March 19, 2021, by School of Medicine

50 at 50: Graduate Entry Medicine, A Different Kind of Freedom

Medicine was almost a spur of the moment choice for me, I don’t quite want to say an epiphany. I hadn’t given it any thought at all until I virtually stumbled across the concept of Graduate Entry Medicine during a rather drawn out period of soul- and job searching in my late twenties.

I still remember the moment my partner came home from work on an early summer’s evening in 2014. “Hey, I think I’m going to be a doctor”, as she walked through the door. She looked a little taken aback.

“Okay!.. uhh.. are you sure?”, thinking no doubt that I was probably half joking. This was a little bit of a step up from the ideas I had been fielding over the previous year or two.

I explained why I thought that this one might be a goer, and some of the sacrifices that would be required of us both. It would mean changing jobs, cities, lives. Possibly many times over with no guarantee of success. After listening for a while, she thought carefully before the verdict came; “So, when do we start?”.

I had only come across the notion that same afternoon but I seemed to instinctively know it was the right thing to do. It was just what I had been looking for in a career. I won’t give you the interview-day pitch you’ve all heard a million times by now save to say that medicine seemed to tick all the boxes. It was a thrilling challenge. A practical, down-to-earth job that required immersion in the wonders of science. Something about it just clicked – why hadn’t I thought of it before? Aside from the varied lovelinesses of it – one of its most important qualities was that it was possible. We could financially justify taking the risk.

Impaired access to education and careers following university had been a trouble for me during that unhappy time. To me, the situation was becoming increasingly dire. I left a pretty soft humanities degree in 2010 as the rambling consequences of the 2008 credit crunch were beginning to bite into the UK economy at the dawn of the austerity era. I had been rejected and repulsed by a clutch of different career paths so far. I was running out of ideas.

It was too late for me to go back and get a trade like my brother which required a few years on an apprentices wage. I just couldn’t afford a postgraduate education. Workplace graduate schemes were drying up. I stubbornly couldn’t stomach working my way up through an office where I knew I would become desperately bored and unhappy.

It felt like giving up. After all this time and student debt, I was too angry for that. Life in Bristol was becoming increasingly unaffordable. We eventually wanted a family. I wanted to be happy [read: I wanted to not be bored and frustrated at work]. After a bunch of plans that didn’t or wouldn’t, I needed a plan that would work.

This could work. I knew it could work.

I’m a council estate kid who got lucky with his 11+ and ended up at a Grammar school on the other side of town. I was bright enough, obsessed with current affairs – ravenously curious about basically everything. I came from a family in which neither parent worked [officially… one was a full-time carer for the other]. This was a kind of static, functional poverty. I never wanted for food, clothing or shelter and luckily had a loving and nurturing environment at home, but holidays and trips were very much a rarity.

Driving was a pipe dream. I wasn’t very good with my finances and wound up with a disastrous credit rating that sealed my exclusion from postgraduate loans. I struggled with confidence [clothes, social life, hobbies]. I loved my family and my hometown but I always wanted to escape. A born day-dreamer.

I was the first person in my family to go to university! It’s such a cliché. But for me the decision to go through clearing when I was twenty-one came after a hard period of indecision and confusion. I had watched all my grammar school pals head off whilst I went out to earn my keep [bartending, office work, whatever was going].

I hadn’t thought about university. It’s hard after all this time for me to understand why I hadn’t really engaged with the idea when I was doing my GCSEs and during 6th Form. Regardless, by the time I finished my A levels, no applications had been made. I chose English at A level because it was pretty much the only thing I was good at and really loved. I think I chose Psychology and Sociology because I wanted to understand and fix the issues I saw around me. For reasons outside the scope of this article I had a vested interest in being (how do I say this politely?) vexed at the various little injustices and failures visited upon the families like mine by the social care ‘safety net’. I don’t think there was ever a real understanding of how I could actually go about doing that fixing.

I do remember eventually just feeling an absolute cynicism. I was that annoying kid in class, arguing every point with the poor lecturer who was simply trying to ground us in the basics of their science, something I took for granted or couldn’t understand at the time. Maybe it was arrogance, or a kind of desperation, but I grew to hate these social sciences and their ridiculously simplified categorical theories of how we and our world worked. It seemed to have so little to do with my situation – I think psychology lost me when I was being taught Freudian psychoanalytics – how could there be any hope of healing our wounded society, my wounded family, if this shambolic mess was what we had to work with?

