A lot of people can be daunted by the prospect of writing an essay in an exam, especially when they don’t have a book they can read on the topic. Worry not, these tips will help you develop the skills to produce a good essay.
The Questions
There will usually be three questions to choose from and you answer one of these. Usually you will have a question to do with some aspect of medicine, a science question and a social question. This broad spectrum of question means that there should be something everyone can answer.
How is the essay marked?
Marks go from 1-5 for the quality of your essay, with higher marks being more desirable, and A-E for the quality of your written English.
To get a 3.0, the essay must:
Answer ALL parts of the question (More information on this in the plan.)
The arguments should be relatively rational
The arguments should be reasonably well argued
Most people scoring under 3.0, have failed to answer all parts of the question. The information in ”The Plan” section will help with this.
What mark do I need?
This varies for each university, so check how the university you are applying to assesses you application, they should have a selection criteria published.
UCL add all the cores together to form a total. Oxford weight the sections, Section 1 and 2 are weighted at 40%, section 3 at 20%, so for Oxford, the essay is much less important, for UCL a higher score will help you gain an interview. In this case, if you have a weak section 1 or 2, it can help a little if you achieve a 4 or a 5. But as section 1 and two are scored out of nine, they can make a greater impact on your score if you score highly, if you average 5 on section 1 and 2, achieving a 4 can be a big boost to your overall score.
You don’t need a very high mark for most universities, scoring 3.0 A is usually fine.
Over all I would say, students spend far too much time ahhing and umming over what score they need. Put that energy into revision and practice, it will do a lot more good. There is also a factor you have no control over, and this is other students scores. What ever the criteria that particular university have, you will be measured against the other students sitting the BMAT that year and the rest of your application. So instead of being focussed on the score you need, focus on improving the score you have.
Pre-reading and Preparation
Looking at the GMC student can give you useful background information on what is expected of doctors and this is especially useful if you choose the medical question, there will be information on ethics, responsibilities, professionalism. It isn’t a riveting read, but it is an important one and if you want to study medicine, you should be familiar with it. If you are studying veterinary sciences, it may not be as important.
The news. This is a good source of current health topics, however, news articles are usually presented with an opinion or bias and so you should take care not to take on that opinion or bias as your own. Either research it further, or just note any facts you read about, or that X has been in the news with a lean towards [The opinion of the article]. Don’t just read the health items suggested by Apple News or Google, read New Scientist, or Scientific American, or search for articles on health issues you are curious about.
Journals. If you see a topic appearing in the news a lot, chances are there will be one or several journal papers about it. Try to find good journal papers which are transparent about their data and how they came by it and do not use emotive language.
Books. Most students have a list of books they are reading - Adam Kay “This is Going to Hurt”, “The Man who Thought his Wife was a Hat.” By Oliver Sacks, “The courage to care” and “The language of kindness” both by Christine Watson, “Do no harm” by Henry Marsh, “Your life in my hands” by Rachael Clarke and others. These are good books, some of which, you should read read as part of you application preparation process, but may or may not specifically help with the essay. Reading any non-fiction books is a good way to prepare for life, you never know when information will com in handy. But reading books as section 3 preparation, is time intensive, so do keep and eye on the news and read anything which will help you understand the structure and purpose of the NHS better.
Your clinical experience is a great source of information for the essay, if you are choosing a medical question. Understanding how the NHS works, roles and responsibilities, structure, funding, how the different arms of the NHS work together - such as MultiDisciplinary Meetings (MDT) where groups of specialists review complex cases and agree on management, they also learn in the process; or how doctors use pathology and the role of pathology in medicine.
Doing the Essay: Plan
In the exam room, once you have chosen your question you need to make a plan. This is a really important step which can dictate the success of your essay, so don’t get stressed about time and miss it out.
Timing:
10 minutes to plan
15 minutes to write
5 minutes to check
Structure of the essay. Most essays will ask you to define the question, argue for, argue against and conclude with your own opinion, or a very close variation of this. This should be reflected in your plan. Sometimes the essay title is bias in a particular direction and you will be asked to explain what it means and this will be the ”Arguing for” section. However, if you get a question like this and if it is important to the essay, you should also define any terms in that section.
First define or deconstruct and words or phrases in the question. For example in the essay title:
In the age of modern healthcare, every time a patients dies after a routine operation, it is a case of medical error.
Define. Here you might consider what do we mean by “Modern healthcare” and “Medical error”, we might also define a “Routine operation”. Modern healthcare is very different in different countries, so this can open up a possible avenue of discussion. Is a medical error just the doctor or surgeon in charge? Is it the whole team in the theatre? Before a routine operation is performed in the NHS, there is a long process, where they are assessed by the consultant, histories are taken, pre-ops are done - which include blood tests, risk factors are considered, so is a medical error just something within the operating theatre, or does it include the admin and procedures leading up to the operation? What is a routine operation? Does it include operations performed under local and general anaesthetic? General anaesthetic always carries a risk, although attempts to mitigate it are taken, a small risk is still there.
