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The US president’s actions have exacerbated the pandemic that has killed more than 200,000 people in the United States, rolled back environmental and public health regulations, and undermined science and scientific institutions. Some of the harm could be permanent.People packed in by the thousands, many dressed in red, white and blue and carrying signs reading “Four more years” and “Make America Great Again”. They came out during a global pandemic to make a statement, and that’s precisely why they assembled shoulder-to-shoulder without masks in a windowless warehouse, creating an ideal environment for the coronavirus to spread.US President Donald Trump’s rally in Henderson, Nevada, on 13 September contravened state health rules, which limit public gatherings to 50 people and require proper social distancing. Trump knew it, and later flaunted the fact that the state authorities failed to stop him. Since the beginning of the pandemic, the president has behaved the same way and refused to follow basic health guidelines at the White House, which is now at the centre of an ongoing outbreak. The president spent 3 days in a hospital after testing positive for COVID-19 and was released on 5 October.Trump’s actions — and those of his staff and supporters — should come as no surprise. Over the past eight months, the president of the United States has lied about the dangers posed by the coronavirus and undermined efforts to contain it; he even admitted in an interview to purposefully misrepresenting the viral threat early in the pandemic. Trump has belittled masks and social-distancing requirements while encouraging people to protest against lockdown rules aimed at stopping disease transmission. His administration has undermined, suppressed and censored government scientists working to study the virus and reduce its harm. And his appointees have made political tools out of the US Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), ordering the agencies to put out inaccurate information, issue ill-advised health guidance, and tout unproven and potentially harmful treatments for COVID-19.“This is not just ineptitude, it’s sabotage,” says Jeffrey Shaman, an epidemiologist at Columbia University in New York City, who has modelled the evolution of the pandemic and how earlier interventions might have saved lives in the United States. “He has sabotaged efforts to keep people safe.”The statistics are stark. The United States, an international powerhouse with vast scientific and economic resources, has experienced more than 7 million COVID-19 cases, and its death toll has passed 200,000 — more than any other nation and more than one-fifth of the global total, even though the United States accounts for just 4% of the world population.Quantifying Trump’s responsibility for deaths and disease across the country is difficult, and other wealthy countries have struggled to contain the virus; the United Kingdom has experienced a similar number of deaths as the United States, after adjusting for population size.What a Joe Biden presidency would mean for five key science issuesBut Shaman and others suggest that the majority of the lives lost in the United States could have been saved had the country stepped up to the challenge earlier. Many experts blame Trump for the country’s failure to contain the outbreak, a charge also levelled by Olivia Troye, who was a member of the White House coronavirus task force. She said in September that the president repeatedly derailed efforts to contain the virus and save lives, focusing instead on his own political campaign.As he seeks re-election on 3 November, Trump’s actions in the face of COVID-19 are just one example of the damage he has inflicted on science and its institutions over the past four years, with repercussions for lives and livelihoods. The president and his appointees have also back-pedalled on efforts to curb greenhouse-gas emissions, weakened rules limiting pollution and diminished the role of science at the US Environmental Protection Agency (EPA). Across many agencies, his administration has undermined scientific integrity by suppressing or distorting evidence to support political decisions, say policy experts.“I’ve never seen such an orchestrated war on the environment or science,” says Christine Todd Whitman, who headed the EPA under former Republican president George W. Bush.Trump has also eroded America’s position on the global stage through isolationist policies and rhetoric. By closing the nation’s doors to many visitors and non-European immigrants, he has made the United States less inviting to foreign students and researchers. And by demonizing international associations such as the World Health Organization, Trump has weakened America’s ability to respond to global crises and isolated the country’s science.Trump supporters, many not wearing masks, gather for an indoor rally in NevadaSupporters of President Trump — many without masks — crowded into an indoor facility in Henderson, Nevada, on 13 September.Credit: Jonathan Ernst/ReutersAll the while, the president has peddled chaos and fear rather than facts, as he advances his political agenda and discredits opponents. In dozens of interviews carried out by Nature, researchers have highlighted this point as particularly worrisome because it devalues public trust in the importance of truth and evidence, which underpin science as well as democracy.