In sociology we pored over early Victorian social theorists and wrote analyses of their painful stretches at putting our world into neat little boxes. This wasn’t it. This wasn’t what I needed. I did an A level in philosophy at a Catholic school a few miles away but gave it up after a term. Being taught philosophy at a Catholic school was one irony too many for me during a time in which I was kicking out against my own evangelical religious upbringing. On reflection, it’s possible that I wasn’t the happiest teenager. Another cliché.

I don’t remember deciding much of anything. I just got my results and went straight to the job pages in the Plymouth Herald. This went on periodically until I got properly fed up of working for minimum wage at a lawnmower company and began spending the free hours at my station… you guessed it… daydreaming of escape. I chose to do a degree in politics after I realised I could get a loan. This came as a real shock to my parents who had about 12 days between my informing them of this decision and me leaving for Bristol. I think they were worried about me and upset that I wasn’t happy where I was, but they supported me and helped me move my stuff and do the paperwork.

By that point the world of global politics [this was the now almost-forgotten immediate post-9/11 era of international high crimes and misdemeanours] had become the vessel in to which I could pour my anger. It was only in the third year that what happened after my degree started to emerge as an issue. I can’t blame my lack of forethought on anyone but myself but this did fit a now chronic pattern of a kind of negligence with respect to the long term direction of my life. I had friends going off to do internships with think-tanks, others getting on their Master’s in International Security.

Where do I even begin? This wasn’t my world. Better just stick to what I know. Going to gigs, seeing mates, getting by. This would have continued to be a perfectly fine and legitimate way to go about things – except that I was now stuck between the two worlds. The relatively transient, shiftless sort of work that students get in between career moves was all I could realistically nail down at that point, amongst the ever-swelling rents of Bristol City, a well documented cost-of-living catastrophe in the early 2010’s which arose largely from the increasing numbers getting out of London during that time.

After the degree, I fell immediately into trying to scrape by, paying the bills in Bristol. That’s what I did for a year or two… or three. Until I met the woman I wanted to marry and thought I’d better finally sort myself out with a career. This was a relatively new concept for me, a new kind of daydream. Less about escape from something than working towards something. A career. It just didn’t feel like something that people like me did, but I couldn’t keep going as I was.

It is no exaggeration to say that my life has been utterly transformed by the opportunity to do Graduate Entry Medicine. In this short article it is impossible to encapsulate all the bitterness, anger, fear, stuttering failures, frustrations and pain that have led us (for it has been a team effort from start to finish) from our previous lives towards the one we hope to have in just a few years from now. I really hope I don’t give anyone the impression it has been simple or easy. It hasn’t. But it has been possible.

Has coming from a relatively poor background made me a better [soon-to-be] doctor? I want to say, emphatically, yes! I make no judgments and can only pronounce upon my own experiences, but I wish I had the time to walk you through all the broken lives and situations I came into contact with in the 31 years it took me to get into my medical training.

I mean that the empathy I have for the people filling your hospitals is more than a high moral ideal. It’s an eye-contact experience of disease, trauma and strife that I think probably becomes more common the further down the socioeconomic ladder you go. I don’t know – maybe it isn’t more common and it’s just a different set of issues. I wouldn’t know how to judge that even if I wanted to. This isn’t supposed to be a value statement. Not everything is about class, but a few things surely are. Statistically speaking, the knocks come harder and more frequently to those without the means to avoid or mitigate them, it’s just logic.

The point of giving you the outline of my story is the following: how many other frustrated, angry young people are out there waiting for their chance to find the thing that they’re meant to be doing? It’s a terrible thought, but one that is full of promise. There’s nothing unique about me. I’m just lucky I stumbled across the website. There must be masses of potential out there, waiting for a lucky strike.

In between the tedium, hard work and petty frustrations that go along with any job, there is something very special going on here. The GEM course is the ride of my life. I am becoming a different person through the experiences it continues to afford me – an experientially richer, occasionally happier and immeasurably more fulfilled person – able to contribute back to the system which made it possible. This process of becoming will continue for the rest of my life. No more stasis, no more boredom. Though they will continue to be tested, the system has gained my loyalty, my faith, and 30 years of service.

What a bargain. How many more bargains are there to be struck?

By Simon Matthews, GEM Student

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