Applying to Medicine : How to choose a fifth UCAS choice
Applying to medical school is highly competitive, so making the most of every UCAS choice is crucial. In the UK, UCAS allows you five course choices, but only four can be for Medicine. This leaves a “fifth choice” that cannot be another standard Medicine course. How should aspiring medics handle this extra option? Here we explain what the fifth choice is, why you should use it, and how to choose a course that serves as a smart backup plan for your medical career goals (including the latest 2026 entry updates).
How Many Medical Courses Can You Apply for on UCAS?
UCAS restricts Medicine applicants to a maximum of four medical school choices. You can pick four Medicine courses (for example, MBChB/MBBS programs at various universities). It’s highly recommended to use all four choices for Medicine to maximise your chances of an offer. In theory, you could include Dentistry, Veterinary Science, or another related field among those four because UCAS groups these as separate subjects – but mixing, say, Medicine and Dentistry in your top four is usually not wise. The reason is that your UCAS personal statement and references would be focused on Medicine, which might not align well with a Dentistry application. Therefore, most applicants stick to four Medicine choices.
Remember that applications to any courses outside UCAS (such as overseas or private medical schools) don’t count toward this four-choice limit. However, within UCAS, after using those four slots for Medicine, you still have one extra choice , which leads us to the crucial topic of the fifth choice.
What Is the UCAS Fifth Choice?
The fifth UCAS choice is an additional course choice outside of Medicine on your application. If you’re applying to Medicine, your fifth choice cannot be another standard Medicine course (or Dentistry or Veterinary, which have their own 4-choice limits). In practice, this fifth choice is usually a non-medical or related course that acts as a backup. Many students use the fifth choice as a fallback option in case they do not get any Medicine offers. Importantly, selecting a non-Medicine fifth choice will not affect your medical school applications – the medical schools won’t see this choice at all in most cases.
Popular fifth-choice options for Medicine applicants include degrees in the life sciences or health-related fields, such as Biomedical Science, Medical Biochemistry, Pharmacy, Psychology, or other Allied Health professions. These courses are closely related to Medicine and can serve as potential stepping stones to graduate-entry medicine later on. Choosing a science or healthcare-related degree for your fifth choice keeps you in touch with the medical field and may strengthen a future application to Medicine (more on that below).
That said, your fifth choice should be something you genuinely find interesting and would be willing to study on its own merits. You should only pursue your fifth-choice course if you’re prepared to complete that entire degree. It’s rare for UK medical schools to allow transfers into Medicine from another course, especially not early in the degree, so you shouldn’t expect to “hop over” to Medicine partway through. Universities also frown upon students who enrol in a backup course and then drop out without a valid reason. In short, pick a fifth choice that you’ll commit to finishing if needed, and that provides a worthwhile education or career path in case you don’t end up in Medicine.
Should I Leave the Fifth Choice Blank?
You might have heard some advice suggesting leaving your fifth choice blank if you are 100% committed to Medicine. The logic some give is that a “true” future doctor wouldn’t need a backup course. We strongly advise against leaving it blank. There is no benefit to doing so – and you could be missing out on a valuable safety net.
Crucially, adding a fifth choice does not harm your chances for Medicine at all. Admissions tutors at one medical school cannot see where else you’ve applied. Universities will not know about your other UCAS choices (including the fifth) unless one of those choices happens to be a course at the same university. Even in that scenario, medical admissions staff care primarily about your suitability for Medicine, and having chosen another course at their university is not considered a lack of commitment. In fact, the Medical Schools Council explicitly states that the optional fifth choice “won’t impact your medical school application”.
Years ago, all UCAS choices were visible to all universities, and interviewers might have asked why you picked a particular fifth course or applied to other schools. This is no longer the case – medical schools now only see the courses you applied to at their own institution, not elsewhere. So, one school will never know if you used your fifth slot for, say, Biomedical Science at another university. The bottom line is that there’s no downside to using your fifth choice. The worst that can happen is your fifth-choice course rejects you – which leaves you no worse off than if you had left it blank to begin with.