“It’s terrifying in a lot of ways,” says Susan Hyde, a political scientist at the University of California, Berkeley, who studies the rise and fall of democracies. “It’s very disturbing to have the basic functioning of government under assault, especially when some of those functions are critical to our ability to survive.”The president can point to some positive developments in science and technology. Although Trump hasn’t made either a priority (he waited 19 months before appointing a science adviser), his administration has pushed to return astronauts to the Moon and prioritized development in fields such as artificial intelligence and quantum computing. In August, the White House announced more than US$1 billion in new funding for those and other advanced technologies.A four-year timeline of Trump’s impact on scienceBut many scientists and former government officials say these examples are outliers in a presidency that have devalued science and the role it can have in crafting public policy.Much of the damage to science — including regulatory changes and severed international partnerships — can and probably will be repaired if Trump loses this November. In that event, what the nation and the world will have lost is precious time to limit climate change and the march of the virus, among other challenges. But the harm to scientific integrity, public trust and the United States’ stature could linger well beyond Trump’s tenure, says, scientists and policy experts.As the election approaches, Nature chronicles some of the key moments when the president has most damaged American science and how that could weaken the United States — and the world — for years to come, whether Trump wins or loses to his opponent, Joe Biden.Climate harmedTrump’s assault on science started even before he took office. In his 2016 presidential campaign, he called global warming a hoax and vowed to pull the nation out of the landmark 2015 Paris climate agreement, signed by more than 190 countries. Less than five months after he moved into the White House, he announced he would fulfil that promise.“I was elected to represent the citizens of Pittsburgh, not Paris,” Trump said, arguing that the agreement imposed energy restrictions, cost jobs and hampered the economy to “win praise” from foreign leaders and global activists.What Trump did not acknowledge is that the Paris agreement was in many ways designed by — and for — the United States. It is a voluntary pact that sought to build momentum by allowing countries to design their own commitments, and the only power it has comes in the form of transparency: laggards will be exposed. By pulling the United States out of the agreement and backtracking on climate commitments, Trump has also reduced pressure on other countries to act, says David Victor, a political scientist at the University of California, San Diego. “Countries that needed to participate in the Paris process — because that was part of being a member in good standing of the global community — no longer feel that pressure.”Cars on a turnpike pass a factory emitting smoke in New Jersey, U.S.The Environmental Protection Agency has rolled back regulations on greenhouse-gas emissions. Credit: Kena Betancur/VIEWpress/Corbis via GettyAfter Trump announced his decision on the Paris accord, his appointees at the EPA set about dismantling climate policies put in place under former President Barack Obama. At the top of the list was a pair of regulations targeting greenhouse-gas emissions from power plants and automobiles. Over the past 15 months, the Trump administration has gutted both regulations and replaced them with weaker standards that will save industry money — and do little to reduce emissions.In some cases, even industry objected to the rollbacks. The administration’s efforts prompted objections from several carmakers, such as Ford and Honda, which last year signed a separate agreement with California to maintain a more aggressive standard. More recently, energy giants such as Exxon Mobil and BP opposed the administration’s move to weaken rules that require oil and gas companies to limit and eliminate emissions of methane, a powerful greenhouse gas.According to one estimate from the Rhodium Group, a consultancy based in New York City, the administration’s rollbacks could boost emissions by the equivalent 1.8 billion tonnes of carbon dioxide by 2035 — roughly five times the annual emissions of the United Kingdom. Although these measures could be overturned by the courts or a new administration, Trump has cost the country and the planet valuable time.“The Trump era has been really a terrible, terrible time for this planet,” says Leah Stokes, a climate-policy researcher at the University of California, Santa Barbara.The Trump administration formally filed the paperwork to exit the Paris agreement last year, and the US withdrawal will become official on 4 November, one day after the presidential election. Most nations have vowed to press forward even without the United States, and the European Union has already helped to fill the leadership void by pressing nations to bolster their efforts, which China did on 22 September when it announced that it aims to be carbon neutral by 2060. Biden has promised to re-enter the agreement if he wins, but it could be difficult for the United States to regain the kind of international influence it had under Obama, who helped energize the climate talks and bring countries on board for the 2015 accord.