Before you start building your arguments, it is important that you define for yourself what these terms are, for the purpose of a short 500 word essay and that you include these in your essay for a well structured argument. I would expect each essay to have 3 terms for you to define. As you define them, the relationship between them should become more obvious and this should be an essential part of building your arguments. There may be more than one definition and this may offer and answer to a difficult argument you are asked to make. There is an example essay at the end of this post, with annotations and a plan. The essay was done by a student who kindly offered to let me put it up here as a training tool for others.
For and against. Another mistake students often make, is not addressing the question asked,
Write argument as headings and underneath, jot down two or three points each. Why? In a Time pressured situation, giving yourself visual aids will make you faster and more accurate, don’t try to keep information in your head.
Make a note of any examples you can think of. Examples can make a big difference to your essay and the quality of your arguments. Your essay may not have full coherence, because at the end of a pressured exam, you may not perform your best and you have little preparation time. So using an example can move your essay from a generalised mish mash, to being reasonably well argued and having some strong points. The very act of finding examples helps you to make sure you address each part of the question and that is essential for obtaining the all important 3-3.5 mark.
Do plan your conclusion. Here, try to bring your points together without contradicting yourself, you can refer to points you have made or examples you have used to support your view. If your view is sitting on the fence, this is especially important. For example:
Although sometimes the surgical team maybe to blame for an error, such as an admin or procedural error; if a comorbidity which is a risk factor was not checked for, or the patient was not asked about allergies which can sometimes prove fatal. However, there are also circumstances where they cannot be blamed or be reasonably expected to predict a situation, as in the case of a patient reacting badly to an anaesthetic with no history of risk factors. Therefore I think we must be balanced and only attribute blame where the circumstance calls for it.
Writing the essay.
Find a balance between writing quickly enough and making sure your handwriting is legible. If it can’t be read it can’t be marked. Don’t use a clever words if you can’t spell them, simple words without mistakes are far better than interesting words with spelling mistakes, which cost marks. The same can be applied to sentence structure and grammar, don’t include long sentences with endless commas, make use of a full stop. Don’t use a semi colon if you might use it incorrectly.
Where you are asked to explain the statement, avoid starting ”The statement refers to…” or any other form of this. It just wastes words and adds no value. Instead go straight into the answer. For the essay title above we could begin: “If a patient passes following a routine operation, which we could define as a commonly practiced operation under local or general anaesthetic, for a non-life threatening pathology and being low risk, it must be due to an error by the surgical or pre-surgical team, either as part of the surgical proceedure, or the admin relating to the proceedure.”
Without using extra words to say “The statement means,” we have concisely answered the question and made use of definitions we made earlier. All our words have value and all the important words have been defined in the introductory paragraph and we have answered the “explain the statement” part of the question.
Practice doing this and it will come easily in the exam. Don’t worry if it is not perfect, if it is quite good and addresses the question that is enough. It should also help to order your thoughts for the remainder of the essay, which is essential in a time pressured exam.
After you write your essay
Use those five minutes to check and re-check your work. When you are under pressure you can easily make mistakes, miss a word, miss-spell a word. Read it through to make sure it makes sense and there are no glaring errors. Check you answered ALL parts of the question.
Improving your marks
Practice is the best way, but practice is no good if you are not able to learn from your errors, or if you have no suggestions on how to improve. You could swap essays with a friend and mark each other’s, but this can lead to you being too nice to each other and when it comes to useful comments….. it can be like the blind leading the blind.
You could ask a teacher, be sure to provide them with the marking criteria and let them know you had 30 minutes to write it. But also be aware that they already work hard and will spend their free time doing this, unpaid. So either ask different teachers, don’t ask too many times or offer to help them with something they need to do in exchange - that will be a pleasant surprise.
There are also people you can pay for this service, either companies or tutors. I do this for my students. Whomever you choose, make sure they seem trustworthy and reputable, if you use a paid service, look for reviews.
An example essay
This was written by a student and student, who has kindly agree that I can use this here as a learning tool. I have annotated this with feedback and suggestions, in a different colour for clarity. This particular essay is very difficult, because it asks you to argue that the skills of individual surgeons are more important for surgical innovation and usually the opposite is true. The argument I present is not the only one which can be made, but demonstrates, how using this method, you can find an argument even for a difficult essay.
Teamwork is more important for surgical innovation than the skills of an individual surgeon.
Explain the reasoning behind this statement. Argue that the skills of individual surgeons are more important for surgical innovation or progress. To what extent do you agree with the statement?
Example plan (Written by myself)
I have written this plan, to try and help the student see that, in defining terms, arguments almost present themselves and this would have helped to attain a higher mark.
