
August
At Confirmation, Colleges should inform their Group Chair (via an updated list) of the actual examination performance of those applicants holding offers at the College, and identify those students they would like to admit. The Group Chair will either convene a meeting of the Group, or else consult with the Group electronically, to assess the extent to which the Group's quota has been achieved. If there are applicants who have not automatically satisfied their offers, but to whom Colleges wish to confirm an offer, the Group Chairs should determine which of these applicants at the various Colleges in their Group are the most deserving. After these Group Meetings or consultations, there will be (generally, on the same day) a meeting of the Medical Quota Committee, at which the merits of these would-be additional students will be weighed against each other, in the light of the actual amount of spare capacity for the current year. Colleges, obviously, are obligated to confirm the offers of applicants who have achieved their conditional offers. However, no College should confirm the offer of any applicant who has not explicitly achieved their conditional offer until after the Summer Pool. The Summer Pool is used to determine the destination Colleges of Open-Offer-holders in Medicine and Veterinary Medicine. Obviously, Open-Offer-holders who have met their offers take precedence over applicants who have missed their offers at named Colleges. In the Summer Pool, priority over Open-Offer-holders is given to Colleges seeking to fill places. In the unlikely event of an overshoot in the quota for Medicine or Veterinary Medicine due to too many applicants meeting their offers, the underwriting College will admit any Open-Offer-holder unallocated after the Summer Pool. The eventual outcome for all applicants should be confirmed to the Group Chair for Medicine or the Subject Convenor for Veterinary Medicine, who will check this information for accuracy and communicate it both to the Chair of the Medical Quota Committee (Mr Jefferies) and to CAO for transmission to other parts of the University.

A College with any queries on the procedures outlined above should consult their Group Chair, the Director of Admissions or the Chair of the Medical Quota Committee (Mr Jefferies). No decisions concerning the Medical and Veterinary places should be taken by Colleges outside the above procedures without the express permission of their Group Chair or, in the case of Veterinary Medicine, the Director of Admissions.

2.6.5 Offers and cover ratios

Colleges may wish to make the following types of ‘offer’ to students in December:

Carried Forward – these students achieved a place for deferred entry the year before.
Unconditional – these students are applying this time around, but have completed their school studies. [Note that, in practice, these offers will not contain academic conditions, but will still be conditional on satisfying the standard fitness to practise (health and CRB) requirements and, in the case of overseas students, producing the necessary financial guarantees.]
Conditional – these students are applying this time around, but have not yet completed their studies.
Concessionary Conditional – these are students being made conditional offers through some scheme, such as the Cambridge Special Access Scheme, to whom the College wishes to make a lower than usual offer. Colleges are able to propose one (or two in the case of Colleges with 14 or more Medicine quota places) such offers for approval at Group Meetings.
Colleges are able to propose one (or two in the case of Colleges with 14 or more Medicine quota places) such offers for approval at Group Meetings.
Transfer – these students are currently in Cambridge, studying another Tripos (most commonly the Natural Sciences Tripos), and wish to change to Veterinary Medicine (the Transfer system for Medicine having been discontinued).
Degraded – these students have previously been in residence, but have degraded, and are expected to return into residence the following October.

Colleges are permitted to make no more offers than their allocated number of quota places. Additional offers needed to provide an appropriate cover ratio across the Colleges collectively will be made as Open Offers.

2.6.6 Pre-medical requirements

Students admitted to read Medicine or Veterinary Medicine need to satisfy the pre-medical requirements set out in Statutes and Ordinances. These are the MINIMUM requirements: in practice, Colleges set further conditions and nearly all successful applicants have at least three A Level science subjects at grade A (or equivalent).

For more information about the pre-medical requirements, please see www.bio.cam.ac.uk/sbs/facbiol/camonly/premed.pdf and the Faculty of Biology's Guidance for Admissions Tutors on Pre-Medical Requirements: www.bio.cam.ac.uk/sbs/facbiol/camonly/admissionsnotes.pdf.

2.6.7 Other requirements

Offers of a place to study Medicine or Veterinary Medicine will be subject to a satisfactory enhanced disclosure from the Criminal Records Bureau (CRB) or similar evidence. From 2011 entry, where courses may involve regular access to children and/or vulnerable adults, students will be legally required to register with the Vetting and Barring Scheme (VBS), which is administered by the Independent Safeguarding Authority. An information sheet for applicants about CRB check procedures can be found in Forms and letters. More information about the CRB check can be found at www.admin.cam.ac.uk/offices/students/crb/.

Medicine students are required to provide proof that they have satisfactorily completed a full course of immunisation against the Hepatitis B virus.

The legal constraints associated with the Preparing for Patients component of MVST Part 1A mean that Medicine students must, at the very latest, attain the age of 18 by the start of the Lent term of their first year.

2.6.8 Disabled students

The General Medical Council (GMC) has published advisory guidance to medical schools, providing practical suggestions to help ensure that students do not face unnecessary barriers to successful medical careers. This advisory guidance can be found on the GMC website at: www.gmc-uk.org/education/undergraduate/undergraduate_policy/gateways_guidance/contents.asp.

A flow chart outlining the procedure to be followed when an applicant for Medicine/Veterinary Medicine discloses a disability or specific learning difficulty (SpLD) can be found at: www.bio.cam.ac.uk/sbs/facbiol/mvst/guidance_tutors.pdf.

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(1) Since the Clinical Medical school at Cambridge is smaller than the undergraduate Medical course, this (in effect) includes those students who commence their studies in Medicine at Cambridge, but complete their Clinical studies elsewhere.