“Rejoining Paris is easy,” Victor says. “The real issue is credibility: will the rest of the world believe what we say?”War on the environmentTrump hasn’t just gone after regulations. At the EPA, his administration has sought to undermine the way the government uses science to make public-health decisions.The scale of the threat came into focus on 31 October 2017 — Halloween — when then EPA administrator Scott Pruitt signed an order barring scientists with active EPA research grants from serving on the agency’s science advisory panels, making it harder for people with the most expertise to help the agency assess science and craft regulations. The order made it easier for industry scientists to replace the academic researchers, who would be forced to either give up their grants or resign.Five ways that Trump is undermining environmental protections under the cover of coronavirus“That was when I said, ‘Oh my god, the fix is in,” says John Bachmann, who spent more than three decades in the EPA’s air-quality programme and is now active in a group of retired EPA employees that formed to advocate for scientists and scientific integrity at the agency, after Trump officials began their assault. “It’s not just that they have their own views, it’s that they are going to make sure that their views carry more weight in the process.”Pruitt’s order, which would eventually be overturned by a federal judge, was part of a broader effort to accelerate turnover and appoint new people to the panels. And it was just the beginning. In April 2018, Pruitt revealed a “science transparency” rule to limit the agency’s ability to base regulations on research for which the data and models are not publicly available. The rule could exclude some of the most rigorous epidemiological research linking fine-particulate pollution to premature death because much of the underlying patient data are protected by privacy rules. Critics say that this policy was aimed at raising doubts about the science and making it easier to pursue weak air-pollution standards.Pruitt resigned in July 2018, but the trend at the EPA continues. Under its new administrator, Andrew Wheeler, the agency has accelerated efforts to weaken regulations targeting chemicals in water and air pollution.Whitman, the former EPA chief, says there’s nothing wrong with revisiting regulatory decisions by past administrations and altering course. But decisions should be based on solid scientific analysis, she says. “We don’t see that with this administration.”Science under siege: behind the scenes at Trump’s troubled environment agencyOne of the biggest recent decisions at the EPA came in the air-quality programme. On 14 April this year, amid the COVID-19 pandemic, the EPA proposed to maintain current standards for fine-particulate pollution, despite evidence and advice from government and academic scientists who have overwhelmingly backed tighter regulations.“It’s devastating, totally devastating,” says Francesca Dominici, an epidemiologist at Harvard University in Boston, Massachusetts, whose group found that strengthening standards could save tens of thousands of lives each year. “Not listening to science and rolling back environmental regulations is costing American lives.”Pandemic problemsThe coronavirus pandemic has brought the perils of ignoring science and evidence into sharp focus, and one thing is now clear: the president of the United States understood that the virus posed a major threat to the country early in the outbreak, and he chose to lie about it.Speaking to Washington Post journalist Bob Woodward on 7 February, when only 12 people in the United States had tested positive for the coronavirus, Trump described a virus that is five times more lethal than the even the most “strenuous flu”. “This is deadly stuff,” Trump said in the recorded interview, which was released only in September.In public, however, the president presented a very different message. On 10 February, Trump told his supporters at a rally not to worry, and said that by April, when temperatures warm up, the virus would “miraculously go away”. “This is like the flu,” he told a press conference on 26 February. In a TV interview a week later: “It’s very mild.”In another recorded interview with Woodward on 19 March, Trump said he had played down the risk from the beginning. “I still like playing it down because I don’t want to create a panic,” Trump said.After the tapes were released, Trump defended his efforts to keep people calm while simultaneously arguing that he had, if anything, “up-played” the risk posed by the virus. But health experts say that explanation makes little sense and that the president endangered the public by misrepresenting the threat posed by the virus.All the while, scientists now know, the viral transmission was surging across the country. Rather than marshalling the federal government’s power and resources to contain the virus with a comprehensive testing and contact-tracing programme, the Trump administration punted the issue to cities and states, where politics and a lack of resources made it impossible to track the virus or provide accurate information to citizens. And when local officials started to shut down businesses and schools in early March, Trump criticized them for taking action.Two decades of pandemic war games failed to account for Donald Trump“Last year, 37,000 Americans died from the common Flu,” he tweeted on 9 March. “Nothing is shut down, life & the economy go on.” Within a month, the US coronavirus death toll had topped 21,000, and the pandemic was in full stride, killing around 2,000 Americans every day.Shaman and his colleagues at Columbia decided to investigate what might have happened had the country acted sooner. They developed a model that could reproduce what happened county by county across the United States from February to early May, as state and local governments shut down businesses and schools to halt the contagion. They then posed the question: what would have happened if everybody had done the same one week earlier?Their preliminary results, posted as a preprint on 21 May suggested that around 35,000 lives could have been saved, more than halving the death toll as of 3 May. If the same action had been taken two weeks earlier, that death toll could have been cut by nearly 90%. Reducing the initial exponential explosion in cases would have bought more time to roll out testing and address the inevitable outbreaks with targeted contact-tracing programmes.