On the other hand, there’s a lot of potential upside to filling that fifth choice. If you’re unlucky with all four Medicine applications, a backup offer could save you from having no university place at all. Even if you’re confident in your application, Medicine is extraordinarily competitive and unpredictable. It’s wise to hope for the best but plan for the worst. Be realistic about what you’d do if you don’t get any Medicine offers– would you take a gap year, go through Clearing, or pursue another course? Having a fifth choice gives you an immediate alternative pathway.
Remember, you are allowed to add a fifth choice after your initial UCAS submission, as long as it’s before the January application deadline for other courses. So even if you weren’t sure what to put down by the 15 October Medicine deadline, you can take a bit more time (up to mid-January) to decide on a fifth course. This flexibility means there’s really no reason to leave it blank – you can make a thoughtful choice and add it in later. In summary: always use all five UCAS choices, even if the fifth is just a backup. It won’t undermine your Medicine applications, and it might turn out to be very important.
Can I Choose a Course with Lower Entry Requirements as a Safer Backup?
Many applicants intend their fifth choice to be a “safety net” course with lower grade requirements than Medicine. This is a sound strategy – if you miss the high A-level grades for Medicine, a less demanding course could still accept you. However, be aware that some courses popular as fifth choices have entry criteria similar to Medicine. For example, top Biomedical Science or Pharmacy programs at prestigious universities might still ask for AAA or similar, on par with medical schools. In some cases, a non-Medicine course could even ask for specific subject combinations or GCSEs that are as competitive as Medicine. So choose carefully: if you aim to have an insurance option in case of lower grades, make sure that the fifth course has lower requirements than your Medicine choices. Otherwise, it won’t serve its purpose as a backup.
That said, don’t automatically choose the course with the lowest entry requirements to play it safe. You need to balance realism with genuine interest. It should still be a subject you’re willing to study and capable of meeting the offer for. Many Medicine applicants do pick a related biomedical or science degree, which tends to have slightly lower (or at least more attainable) requirements than Medicine – confirm the exact grades needed so you know where it stands relative to your predicted grades.
Do you need any help with your medical school interview? Blue Peanut’s Medical School Interview Course offers tailored coaching from experienced doctors to boost your confidence and performance in both panel and MMI interviews.
Which Subject Should I Choose as My Fifth Option?
The best fifth choice for a Medicine applicant is highly individual – it depends on your interests and your backup career plans. However, most applicants gravitate toward subjects that align with Medicine in some way. Here are a few considerations:
Allied or Biomedical Sciences: The majority of medical hopefuls choose an allied subject like Biomedical Science, Biochemistry, Human Physiology, Pharmacology, or similar for their fifth choice. These courses cover scientific foundations related to human health and can prepare you for a career in medicine in the future. A degree in biomedical or life sciences is a common route into Graduate Entry Medicine (the 4-year accelerated medical programs for graduates). Some graduate-entry courses require or prefer a bioscience degree so this option keeps many doors open.
Allied Health Professions: Some students opt for courses like Nursing, Midwifery, Pharmacy, Dentistry, or other health professions. These can lead to fulfilling careers in healthcare even outside the doctor pathway. If you’re passionate about an allied health career (or you’re considering it as a Plan B), this could be a good fifth choice. Keep in mind that certain graduate-entry Medicine programs specifically target allied health graduates – for example, a few med schools reserve places for nurses, paramedics, or similar professionals in their graduate courses. Choosing an allied health degree might position you well for those routes. However, be cautious with options like Dentistry as a fifth choice. Dentistry is just as competitive as Medicine (and also has the 4-choice UCAS limit). Unless you truly see yourself happy to become a dentist, it’s usually not an adequate “backup” for Medicine. Additionally, your UCAS personal statement would be all about Medicine, which won’t impress a Dentistry admissions tutor. So, dentistry is generally not recommended as a fifth choice for Medicine applicants (nor is Veterinary Science, for similar reasons).
