Working in the health service is one of the most fulfilling, yet challenging, career paths an individual can choose to pursue.
That challenge begins at the Leaving Cert stage, with courses in medicine and nursing often requiring incredibly high points, putting significant pressure on people wanting to study them.
In fact, that is the case for a large proportion of courses in science technology, engineering and maths (Stem). Viewed as a reliable industry with positive job prospects, the realm of Stem is popular with many school-leavers, pushing up competition for places and – consequently – the required CAO points.
The high number of top grades last year resulted in many universities using lottery systems for high-points courses, particularly in medicine, dentistry and veterinary medicine, despite a move by the Government to add 1,000 college places.
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This means that some students who secured enough points to get into one of these courses missed out due to random selection.
In more positive news, points for most medicine courses have stayed largely steady in recent years, though remain very high.
Last year, students required 743 to study medicine in UCD, the same as the previous year. The medicine course at the Royal College of Surgeons, meanwhile, also remained unchanged year on year, requiring 741 points. UCC’s medicine course required 738 points.
At Trinity, required points fell by two points from 2021, down from 745 to 743. Only at the University of Galway did points increase, from 736 to 737.
Points for medicine courses are calculated by adding a student’s Leaving Cert points with the points from the Health Professions Admission Test (HPAT), which examines several things in candidates such as logical reasoning, problem-solving skills and non-verbal reasoning.
Nursing courses last year, meanwhile, saw some slight point drops: at DCU general nursing was down from 456 points in 2021 to 447 last year. At Trinity, it was down from 462 to 434, and at Dundalk IT students needed 415 points in 2022, compared with 440 the previous year.
Demand for some of the previously popular health courses did see a drop in demand this year, according to the July CAO “change of mind” figures, which could have further positive impact on points.
The number of people who applied for medicine was down 9 per cent when compared to the previous year, nursing was also down 9 per cent, while health was down 6 per cent.
Part of this could be in recognition of how competitive it is to ascertain a place on these sought-after courses. But even with all of these points changes, an individual who wants to pursue a career in this area shouldn’t be dissuaded by the highly competitive nature of securing a place on one of the courses.
There is good news in this regard: there are other access routes outside of solely relying on CAO points that can make these careers more accessible for those seeking to work in this field.
Colette Keogh, from the access office in DCU, said the Hear and Dare schemes are applicable for these courses.
“Students who apply to them can apply for any course, including nursing, and avail of a reduced point entry. It’s based on a number of criteria, so it is aimed at socially disadvantaged students,” she said.
However, for students who do not qualify for these schemes, other options remain. According to Ms Keogh, the QQI option is very popular across all courses, but especially for nursing.
The QQI route means a student undertakes a post-Leaving Cert (PLC) course relating to the degree they would like to undertake at third level, and can use that qualification to apply for a place on the course at university.
“Last year, in 2022, we had a reserved number of places for those entering on the QQI route and they were all filled. In fact, they were oversubscribed. So we would say to students that there is no guarantee [of entry] because it is so competitive,” she said.
“If they are applying through the CAO for a specific course, they would have to have completed specific modules in the QQI course. They would have to choose those carefully.”
Ms Keogh said there are many reasons why the QQI route, or the PLC route as it is also known, is an excellent option for students.
“If you take Stem courses, for example, when a student is unsure about what area they want to go into, they have that time, a year, or sometimes two, to get a taster,” she said.
“It also provides them with research, teamwork and presentation skills that you’d need in college.”
Suzanne Donnelly, associate professor of medicine at UCD, said while the Hear and Dare routes are at UCD, there is also another route for mature students: science, engineering, agricultural ccience and medicine (Seam).
It is a one-year course that is designed to be very flexible and consists of six modules, Dr Donnelly said.
“The overall premise is that it’s for those aged 22 or over at the age of application. The application is not based on educational attainment. There’s an online application form that gets you to answer a few questions such as previous experience of learning and why you want to enter the programme,” she added.
“It [the programme] is there as an acknowledgment that not everybody in their teenage years has the opportunity to excel at Leaving Cert, and in some cases maybe not even take a Leaving Cert at all. It’s really important for people who, quite early on in life, have come up against challenges that stop them pursuing what they really want to be in life.”
Outside of that, there is also the graduate entry route to medicine, which was introduced as a broadening access route to the area of study.
“That’s the opportunity for people who maybe wanted to do medicine from the time they did their Leaving Cert but maybe didn’t get in initially who went on and did a degree and then have the opportunity to do a shortened four-year medicine degree,” she said.
“Also, for people who did a different degree and then through their student life and as they grew older, they realised that actually medicine was where their heart lay. We have multiple routes other than direct from school, CAO routes.”
Dr Donnelly said there is an “inspiring” range of backgrounds and life experiences of medicine students as a result of these access routes.
She said the academics themselves don’t know through which route a student has entered the course – unless that student decides to share that information with them – and that all students are equal when on the programme.
“We do know that all of our students do equally as well once they come into medicine. There’s no set type of person, there’s no set background that ultimately makes you successful in a medicine degree or makes you a good doctor,” she said.
“I would hate to think there are young people or even mature applicants out there who think they mightn’t in some way be able to succeed in the medical programme. Our experience is the opposite, they flourish. Just because you’re not coming through the traditional very points-driven route, that doesn’t actually disadvantage you if you apply through one of these routes.”
Dr Donnelly said these access routes are incredibly important to ensure the healthcare system reflects the diversity of society at large.
“The practice of medicine means we ultimately serve the communities we work in. It’s very widely known, accepted and evident that our healthcare providers really should reflect the make-up of those communities. There was, certainly, an idea that medicine is for those who are privileged and I think it’s really important that our system and any interventions we make in terms of access programmes that address that and that they break down those barriers,” she said.
“Medicine is academically challenging, there’s no getting around that. As a course, as a career, as a profession, it’s academically challenging. But you don’t need to have a perfect Leaving Cert to do medicine.”
Dr Donnelly added that it was “really important” that these stereotypes or pre-conceived notions are challenges to ensure a vibrant and diverse healthcare system. Alternative routes are important, as there is no “one-size-fits-all” approach to what constitutes a good healthcare worker.