“There’s no reason on Earth this had to happen,” Shaman says. “If we had gotten our act together earlier, we could have done much better.”Gerardo Chowell, a computational epidemiologist at Georgia State University in Atlanta, says that Shaman’s study provides a rough approximation of how earlier action might have changed the trajectory of the pandemic, although pinning down precise numbers is difficult given the lack of data early in the pandemic and the challenge of modelling a disease that scientists are still trying to understand.Trump responded publicly to the Columbia study by dismissing it as a “political hit job” by “an institution that’s very liberal”.Control the message, not the virusWith the economy in freefall and a mounting death toll, Trump increasingly aimed his vitriol at China. The president backed an unsubstantiated theory suggesting that the virus might have originated in a laboratory in Wuhan and argued that international health officials had helped China cover up the outbreak in the earliest days of the pandemic. On 29 May, he made good his threats and announced that he was pulling the United States out of the World Health Organization — a move that many say weakened the country’s ability to respond to global crises and isolated its science.For many experts, it was yet another counterproductive political manoeuvre from a president who was more interested in controlling the message than the virus. And in the end, he failed on both counts. Criticism mounted as COVID-19 continued to spread.Science and the US presidential election: what do you think?“The virus doesn’t respond to spin,” says Tom Frieden, who headed the CDC under Obama. “The virus responds to science-driven policies and programmes.”As the pandemic ground forward, the president continued to contradict warnings and advice from government scientists, including guidance for reopening schools. In July, Frieden and three other former CDC directors issued a sharp rebuke in a guest editorial in The Washington Post, citing unprecedented efforts by Trump and his administration to undermine the advice of public-health officials.Similar concerns have arisen with the FDA, which must approve an eventual vaccine. On 29 September, seven former FDA commissioners penned another editorial in The Washington Post raising concerns about interventions by Trump and Department of Health and Human Services (HHS) secretary Alex Azar in a process that is supposed to be guided by government scientists.This kind of political interference doesn’t just undermine the public-health response, but could ultimately damage public trust in an eventual vaccine, says Ezekiel Emanuel, a bioethicist and vice-provost for global initiatives at the University of Pennsylvania in Philadelphia. “Everybody is wondering: ‘Am I going to be able to trust the Food and Drug Administration’s decision on the vaccine?’” says Emanuel. “That fact that people are even asking that question is evidence that Trump has already undermined the agency.”Elias Zerhouni, who headed the US National Institutes of Health under former President Bush from 2002 to 2008, says the Trump administration failed to control the coronavirus and is now trying to force government agencies to use their prestige and manipulate science to buttress Trump’s campaign. “They don’t really get the science,” says Zerhouni of Trump and his appointees. “This is the rejection of any science that doesn’t fit their political views.”The White House and the EPA did not respond to several requests for comment. The HHS issued a statement to Nature saying: “HHS has always provided public health information based on sound science. Throughout the COVID-19 response, science and data have driven the decisions at HHS.” The department adds: “President Trump has led an unprecedented, whole-of-America response to the COVID-19 pandemic.”Isolationist scienceOn 24 September, the US Department of Homeland Security proposed a new rule to restrict how long international students can spend in the United States. The rule would limit visas for most students to four years, requiring an extension thereafter, and impose a two-year limit for students from dozens of countries considered high-risk, including those listed as state-sponsors of terror: Iraq, Iran, Syria and the Democratic People’s Republic of Korea.Although it is not yet clear what effects this rule might have, many scientists and policy experts fear that this and other immigration policies could have a lasting impact on American science. “It could put the US at an enormous, enormous competitive disadvantage for attracting graduate students and scientists,” says Lizbet Boroughs, associate vice president of the Association of American Universities in Washington, DC, a group representing 65 institutions.What Trump’s Supreme Court pick could mean for scienceIt fits in with previously implemented travel restrictions that have made it more difficult for foreigners from certain countries — including scientists — to visit, study and work in the United States. These policies mark a sharp shift from previous governments, which have actively sought talent from other countries to fill laboratories and spur scientific innovation.Researchers fear that the latest proposal will make the United States even less attractive to foreign scientists, which could hamper the country’s efforts in science and technology.