Unrelated Subjects: Occasionally, applicants consider a completely different field – like Engineering, English, or History – either out of a second academic passion or as a radical fallback. While UCAS technically allows your fifth choice to be anything, think very carefully before choosing an unrelated course. The fifth option is ultimately meant to be a stepping stone toward entering Medicine, or at least a degree you wouldn’t mind completing if Medicine doesn’t work out. If you pick something like Music or Art as your fifth choice purely because you enjoy it, ask yourself: Will studying this for three years help me become a doctor, or will it derail my path? It’s not impossible to switch trajectories (some people do an unrelated degree and then still get into Medicine later), but it can complicate things. If you pursue an unrelated subject, you might have to do the complete five-year Medicine program as a second degree (since you wouldn’t meet the criteria for graduate-entry Medicine at many schools). You also need to be genuinely willing to build an alternate career if Medicine never pans out. There’s no point selecting a course you have zero intention of ever using – that would be a waste of time and money. In summary, an unrelated fifth choice is only viable if you truly love that subject and see it as an acceptable Plan B. Otherwise, a science/health-related course is usually the better choice.
No matter what subject you choose, do some research on how it might benefit (or at least not hinder) a future Medicine application. For example, if you think you’ll attempt Graduate Entry Medicine, check what different medical schools require from applicants’ undergraduate degrees. Some graduate-entry programs will accept any undergraduate degree(arts or science) as long as you meet minimum academic standards. However, you may need to take entrance exams like the GAMSAT and demonstrate substantial healthcare experience in those cases. Other programs prefer or require a specific type of degree – e.g. some only accept degrees in biomedical sciences, and some only accept allied health professions. Choosing a fifth-choice subject that aligns with those expectations could give you a smoother route later. If you pick a completely unrelated field, you should be prepared that you might need to apply to the standard five-year Medicine courses as a graduate (since your degree won’t qualify you for the shortened graduate programs).
Lastly, avoid assuming you can transfer to Medicine during your first degree. A few universities have special schemes that allow high-performing students in specific courses (like Biomedical Science) to transfer into Medicine after the first or second year. These opportunities are scarce and extremely competitive– often only a handful of students get in, if the scheme exists at all. You should not bank on a transfer. Instead, think of your fifth-choice subject as either a standalone alternative career path or as a bridge to graduate-entry Medicine once you finish. This mindset will help you make more informed choices.
Which University Should I Pick for My UCAS Fifth Choice?
In addition to the course subject, consider the university carefully. You do not have to choose the same universities for your fifth choice as you did for your four Medicine choices – it can be any university in the UK. Some applicants use the fifth choice to get into a university they really like (even if it's a medical school that rejected them). Others prefer to stay within a familiar environment. Here are some tips:
Picking a university that also has a medical school can be advantageous. Many medical schools may not officially advertise this. Still, some tend to favour their own graduates for graduate-entry Medicine or may offer support to students in related courses aiming to move into Medicine. For example, a university might have an unwritten policy of reserving a few graduate-entry Medicine places for students who did their Biomedical Science there (or they may be more inclined to interview their own graduates). Additionally, if the university has a transfer scheme or a “Pathway to Medicine” program (like the one at Swansea University) for students in specific courses, being enrolled there could give you a shot at transferring or at least a guaranteed interview for Medicine. This is not true everywhere, but it’s something to research for the universities you’re considering.
Choosing a university with a medical program also means that as a student in a related course, you might have access to some medical school resources or societies and be in an environment with other aspiring medics. This could provide opportunities like mentoring or additional advice on applying to Medicine.
That said, don’t choose a university solely on hearsay that it might ease your path to Medicine. If a university’s course fits your interests and it happens to have a med school, great. But remember that nothing is guaranteed. Even if there’s a rumour that “University X likes its Biomedical Science grads for graduate Medicine,” you will still have to meet all the competitive criteria and excel to be selected. Treat any supposed advantage as minor. The priority is to choose a fifth-choice course/university where you will thrive academically, because you’ll need a strong degree result and CV to reapply for Medicine later.
Location and student life are also factors. If your fifth choice ends up being the course you do, you’ll spend 3+ years there. So pick a university where you’d be happy living, with a course environment that suits you. Don’t, for example, pick an obscure course at a university you dislike just because you think it might help you get into their med school later – that could backfire if you’re miserable or don’t do well in your studies.
In summary, for the fifth choice, it can be smart to pick a university that also offers Medicine (since there might be subtle benefits down the line), but weigh that against the overall fit of the course and university for you.
Will My Fifth Choice Affect My Medicine Application?
