ScotGEM: an alternative pathway to medicine

From civil engineering to medicine – why Sara Cali chose an alternative route to working as a doctor within NHS Scotland.

I’m Sara and I’m a final-year medical student. My journey into medicine has been rather unconventional, through Scottish Graduate Entry Medicine (ScotGEM) – a four-year post-graduate course based between the Universities of St Andrews and Dundee. 

What is ScotGEM?

ScotGEM was initially designed to promote remote and rural general practice. The first two years revolve around case-based learning, with a different health topic each week – diabetes, obesity, etc. – covering anatomy, pharmacology, physiology and clinical skills relating to that topic. We also see patients one day a week in general practice. 

Third year is based in a single GP practice. We have more independence: managing patients on our own and studying for finals. In fourth year, we return to hospital placements and finalise our portfolio work. Each year, we also do healthcare improvement projects.

ScotGEM is quite different to undergraduate programmes. We see patients and practice procedures like venepuncture from week one. We have one year of anatomy teaching, and there’s a huge amount of peer teaching. There’s also an expectation to take control of your own learning and experience – in third year, you organise your own hospital placements. 

Another big difference is the travel. I have lived at nine different addresses with this degree – second year rotates between NHS Fife, Dumfries and Highlands, and third year GP practices are spread across Scotland, from Orkney to Annan. The year groups are also smaller – mine only has 48 students! 

Why ScotGEM?

I had no interest in medicine during school and instead pursued a degree in civil engineering. After working as a lifeguard for children with disabilities, I realised I was more suited to healthcare than I originally thought. I considered nursing, paramedics and social work before coming across ScotGEM. I liked the idea of an accelerated learning pathway. There was more patient interaction and clinical skills earlier on than conventional medical routes.

The biggest deciding factor for me, however, was cost – graduate medicine in Ireland can cost around €16,000 per year. ScotGEM offers a £4,000 annual return-of-service bursary to all students.

While engineering was a big leap to medicine, my undergraduate degree proved quite useful. In ScotGEM, there’s a lot of independent learning – I was able to keep on top of the workload because I already knew how to study and organise my time. Problem-solving, literature-reviewing, note-making: all these skills were handy. 

Less appreciated but just as important were soft skills – being able to communicate and empathise with patients came quite naturally after multiple years spent working in hospitality and with children. 

Lastly, the first three years of ScotGEM are self-directed, with a significant degree of independence in your third year. Fourth year has been a slight regression in autonomy with learning and placements, as we’re linked back in with final-year undergraduate students in Dundee. The structure is very different and takes some adjustment.

Benefits and challenges

If you’re thinking about medicine as a postgraduate entrant, I would recommend ScotGEM – but consider the implications of moving constantly and associated costs carefully. Funding is a massive worry for most postgraduate students, and it’s hard to work part-time alongside this degree. One of the biggest expenses is having a car – with the locations of placements and all the moving, a car is vital for getting through this course.

But the level of patient exposure is fantastic, and your learning is closely supported by multiple GP tutors and clinical mentors. All doctors are expected to carry out annual reflections, audits, event analyses, etc. – ScotGEM has us well-practised as most of our assignments cover these tasks.

As an older student, there’s also less pressure to make medicine your sole life purpose. In fact, it’s actively encouraged to make time for yourself away from medicine, and this is something I will continue into my career.

I would choose ScotGEM every time for medical training. I feel ready to be a junior doctor, with an air of muted confidence that I can only attribute to the mountain of patients I have seen. Even though the course focuses on GP, it prepares us well for all possible specialties and training routes. I have a more holistic view of my patients, and plenty of exposure to all aspects of the patient care journey.

Career and lifelong learning

Medicine is not a career to undertake lightly, and most people in a postgraduate course will be there because they have thought long and hard about it. You’ll be surrounded by a group of very hard-working people, with a diverse set of backgrounds and knowledge. 

I mentioned peer teaching earlier – while this might seem daunting, it was an invaluable skill to develop as medicine is a career based on lifelong learning and educating your colleagues and future students, and your peers will be some of the best teachers you have. 

I chose medicine because I want a career where I can care for unwell and vulnerable people to the best of my ability – ScotGEM provided a learning platform aligning with that, and I’m really excited to see where this degree takes me.

This page was correct at publication on 22/11/2023. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Sara Cali

by Sara Cali

Sara Cali is a final-year ScotGEM student based in Dundee. Her first degree was in civil engineering at University College Dublin. She is keeping an open mind when it comes to specialty training, but paediatrics is currently the favourite! Her hobbies include running (a self-described ‘enthusiastic plodder’), sudoku and eating cake. 

Sara was the secretary of the ScotGEM Society, a student- and alumni-led body to support and link past and present ScotGEMs. The society also organises the occasional cèilidh and conferences for medical students.