“How we intersect with students from other countries has been hugely impacted,” says Emanuel. If the best and brightest students from other countries start to go elsewhere, he adds, US science will suffer. “I fear for the country.”The proposed rule provides a glimpse of what a second Trump term might look like and highlights the intangible impacts on US science that could endure even if Biden prevails in November. Biden could reverse some of the Trump administration’s regulatory decisions and move to rejoin international organizations, but it could take time to repair the damage to the reputation of the United States.James Wilsdon, a science-policy researcher at the University of Sheffield, UK, compares the US situation under Trump to the United Kingdom leaving the European Union, saying both countries are at risk of losing influence internationally. “Soft power is driven a lot by perception and reputation,” Wilson says. “These are basically the intangible assets of the science system in the international arena.” Whether or how quickly that translates into a loss of competitiveness in attracting international scientists and students is unclear, he says, in part because scientists understand that Donald Trump doesn’t represent US science.On the domestic front, many scientists fear that increased polarization and cynicism could last for years to come. That would make it harder for government agencies to do their jobs, to advance science-based policies, and to attract a new generation to replace many of the senior scientists and officials who have decided to retire under Trump.Re-establishing scientific integrity in agencies where government scientists have been sidelined and censored by political appointees won’t be easy, says Andrew Rosenberg, who heads the Center for Science and Democracy at the Union of Concerned Scientists, an advocacy group based in Cambridge, Massachusetts, which has documented more than 150 attacks on science under Trump’s tenure. “Under Trump, political appointees have the authority to override science whenever they want if it doesn’t conform to their political agenda,” Rosenberg says. “You can reverse that, but you have to do it very intentionally and very directly.”At the EPA, for example, it would mean rebuilding the entire research arm of the agency, and giving it real power to stand up to regulatory bodies that are making policy decisions, says one senior EPA official, who declined to be named because he is not authorized to speak to the press. The problem pre-dates Trump but has accelerated under his leadership. Without forceful action, the official says, the EPA’s Office of Research and Development, which conducts and assesses research that feeds into regulatory decisions, might simply continue its “long decline into irrelevance.”If Trump wins in November, researchers fear the worst. “The Trump folks have poured an acid on public institutions that is much more powerful than anything we’ve seen before,” says Victor.“People can shake some of these things off after one term, but to have him elected again, given everything he has done, that would be extraordinary. And the damage is done would be much greater.”

Well I feel this question is attempting to ask two different things. The first is the literal question "How do you apply to Medical School in the UK?" and the second is the underlying meaning "How do you get in to Medical School in the UK?". I will attempt to answer these although the second question is a bit more subjective. I think before I begin i will outline a few important characteristics of Medical School in the UK. For one, when I say "University", I mean undergraduate level. I know in the US, such institutions are called "Colleges" so this is to dispell any mis-communication in this answer. Unlike the US, UK medical schools are not all graduate entry (although a few are) and school leavers can apply. The majority of applicants tend to be between 17 and 19 in age. Although as far as I know, medical schools in the UK require students to be 18 when they start. I was 17 when I sent off my application in October, but am now 18, which is really the youngest age people can successfully apply to medical school in the UK. I think last year there were over 20000 applications for 7500 places which made the success rate between 30% and 40% (for 1 offer, so its about 10 applicants to a place at a given medical school). I know competition has increased this year, but I haven't found any figures. It might also be added that for people in their last year of school (such as myself) will be applying with predicted grades and will receive a "conditional offer" if they are successful. This means they get in provided they meet the grades on results day, August. I currently have 2 conditional offers to study Medicine starting next academic year. These are for University College London and Barts and the London Medical School.How do you apply for Medical School in the UK?Applying to Medical School in the UK isn't all that complicated a task. You have to register with UCAS- the university admissions service for the UK- and fill out personal details including information on your education and academic qualifications to date. The main qualifications looked at for Medicine in the UK are GCSE (or General Certificate of Secondary Education) and GCE (General Certificate of Education- A Levels). Although overseas qualifications, Scottish certificates and International Baccalaureate are