This is a common worry, but you can relax: your fifth choice will not affect your chances for Medicine. As noted earlier, other universities won’t know about it. Admissions tutors at medical schools care about your performance and passion for Medicine, as evidenced by your grades, personal statement, tests, and interview – they do not see or consider any unrelated course you applied to elsewhere. The Medical Schools Council and UCAS both acknowledge the fifth choice as a standard option for Medicine applicants, and using it does not indicate any lack of commitment on your part.
Even if your fifth choice is at one of the same universities as a Medicine choice (for example, you apply to Medicine at University A and also put a Biomedical Science course at University A as your fifth), it’s very unlikely to “flag” anything negative. The two departments might not even compare notes. In the past, candidates worried they’d be asked in a Medicine interview, “Why did you also apply for Biomedical Science here? Are you not confident about Medicine?” Nowadays, you shouldn’t face such a question in any official interview. Medical schools are aware that the fifth choice is a backup and should not hold it against you. If anything, having a science backup could show you are scientifically oriented and determined to be in healthcare one way or another.
Tip: Focus on strengthening your Medicine application (grades, UCAT, work experience, interview prep) rather than worrying about the fifth choice. And speaking of interview prep, don’t forget that once those UCAS applications are in, the next hurdle is interviews! Consider practising early to improve your interview skills. Our Mock MMI Interview Circuits can give you a realistic practice of medical school interviews and boost your confidence before the real thing.
For realistic practice in the MMI format, consider Blue Peanut’s Mock MMI Interview Circuits. These simulated interview circuits put you through a series of real-style MMI stations with feedback – an excellent way to build confidence and identify areas to improve before the big day.
Should I Choose an Unrelated Course as the Fifth Choice?
We touched on this above, but it’s worth emphasising: an unrelated course (one not connected to Medicine or science) is generally not the first choice for most Medicine applicants’ fifth slot. The reason is simple – if your heart is set on becoming a doctor, spending three years on an entirely different subject may not contribute much toward that goal. For instance, a degree in English Literature or Business won’t cover scientific or clinical knowledge, and you’d have to work hard on the side to gain relevant experience for a later med school application. Moreover, if you do get a place in an unrelated field and end up following through with it, you might find it difficult to switch back to Medicine unless you pursue graduate-entry Medicine (which, again, would likely be a 5-year course for you because your degree isn’t science-based).
However, there are exceptions. If you have a genuine second passion and would genuinely be happy pursuing that field as an alternative to Medicine, then it’s not wrong to put it down. Some applicants include courses like Biomedical Engineering or Psychology – not because they are easy backups (they often aren’t easier), but because those fields interest them and also have some relevance to healthcare. A few even choose something completely different, like History or Economics, because they feel they’d rather reapply to Medicine after a gap year anyway, so the fifth choice is a “just in case” for a different career they also like. This is a very personal decision. The key is, don’t select an unrelated fifth choice on a whim or due to pressure. Only consider it if it’s part of a clear, conscious backup plan that you are willing to embrace should it happen.
For most candidates, an allied science or health course is a more straightforward and functional fifth choice. It keeps you close to the field of Medicine and often has overlapping prerequisites (so your academic preparation isn’t wasted). It also tends to make your personal statement situation easier, since you’ll be talking about science/health experiences that at least tangentially apply to the backup course as well.
What Do I Write in My UCAS Personal Statement if I Have a Fifth Choice?
Focus your UCAS personal statement on Medicine. You have one UCAS personal statement that goes to all your choices, and it should be tailored exclusively to why you want to study Medicine and why you’d be a great medical student. Do not dilute your Medicine personal statement by trying to also cater to a different course. Admissions tutors in Medicine need to see full commitment and passion for becoming a doctor. They are well aware that many applicants have a non-medical fifth choice, so it won’t surprise or bother them if nothing in your UCAS personal statement relates to that other course. Other universities expect to see a Medicine-centric personal statement from you. If they receive an application from someone with four med school choices and one science choice, they know the situation and will usually not hold it against you. Many such departments actually welcome medical applicants; they know you likely have excellent grades and motivation, even if your statement is about Medicine.
