5 A*s, 4 rejection letters: How an international student beat the competition to study medicine in the UK

medical student
Medical student Sarah in her scrubs at Queen’s University Belfast, Northern Ireland. Source: Sarah Tuan

Sarah Chanakarn Tuan’s path to becoming a medical student started with four rejection letters from the universities she planned to join. 

It was May 2023 and she was pretty confident of her chances. An all-rounder,  Tuan scored 5 A* for A Levels, was top in Malaysia for IGCSE Biology, shadowed a doctor, participated in prestigious art competitions, took part in various sports, and the list goes on.

Despite all that, she still failed to secure a spot as a medical student, which had been her lifelong dream.

This meant that she had to consider her second option: pursuing a biomedical engineering course at the University College of London (UCL). 

Every year, hundreds, if not thousands, of international students apply to get into a medicine programme in the UK.

But the average success rate is only between 5% and 10%, according to The Future Medic

In fact, just ask any medical student, and they’re sure to tell you that applying to get into medicine is far more stressful and intense than the five-year-long course itself. 

All students have to brace through tough admission interviews, sit for the University Clinical Aptitude Test (UCAT), and last but not least, produce evidence of all previous achievements, including relevant work experience that showcases why they deserve a spot in their chosen university. 

As luck would have it, one day, in August, Tuan unexpectedly received a waitlist offer from Queen’s University Belfast in Northern Ireland to pursue medicine.

She jumped at the opportunity to be on the waitlist — and before she knew it, she was on her way to Northern Ireland to realise her lifelong dream. 

We caught up with the medical student to learn more about how she did so well in her A Levels, her time at Queen’s University Belfast, and her journey to becoming a doctor:

Sarah has conquered Mount Kinabalu, one of the tallest mountains in the world. Source: Sarah Tuan

1. Congratulations on making it as a medical student! Tell us what sparked your interest in medicine. 

I think a lot of people have asked me this question, but it’s been difficult to pinpoint the reason behind it.

It’s been a lifelong journey for me to discover my interest in medicine — when I was younger, I had an interest in biology and it was always about helping others. 

I started off wanting to do marine biology, but I think after going through summer camp and life events, I slowly discovered my love for medicine and eventually, it became an ingrained part of me where I want to help people, discover more, and bring back technology to Malaysia. 

I also think a big part of my interest is that I’ve always wanted to study overseas and somehow contribute back to Malaysia.

I was inspired by a doctor that I had previously shadowed for two days. He studied at University College Dublin, and then he went to John Hopkins University to further his studies.

He came back and introduced new technology to Malaysia. And that’s kind of what I want to do in the future. 

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When Tuan isn’t busy living her dream as a medical student, she loves to draw and paint. Source: Sarah Tuan

2. Why did you apply to Queen’s University Belfast?

Coming from Kolej Tunku Jaafar (KTJ), which is a British-style boarding school, it was only natural for me to go to the UK.

I did consider going to the US, Australia, and Singapore. Personally, Ireland is a great place that I would recommend students to study in.

But the problem with these countries is that international students are not guaranteed a job. It’s also extra competitive when you apply because they will prioritise home students. 

For the UK, it’s hard to get in, but the moment you graduate, you know that you’ll have a job. 

I chose Queen’s because it’s a very affordable school, and has a good acceptance rate for international students. It also offers plenty of student initiatives. 

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Sarah Tuan (right) and her friends during their sixth form graduation. Source: Sarah Tuan

3. Can you tell us about your experience as a first-year medical student so far?

It’s great! I don’t deny that there is an overwhelming amount of workload — it feels like I’m back in boarding school, studying from nine to five every day.

But there’s a sort of like, you’ve been longing to study this for so long, and you’ve made it kind of moment.

I got my first stethoscope and I even got to put on my own scrubs for the first time!

It’s like a dream come true kind of moment for someone who dreamt of it, failed, but as luck would have it, eventually got in. It was magical. 

Queen’s is also great. The university’s teachings are non-traditional.

Traditionally, medical students will have to go through two years of clinical studies, and then the three years after that are their clinical years.

Queen’s does it in a way where there’s a lot more teamwork and integration.

As a year 1 student, I am already going to a GP clinic where I am training to engage in proper patient interaction and learning clinical skills. I also get to palpate on real simulated patients. 

4. Besides your medical student journey, can you describe your experience at the university so far?

I had reservations about going overseas. As an Asian, I was quite worried about the cultural aspect.

I didn’t know at the time that Belfast was going to be a predominantly white city, making it very obvious that you’re a minority.

However, if you’re open-minded, open to socialising, and exploring other people’s cultures, slowly but surely, you will make friends outside of your ethnicity. 

Also, what I like about Queen’s is the monetary aspect. Although I may come from a privileged position, you can’t deny that as an international student, things are significantly more expensive for you.

But Queen’s has a lot of incentives, one of which is the pantry staples, where I can get the basics such as rice, noodles, grains, toilet rolls, spices, and detergents for free.

Another is the student discounts, which have been quite helpful. 

I’ve also joined the Mountaineering Club. Ever since coming to the UK, I’ve been bouldering, and it’s been really nice.

I also joined the Teddy Bear Society, which is basically medical students volunteering to teach children about being doctors and healthcare practitioners. I am also part of the Malaysian Society. 