all accepted, it all depends on personal circumstance. On UCAS you are able to apply for up to 4 Medicine courses. The only rules about where you can and cannot apply are that you cannot apply for both Oxford and Cambridge (unless you are applying for Organ Scholarship at Oxford in which case there is a loophole where you can apply to both).On your UCAS form you have the space for a 4000 character (or 47 line) Personal Statement. This is where you have space to "sell yourself" to the universities you are applying to. This can include anything you want. Some candidates write about their academic endeavor extra curricular activities, work experience, voluntary work, extra reading or other motivations to study medicine.There are also two entrance exams you might consider sitting. You don't have to sit these, but there are only four medical schools in the UK which don't require applicants to sit them; Liverpool, Lancaster, Bristol and Birmingham. The BMAT stands for Bio-Medical Admissions Test and is the Cambridge entrance exam, which is also used by Oxford, Imperial College London and University College London. The UKCAT stands for UK Clinical Aptitude Test and is required for all other medical schools in the UK.I think that's it for "How do you apply for Medical School in the UK?" other than there is a space for a reference attached to your UCAS which, if you are applying through a school or college, your tutor or designated teacher will write. if you are applying independently you are free to ask whomever to write this part of the application. UCAS forms need to be submitted to UCAS by the 15th October which is the early deadline for applications to study Medicine. I think this question demands a more important answer and that is "How do you get in to Medical School in the UK?"How do you get in to Medical School in the UKThe first thing is A Level grades. At this point in time all Medical Schools in the UK require AAA at A Level either predicted or achieved. The only exceptions to this are Birmingham, Oxford and Cambridge who require A*AA and grad schools who may require lower (I haven't researched this). Some medical schools also expect grades in a 4th Advanced Subsidiary (first year of A Level). For example, King's College London require a B in this 4th AS, Queen's University Belfast require an A and University College London require a "pass" (E). These aren't the only universities that require this, these are just examples. If you are not predicted AAA then you are going to run into difficulties. I think Keele Medical School and BSMS (Brighton and Sussex Medical School) will consider your application if you have or are predicted A*AB but that's not ideal. If you already have achieved grades but you need to resit to get the AAA and you don't have exceptional circumstances, then only a handful of medical schools will consider you. These include Keele, Liverpool, Lancaster, Exeter, BSMS, UEA and Southampton I don't know if these are all of them, I haven't done a huge amount of research into this. There are exceptions to this, for example there are outreach schemes available to students who come from disadvantaged homes and who happen to live in certain cities, where students may be guaranteed interviews or given reduced offers such as AAB or ABB. There isn't much else to say about A Levels apart from few medical schools place emphasis on A* grades. This si because many students are predicted A*s and then don't achieve them and getting AAA is not really a necessitous to be able to cope with medical school and become a successful doctor, but just a general cutoff used by universities to filter out a proportion of applicants and keep in line competitively with other schools. Chemistry is required at all medical schools (except UEA?) but most others either require Biology as well, or another science/maths A Level. Cambridge is the only one I know to "require" three science/maths A Levels and requirements are set by college (for instance Magdalene requires maths). You don't need maths at A level, UCL for instance "gives preference" to candidates who have a contrasting arts subject, along with the required Biology and Chemistry.The next thing I am going to talk about is the importance of good Advanced Subsidiary grades (OK I kind of lied when there was nothing else to discuss about A Level grades, but this is the grades you have in hand from the first year of A Levels which are counted as a qualification in their own right. If someone wants to ask about the structure of A Levels then I am happy to discuss it in detail, but basically the A Level is a 2 year qualification made up from a year of AS and a year of A2. AS is the first year and you gain a certificate for this.). These grades are fairly important because they show the medical schools that you are capable of meeting the predicted grades. A candidate with 4As at AS (the average applicant takes 4AS level and drops one to complete 3 A Levels) is justifiably predicted AAA at A2 while a candidate with CCDD may be filtered out because they are unlikely to meet the offer. Most medical schools tend to use AS grades in this way. It's a general rule of thumb that any predicted grade over one grade above AS is unjustifiably high unless there were exceptional circumstances or a particular unit dragged the grade down. However, there are some institutions that don't look at AS at all. For instance, Newcastle and Durham use UKCAT as their sole tool for shortlisting applicants for interview, providing they meet the minimum requirements for A Level (AAA) and GCSE. So if an applicant has a more modest AS profile, then they can get in providing they