Starting with the 2026 entry admissions cycle, the UCAS personal statement format has changed slightly. Instead of a single extended essay, it’s now split into three structured questions:
“Why do you want to study this course or subject?”
“How have your qualifications and studies helped you to prepare for this course or subject?”
“What else have you done to prepare outside of education, and why are these experiences helpful?”
You’ll answer these in separate sections, but the overall content (4,000 characters total) remains similar to a traditional personal statement. For a Medicine applicant, all these answers will naturally be about Medicine – your motivation for Medicine, your academic preparation for Medicine, your medically related experiences, etc. So long as you stay focused on Medicine in your responses, you are doing the right thing. There’s no need to mention your fifth choice course at all in those answers. Trying to split focus would weaken your statement. So continue to write one strong, Medicine-focused personal statement (or structured responses) as if Medicine were your only goal
What about the fifth-choice university? If they’re in a different subject, won’t they wonder why your entire personal statement is about Medicine? Most will understand the context. However, it’s a good idea to check with that university if they have a policy for this situation. Some universities offering popular “backup” courses (like Biomedical Science) explicitly say they do not mind a Medicine personal statement. Others may allow you to send a separate personal statement directly to them for consideration of the fifth course. For example, you might contact the admissions office of your fifth-choice department and say, “As my UCAS personal statement is focused on Medicine, would you like me to provide a separate statement about why I’m interested in your course?” If they offer this option, take it – it can only help. Not all universities do this, and many won’t require it, but it doesn’t hurt to ask. If you’re unsure, reach out to the university; most will not “hold it against you” that your UCAS personal statement is about Medicine. They know medicine applicants are often high-calibre students and are generally happy to consider you as long as you meet their entry criteria.
In summary, write your UCAS personal statement for Medicine. If your fifth-choice university wants additional info, they’ll let you know (either via allowing a separate statement or perhaps an interview/questionnaire for that course). The new structured personal statement format for 2026 doesn’t change this advice – it just means you’ll explicitly answer why you want the Medicine course and how you’ve prepared, which is precisely what you’d do anyway.
Can I Rely on the UCAS Fifth Choice if I Get No Medicine Offers?
Picture this scenario: it’s spring, and unfortunately, you’ve received four rejections from your chosen medical schools (or perhaps you only got one offer but didn’t meet the grades). This is where your fifth choice can become a lifeline. If you have an offer from your fifth choice, you have a guaranteed university place – not for Medicine, but at least you won’t be left without any options. Without a fifth choice, if you get zero medical offers, you’d automatically be entering UCAS Clearing or taking a gap year to reapply.
Whether to actually use that fifth choice (i.e. accept the offer and enrol in that course) is a big decision. Some students, when faced with no Medicine offers, choose to take a gap year and try again rather than going for their backup course. Others might go into Clearing to see if any medical schools have leftover spots. It’s worth noting that, historically, very few medical school places were available in Clearing – but recently there has been an increase in opportunities. For example, in 2023 and 2024, many medical schools unexpectedly had vacancies for Medicine in Clearing. This included new medical programs and even some established ones, reflecting how unpredictable the system can be. In 2024 entry, more medical schools than ever offered places via Clearing (such as Brunel, Newcastle, Aberdeen, Leeds, and others). So, some strong applicants might feel that if they fall short initially, they could gamble on Clearing or reapply next year with improved credentials, rather than committing to a different course.
What should you do? It depends on your profile and appetite for risk. If you have excellent grades (achieved A-levels), a strong UCAT, and you think your application was close to success, you might consider reapplying next cycle or trying Clearing, since you stand a good chance with another attempt. On the other hand, if you feel that your application needs significant improvement (or you’re simply ready to start university life), then your fifth-choice offer might be worth taking up. It provides a structured path forward: you earn a degree in three years and then potentially pursue graduate Studies in Medicine.
Without a fifth choice, your only immediate fallback is Clearing (or results day waiting lists). Clearing for Medicine is still very competitive and not guaranteed – you could end up without any place at all if you rely solely on that last-minute route. So having that fifth choice in hand is a comfort. You don’t have to decide on it until you know your Medicine outcomes and your results, but it will be there as an option. In essence, the fifth choice is insurance. You hope you won’t need to use it, but it’s there if things don’t go to plan.