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Participants take part in St. Patrick’s day celebrations outside the City Hall in Belfast, Northern Ireland. Source: AFP

5. Could you walk us through your A Levels journey? How did it help you enrol at your chosen university? 

KTJ is one of the desired schools in Malaysia that a lot of students go to do A Levels, and I could definitely see why.

The college takes a more holistic approach that’s allowed me to build a good set of skills. 

Because you’re in a boarding school, you gain social skills and have to be independent in a regulated way. This helped me to build a routine for myself.

Like, I study six days a week now, and this isn’t much of a difference for me because I have had this study schedule since KTJ. 

Having studied chemistry for A Levels has decently helped me with my degree so far. It started my shift towards understanding and application.

By comparing when I sat for my A Levels papers versus my university education, I saw a stark difference in how I applied what I learned. 

But it’s not just the content in A Levels — it’s the skills you gain.

If you implement good study skills that you practise during A Levels — like for me, I started using Notion (productivity and note-taking app), Anki (flashcard programme — most university students’ holy grail), and kickstarting a study routine — they’ll help you a lot.

These study skills actually helped me a lot more than the content itself. 

6. Besides scoring many A*s in your A Levels, what else did you do to secure a spot at your chosen university?

Many universities look at your supra-curricular (activities you do to deepen your curriculum knowledge) during your application.

Think of it as something like extra-curricular, but things that you do that are outside of clubs and societies.

With supra-curricular, it makes you look more well-rounded and interested in your chosen field of study. 

For me, I attended various medical talks, shadowed a doctor, did sports, joined competitions, and wrote essays to get summer school scholarships. 

It’s quite common practice for medical students to shadow during their summer break. As a medical student, it’s so, so essential for you to shadow a doctor.

If not, you don’t know what being a doctor is like — you won’t know what goes on at the hospital. You basically won’t understand what healthcare is until you see it and experience it for yourself.

And the only way for you to do that is by shadowing a doctor, volunteering, or being sick and warded. 

So, shadowing is an essential part that you need to include in your personal statement, especially because this is what most home students would go through.

As international students have a low admission rate for medicine in the UK, most can’t pursue medicine without shadowing. 

If you’re interested in medicine, you have to look at it from a very medical perspective.

If you are in St John, for example, you gain first aid skills that will showcase to your applied university.

Your application practically says: “Look, I really enjoy doing medicine. I really want to do it. I’ve volunteered. I’ve done all of these. I already have the basic foundation of first aid.”

7. Do you have any other advice you’d like to share with other students, especially those who would like to pursue medicine?

Shadow a doctor. By any means necessary, try to get the opportunity. Ask everyone you know, whether it’s your teacher’s uncle or your friend’s father.

Just try to ask. Even shadowing for one day is a good opportunity. 

Another important thing is preparing for the University Clinical Aptitude Test (UCAT).

I cannot stress how important it is for students to prepare for it, especially now that the UK education system is removing the BMAT exam requirement, which will make getting into medicine a lot more difficult. 

You have to do well for the UCAT. I would even say it’s more important than your A Levels. 

UCAT isn’t a knowledge-based exam — it requires quick thinking and quick analysis and helps to build your moral values. It’s not something you can study for in one day.

My word of advice is to study for UCAT the minute you begin your A Levels course. It’s that difficult of an exam. And the scariest part is that you only have one chance every year.

I’ve seen students devastated after receiving their results because they’ve lost their one shot. And that’s also because the exam itself is very expensive. 

Other than that, try to do things that are medicine-related. On top of that, I also did a lot of things that were art-related because it’s my hobby. 

It’s never too late. I started quite late, and with God’s miracle, I got in! 

After your UCAT exams, you have to start thinking about your interview preparation right away. It is the next step to securing a spot in medical school.

More medical schools are moving towards a format called an MMI (multiple-mini interviews) instead of a more standard panel interview. 

Preparing for it is tricky as you have to not only understand the UK medical system but also have to build many soft skills to navigate through the MMI stations.

I found that looking through free resources online helps you get started as well as asking your seniors for advice.

8. Do you have any tips you’d like to share with current and prospective A Level students? 

Study hard. This tip is pretty much a given for A Levels students. 

If you’re worried about your higher education finances, there are plenty of scholarships that can help you.

Honestly, shoot your shot at whatever opportunity you get during your A Levels. These opportunities are given to you for a reason. 

Make connections. Do internships

Another thing is to have an open mind. Don’t be afraid to say hi to someone or ask about their day.

I know it’s not a cultural thing in Malaysia to do this, but you have to start learning how to do this, i.e. to be culturally competent wherever you are

Building such habits for yourself when you’re young makes many things a lot easier when you’re older. 

9. What are your current plans after graduating from university? 

The same with every medical graduate, the next step is to do my foundation years. This is kind of an inevitable future. 

However, I also plan to take the United States Medical Licensing Examination (USMLE) and the Medical Licensing Assessment (MLA) at the same time so I can further my studies in the States.

The States houses many big-name hospitals like The Johns Hopkins Hospital and Southern California Hospital and pharmaceuticals like Johnson & Johnson. 

I have always enjoyed sports and have gotten various sports injuries, so I think I want to focus on that in the future.

I also want to go into the male-dominated specialisation that is orthopaedics, which is tied to sports medicine. 

This interview has been edited for clarity and length.