Definitions: Teamwork – a group of skilled specialists essential for surgery – may include nurses, junior surgeons, anaesthetist, technicians, etc.
Individual surgeon – defined here as the lead surgeon in charge of the operation and who has overall responsibility.
Surgical innovation – new types of surgery such as craniotomy (Which was once a huge innovation), robotic procedures. A way to manage a non-typical case, or an issue not-seem before, such as a case where a gentleman had a lymphoma in his testicle causing the testicle to grow to about 18 inches, could also include unusual cancers, or a case of a tumor whose location affect several organs.
Note: As soon as we begin defining these things, a possible argument appears, where the argument for the individual surgeon being more important. This can be seen in a surgeons ability to manage these unusual cases, while the “Team” are involved as much as ever, their skills are not specialist to this situation and the skills of the surgeon are, even more so if he has experience in a similar situation. But you would need put the definition in your argument, for example: The skills of an individual surgeon are more important for innovation where it can be defined as the ability to plan and manage surgery for unusual and rare cases which may not have been seen before, for example the a case where [Example: ]. Although the surgical team are still essential, their skills contribute to the surgery going ahead, but not to the innovation. The skills of the surgeon are even more essential for this kind of innovation, if he has experience of similar situations.
Explain the reasoning behind the statement – Members of the team all contribute to the surgery,
innovative ideas could not proceed without them. For a craniotomy specialised anaesthesia was an innovation. The planning of innovative surgery is likely to be a team exercise with different surgeons
contributing ideas and suggestions, maybe other specialists too.
Argue the skills of the individual surgeon are most important – For planning and carrying out unusual
procedures, where his specific skill and experience make the difference and not requiring skills of the
larger team.
To what extend do you agree with the statement– Everyone has a role to play and sometimes particular skills make the difference, but usually it is more likely to be a team effort, consultant and junior surgeons, consultant surgeons conferring, especially where anatomical specialities converge.
Students essay
Comment 1: A plan would have helped you here.
The ability for the surgical team to co-operate and communicate with each other is a larger contributory factor in advancing surgery further rather than solely the surgeon’s skills. Each role in a surgical team is vital and no role can be undermined—for example without the anathesist then a patient can wake up during surgery, and without a surgical technician, whose role is to sterilise the operating theatre, the patient could acquire an infection. Both of these situations will result in an unsuccessful surgery. Surgical innovation has the ultimate goal of making each surgery as efficient as possible, and with patients interests at the heart of the innovation. Thus, surgical innovation cannot occur without the communication between all members of the team: each member will be needed to ensure that the patient is the safest when a new, innovate surgical procedure is implemented. For example, during robot-assisted surgery, an example of surgical innovation, the teamwork between the robot technicians and surgeon is the most important, as if an issue arises such as the robot malfunctioning, the first port of call would be the robot technicians. Thus, new innovative surgery can only be a collective effort.
Comment 2: This does address the aspect of the question "Explain what is meant", it is fairly well reasoned, lacks some force and coherence, but it is clear the student is saying all members of the team have an important role. This is enough for this paragraph to gain a 3.0
I like the description of surgical innovation being to make surgery as efficient for a patient as possible and the patients interests being at the heart of innovation. At this stage I would hope these would be picked up later in the essay. The example of the robot is good, not perfect but it demonstrates the point the student is trying to make.
My criticisms would be that it is far too long. This can be explained with fewer words, saving space for points in your following arguments.
However, ultimately the surgeon is the leader of the operating theatre, as they make the most important decisions concerning the patient’s health. Thus a surgeons’ experience and knowledge can only determine whether a patient should be operated using a new surgical innovative technique such as minimally invasive surgery or whether a traditional surgery would benefit them. When innovation is implemented in a surgery, there is a larger chance of errors during a new procedure, thus a larger emphasis will be placed on a surgeons’ focus and dexterity to ensure the surgery is successful. During a new procedure, the other members of the team will only have supporting role as the final outcome will only be determined by the incisions made.
Comment 3: The student doesn't really talk about surgical innovation and the individual surgeon being the most important person for this. This paragraph more discusses the application of innovations which have already been done. This could have been avoided by making a plan. This paragraph takes the essay down to a 2.0 as not all components of the question have been addressed.
In conclusion, since the end goal of surgical innovation is for the improvement of outcomes for the patient, I believe to a considerable extent that teamwork between members of the surgical team will be a larger contributory factor to the success of a surgical innovation. The success of a surgical innovation cannot solely depend on the surgeon. Without the technicians, the anaesthetists or assistant surgeons, a surgery simply cannot take place and these members are even more vital in ensuring the success of a surgical innovation.
Comment 4: The student has clearly indicated agreement with the original statement. But again is straying from surgical innovation, to surgery generally. This is not the subject of the essay and it is a very common mistake.