Can I Change My Mind After Accepting a UCAS Fifth-Choice Offer?
Suppose you receive an offer from your fifth choice and, come spring, it’s your only offer (or one of two, along with maybe one Medicine offer that you missed the grades for). You decide to accept the fifth-choice offer as your firm or insurance choice on UCAS. What happens if over the summer you change your mind – say, you want to take a gap year after all, or you get into a med school via a late waitlist or overseas offer?
Accepting any offer (firm or insurance) is a serious commitment. When you firm a choice, you are entering into a contract with that university that you intend to enrol in that course, provided you meet the conditions. If it’s an unconditional offer and you firm it, the contract is immediate. If it’s conditional and then you meet the conditions on results day, it becomes binding at that point. So treat a fifth-choice acceptance with the same weight as any UCAS acceptance – don’t take it unless you’re prepared to follow through.
That said, life happens, and sometimes people change plans. If you have second thoughts after accepting an offer, you have a few options:
Before the course starts: You can contact the university and ask to release you from your place. Many universities will oblige if you notify them early enough (because they can then offer your spot to someone else, possibly via Clearing). If you do this quickly, you might avoid any contractual penalties. Do not wait until the term has begun – if you are officially enrolled and then leave, you could be liable for a portion of fees, and this could create more complications. So if you decide not to go, let them know as soon as possible over the summer.
After firming, wanting to switch to insurance: If you place your fifth choice as Firm and another as Insurance, and later you think “perhaps I’d rather go to my insurance choice,” know that UCAS doesn’t allow a straight swap. Once you decline your firm (assuming its conditions were met and it became unconditional), your insurance is usually voided as well. The only way to keep the insurance is if the firm choice agrees to release you, and the insurance university agrees to still take you. This is not guaranteed – it’s entirely at the discretion of the universities involved. If you ever find yourself in this situation, immediately call your insurance university and explain – sometimes they can manually reclaim you if they have spaces, but time is of the essence.
After enrollment: If you start the fifth-choice course and then have a change of heart (for example, you reapply to Medicine and get in elsewhere the following year), you can leave the course, but you’ll have incurred some fees and loan usage for that year. Again, try to make that decision early. It’s better to withdraw sooner than later if you know you won’t continue, both financially and academically.
In summary, don’t accept a fifth-choice offer casually. Treat it as a real commitment. If you later decide to back out, act promptly and communicate with the universities. But ideally, only firm/insure a fifth choice if you are genuinely okay with undertaking that degree.
When Will I Hear Back About My UCAS Fifth Choice?
In many cases, universities respond faster to fifth-choice (non-Medicine) courses than medical schools do. Medicine applications have an early deadline (15 October) and involve a lengthy process with admissions tests and interviews that often stretch into spring. Non-Medicine courses (which follow the January deadline) might start making offers on a rolling basis through the winter, and they typically don’t require interviews or additional exams (except in certain fields).
So don’t be surprised if you receive an offer from your fifth choice as early as November or December, long before you hear anything definitive from your medical schools. It’s not a guarantee – some universities also wait until after the January deadline to offer places – but many applicants find their fifth-choice offer arrives quickly. For example, a Biomedical Science course might review your grades and personal statement (even if it’s about Medicine) and issue a conditional offer without any interview. Meanwhile, you could be waiting until March for all your med school interview decisions. This staggered timing can be a bit nerve-wracking, but it’s normal.
One thing to keep in mind: you do not have to reply to any offers (accept or decline) until you’ve received decisions from all your UCAS choices. So even if your fifth-choice offer comes in early, you can hold onto it while you await your Medicine outcomes. Only after all five have replied (or by the UCAS decision deadline) will you need to choose your firm and insurance. So early offers from a fifth choice sit there as a reassurance while you focus on getting those Medicine interviews.