apply to medical schools that don't select using it. Cambridge, as an example, looks at AS UMS (Uniform Mark Scale... basically %) over the three most relevant. The average UMS of an applicant to Cambridge is 90% and the average for a successful is 95%. Obviously it would be a waste of an application to apply here with Bs at AS. Birmingham also prefer Candidates to have 4As in the first year of AS. These are just examples, all medical schools have different means of selection.GCSEs are sat usually between the ages of 14 and 16. These determine to an extent what medical schools you are able to apply to (note this is different for students who have not sat GCSEs because of international qualifications/Scottish certificates etc). Most medical schools have minimum requirements for GCSE- i.e C in English, maths and Science. I think the exceptions to this are Dundee, who don't set minimum but say they select in favour of candidates with the highest grades and Cambridge, who believe there are other academic selection tools that better determine the quality of the medical school student (although as you can expect, the GCSEs are still very good for an average student). For some medical schools, GCSEs play a minimal role in the selection process- not meaning anything beyond the minimum requirements. The schools include Newcastle, Durham, Exeter, Plymouth, Barts and the London and others. For other medical schools, it can be very important. Oxford, for example, contrast percentage of A* at GCSE with BMAT scores to shortlist candidates for interview with their average applicant having about 75%~ish A* at GCSE and their average shortlisted applicant having 90%~ish. Birmingham specifically ask for A* grades in Maths, English and Sciences and King's College London use a similar sliding scale as Oxford but contrast GCSEs with UKCAT scores, the average shortlisted applicant having around 7A* at GCSE. Again, research where your applying, GCSEs are not something you want to get rejected over.The UKCAT means different things to different schools. For general information, the UKCAT is split into four sections scored between 300 and 900 and an average is found. I believe this was somewhere between 625 and 630 this year. Most candidates will score between 600 and 700. The UKCAT has more of an impact in terms of getting shortlisted rather than getting in altogether as it's really just a tool to get rid of an inundation of applicants. Of the medical schools that use it there is quite a big variation in how the uKCAT scores are used. Most will set a cut-off, say rejecting the bottom 25% of applicants (I know St.Georges London and Southampton use this kind of system), some will have a predetermined cutoff of say 600 (Barts and Sheffield have this, although for Barts scoring above 600 has a positive impact on the application) and some use it very heavily to determine who gets an interview. Newcastle and Durham will interview the top 45% of UKCAT scores which means their cutoff is something like 695. Kings contrast it with GCSEs and due the the standard of their cohort, a similar score is needed for a competitive application. Some medical schools like Exeter and Plymouth set individual cutoffs for each section, and some barely use it at all (like Cardiff or Keele) so it is more for picking out candidates who would have otherwise been overlooked.The BMAT is only used by four medical schools; Oxford, Cambridge, University College London and Imperial College London. Unlike the UKCAT, you sit this after you apply so it's a bigger risk if you choose to apply to one of these universities or more. The exam is split into three sections, the first two being thinking and reasoning and scientific knowledge and application. These are multiple choice and scored between 1 and 9. The average this year was about 4.5 in each of these this year. The third section is an "essay" which is given a grade from A-E for written communication and 5-1 (5 being best) for the content. The average this year was between 3A and 3.5A. How these scores are used depends on the university. Imperial set cutoffs of the average in sections I and II (so around 4.5 this year) and then slightly lower for the essay because they care less about that (2.5C I believe). UCL view the whole application holistically and give extra credit for high scores and discriminate low scores although underperforming in a section isn't the end of an application. Oxford contrast the scores with GCSE with a weighting ratio fo 2:2:1 for sections I:II:III respectively. Use of the BMAT at Cambridge varies from college to college although they designed the test based around their own curriculum so they expect high scores. Universities are given the scores for each section and a copy of the BMAT essay. This is so they can use it if they wish in the selection process- for instance UCL get you to discuss your BMAT essay at interview.The last thing that really contributes to an application before interviews is the Personal Statement and the Reference. The latter of this you can't really manipulate and is dependent on your relationship with the designated tutor. For the personal statement, however, there are some really important steps you can make to make sure its the best it can be. Some medical schools place a huge amount of emphasis on the Personal Statement- Bristol say they put 80% of the decision to shortlist an applicant on the personal statement, while Edinburgh and Southampton don't interview at all and use the personal statement to determine the personal qualities of the candidate. On the other hand, the Personal Statement is not all that important for some medical schools