Financial Factors to Consider with the UCAS fifth choice
Pursuing any university degree is a significant financial investment, and a fifth-choice backup is no exception. If you end up enrolling in your backup course, you’ll be dedicating time and money to it just as you would with Medicine. It’s essential to evaluate the financial implications of that path:
Tuition Fees and Loans: In England, for example, tuition is around £9,250 per year for most undergraduate courses. Over a three-year course, that’s about £27,750 in tuition fees. Add living costs (which might be ~£8,000–£12,000 per year depending on your situation), and you could be looking at £45,000 or more in student debt after a three-year degree if you take maximum loans. This is similar in scale to doing a Medicine degree. Still, the difference is if you do this and then go on to Medicine as a second degree, you might accumulate even more debt (and note that student finance for a second degree in Medicine has its own rules – graduate Medicine students often have to self-fund a portion of the tuition in the first year, etc.). So, financially, doing a backup degree is a commitment. Make sure you consider whether that degree provides value for money in terms of career prospects or personal development.
Career and Earning Potential: If you undertake the fifth-choice degree, what are the outcomes? Ideally, it should be a field where the career opportunities or further study opportunities justify the investment. For example, a degree in biomedical science can lead to jobs in research, pharmaceuticals, or healthcare industries, and can also be a springboard to a Career in Medicine later. That’s likely a worthwhile investment. On the other hand, if you choose a course just because it’s “easy to get into” but you have no interest in the career it leads to, you might find yourself paying a lot for a degree you don’t use. As Blue Peanut’s advisors often say, any degree you do should be “commercially viable” – it should enhance your job prospects, earning potential, or skills in a meaningful way. If your fifth-choice course passes that test and you think you’d enjoy it, then it’s a sound option.
Opportunity Cost: Consider the time aspect. If you go down the route of doing an alternate degree for three years, that’s time you are not in medical training. For some, this is fine – you might graduate at 21 and then start Medicine at 22, becoming a doctor a bit later but with another degree under your belt. For others, the idea of “losing” three years is frustrating if Medicine was the only goal. This isn’t a direct financial cost, but it is something to weigh. Taking a gap year and reapplying is one year; pursuing a different degree is three or more years. Make sure you’re comfortable with that timeline if you choose to use your fifth choice as a degree to actually pursue.
In short, go into a fifth-choice degree with your eyes open about the costs. It can be a fantastic investment if it leads to a career you value (including eventually Medicine via graduate entry). But if you think you’d begrudge spending money and time on that course, you may be better off reconsidering your plan (perhaps opting for a gap year instead of starting a course you don’t want). The decision will be different for everyone, but financial realism is key.
Can Universities Advise Me on My UCAS Fifth Choice Strategy?
You might think of asking the universities themselves for advice on what to choose as a fifth option. For example, if you’re applying to University X for Medicine, should you ask them what a good fifth course at their institution would be? Or if you have an offer from a fifth-choice course, can you ask how it might help you get into their Medicine program later?
It’s important to note that universities can only provide limited guidance in this area. Admissions staff can tell you about their own courses’ content and maybe how previous students have progressed. For instance, they can explain “This Biomedical Science course offers some clinical modules and opportunities to interact with our med school” or “We offer a guaranteed interview for our biomed graduates who apply to our Graduate Entry Medicine program.” They will happily share factual information about their programs that might influence your decision.
However, universities will not give you personalised strategic advice on getting into Medicine beyond their specific linkages. It’s somewhat beyond their remit – their job is to talk about their course offerings, not to tell you whether you should take a gap year or how to plan your career. In fact, if you ask outright, “Do you think I should do this course or reapply to Medicine?”, they may defer, because that’s your choice. They might reiterate how their course could be helpful, but don’t expect impartial career coaching from them. Also, if it’s a different university from your med choices, they certainly won’t comment on your chances at other med schools.
Our advice: do your own research (through guides like this, talking to current students, consulting career advisors, etc.) and use universities for specific questions about their courses. For example, ask if the course has any formal or informal pathways to Medicine, what recent graduates have gone on to do, or if they allow separate personal statements for Medicine applicants. Gather those facts and then make your decision in a broader context.
Remember, Blue Peanut offers expert one-on-one consulting if you need tailored advice on your medical application strategy. We can help weigh your options objectively, whereas a university will naturally focus on promoting its programs.
Beware of “Alternative” Medicine Pathway Courses
When selecting a fifth choice, you might come across courses that sound like direct routes into Medicine, often labelled as Foundation Year, Gateway to Medicine, Pre-Med or similar. These are typically one-year programs or integrated foundation degrees aimed at students who didn’t meet the standard entry requirements for Medicine (often targeting widening participation criteria). They have UCAS codes like A104, A900, etc., and are linked to specific medical schools. While these can be a valid route for some students, approach them with caution:
Limited Scope: Most foundation or gateway courses are offered by a particular university’s medical school and are only recognised by that same medical school. If you do a “Medicine with a Foundation Year” at University Y, it usually means you have a conditional place to progress into Year 1 of University Y’s MBChB if you pass the foundation year. You typically cannot take that foundation year certificate to another university’s medical program easily. In other words, the pathway is narrow – you either make it into University Y’s Medicine program or you’ve just done a year of study without a medical school seat elsewhere.
Competitive Progression: These courses often do not guarantee that all students will get into Medicine. You might need to achieve a particular grade or rank in the foundation year, and even then, there may be only a handful of spots. Always find out how many students from the foundation actually progress into Medicine. If a program takes 50 students in the foundation year and only, say, 5 get into the actual Medicine course, you should be aware of those odds. We have seen students complete such foundation programs only to find they did not secure a medical place afterwards. That can be heartbreaking, as they must then consider other options after investing a year.
Eligibility and Requirements: Some foundation or gateway courses are only open to certain applicants, such as those from specific underrepresented backgrounds, lower-income households, or particular regions. Make sure you actually qualify before choosing one. Also, even though they are “lower” requirement courses, you still need to pass that year and often meet additional requirements to move on (for example, you might still need to take the UCAT or another exam during that year, or go through a successful interview).
No Transfers Unless Structured: Apart from formal “gateway” programs, transferring between courses is usually not possible. If a regular biomedical sciences course isn’t explicitly part of a transfer scheme, you generally won’t be able to jump into Medicine unless you finish the degree or reapply from scratch. Don’t assume you can transfer just because you’re in the same university—always verify if a formal scheme exists (they are rare).
The point here is not to scare you off these options entirely. Meet the criteria and understand the risks. A Medicine foundation year at a university might be your foot in the door (some do offer a guaranteed interview or guaranteed consideration if you meet all the conditions). Just go in with eyes open: “guaranteed interview” is not a guaranteed place in the medical course. Check if there are fallback awards (for instance, some programs award a certificate or let you transfer to a biomedical degree if Medicine doesn’t work out). Do thorough research on any such course’s success rates and terms.
For most candidates, a straightforward degree in a related subject with the intention to reapply to Medicine might be a more flexible and less pressured path than a do-or-die foundation year. You can use the fifth choice wisely based on your own strengths and the information you gather.
Conclusion: Keep Your Eyes on the Prize (Medicine)
In deciding how to use your fifth UCAS choice, always circle back to your ultimate goal: becoming a doctor. The fifth choice should be a means to that end, not a dead end. If you don’t get into Medicine on the first try, it’s not the end of the road. Far from it – many students take a gap year to strengthen their applications, resit exams to meet grade requirements, or even study Medicine abroad and later come back to practice in the UK. These alternatives can be preferable to spending years on a course that interests you little. So don’t select a fifth choice out of pessimism or panic, assuming you’re definitely going to fail. Believe in your ambition to do Medicine, and use the fifth choice as just one of several backup strategies.
Ultimately, you want to exhaust all viable options for Medicine before deciding on a different path. Filling your fifth UCAS slot is one such option – it’s a prudent fallback, but you should simultaneously plan how to improve and try again if needed. If you do embark on your fifth-choice degree, make the most of it and keep working towards Medicine if that dream is alive. Some students finish their degree and successfully enter Medicine as graduates; others find new passions and career paths along the way.
Never give up on your pursuit of studying Medicine until you have truly exhausted every avenue. And remember, the Blue Peanut Medical team is here to support you at every step. From acing the UCAT to shining in interviews, we’ve helped countless students turn applications into offers. If you do get those coveted med school interviews, consider enrolling in a professional preparation course to maximise your performance. Our comprehensive Medical School Interview Course is designed to help you secure that offer – our goal is for you to get four out of four Medicine offers, and many of our students do!