like those who use other factors to determine who gets an interview. It's helpful for schools in seeing what steps the candidate has taken to show they are motivated (i.e. volunteering), whether they have a realistic expectation of medical school and medical practice (extra curricular activities, work experience), and anything interesting about themselves which separates them from the rest of the pile of applicants (extra reading, extra curricular etc etc etc). Not only is it used in shortlisting applicants but it can also be used in the interview as a springboard from which questions are asked.At all medical schools apart from Southampton and Edinburgh, you will have to go through an Interview in order to get a place. There are a few differences in how universities interview candidates. At most there is the traditional interview format where an individual applicant will get interviewed by a panel of 2 or 3. This was the case at all of the interviews I attended. However there is also the "Multi-Mini Interview", or MMI, format which includes a number of "stations" where a skill is assessed at each one. I know St.Georges, Birmingham, Leicester, UEA and Manchester, among others, all have these style of interview. One of my friends described their experience as "speed dating". The kind of questions asked at each one also varies from school to school. At Oxford and Cambridge, the emphasis is on scientific aptitude, while at most others it is about gauging the interpersonal qualities of the candidate and whether they have a suitable personality for medicine and medical school. At UCL they may ask you to discuss you BMAT essay and some medical schools, like Barts, will give you an article beforehand to read and then discuss in the interview. Some medical schools such as Keele even set up scenarios for you to partake in. What kind of interview you may get shouldn't really have any effect on where you apply although if you know for certain that you will not perform well at an academic interview like Oxford, Cambridge and to an extent UCL, then you might choose not to apply there, meanwhile if you really like the MMI format, then you might go for one of those.I suppose that's all I can really say for the time being without going into a ridiculous amount of detail. If you have any specific questions about a part of the application then feel free to ask. Also, if you want a "personal" experience then ask away.Lloyd

A study published last year warned that all the scenarios for keeping global temperature rise to 2C require “negative emissions” – removing CO2from the atmosphere and storing it on land, underground or in the oceans.Although plenty of negative emissions technologies have been proposed, none are ready to be rolled out around the world, or, in some cases, even demonstrated to work at scale.Kicking off a week-long series on negative emissions technologies (NETs), Carbon Brief takes a look at the many and varied options.Net-zero emissionsThe Paris Agreement was a “historic moment and quite a fantastic result”, says Prof Joanna Haigh, co-director of the Grantham Institute for Climate Change and Environment at Imperial College. But, as she explains to Carbon Brief, now comes the difficult bit:“It’s fantastic that they’ve agreed, but how to do it is now the big issue. The main way we’re going to try to do it, of course, is to reduce carbon emitted into the atmosphere, for example, by using more renewable energy sources and green technology more generally. But there may be sources of carbon that we can’t avoid.”If we can’t stop carbon emissions altogether, then we need to counterbalance them by taking some CO2back out of the atmosphere, says Haigh. This is necessary in order to achieve net-zero emissions, she says:“To get to net-zero emissions, we need to have some of what are called “negative emissions” technologies, or things which will suck the CO2out of the air to compensate for the ongoing release.”NETs take more CO2out of the atmosphere than they put in. No one single technology can solve climate change, but many have been proposed that could contribute to reducing atmospheric CO2. Some consider the notion to be a form of geoengineering, and sometimes refer to it as “CDR” (carbon dioxide removal).In depth details:Carbon Brief takes a closer look – in alphabetic order – at 10 of the most frequently proposed NETs, which you can also see in the infographic at the top of the page…Afforestation and reforestationBiocharBECCS‘Blue carbon’ habitat restorationBuilding with biomassCloud or ocean treatment with alkaliDirect air captureEnhanced ocean productivityEnhanced weatheringSoil carbon sequestrationAfforestation and reforestationAfforestation means planting trees where there were previously none. Reforestation means restoring areas where the trees have been cut down or degraded. Because trees take up CO2from the atmosphere as they grow, planting more trees means boosting how much CO2forests absorb and store. As a method of removing CO2from the atmosphere, this is one of the most feasible options, although it still has drawbacks and uncertainties.Reforestation is almost universally desirable in its own right, particularly if it means re-planting native trees, and is already widely recognised and used to tackle climate change. Many countries are already practising it, such as Brazil, which has pledged to restore 12m hectares of forest. The UN’s Clean Development Mechanism provides a financial incentive for countries to increase their forest stocks.Estimates suggest that afforestation and reforestation can sequester CO2at a rate of 3.7 tonnes per hectare per year, and comes with an associated cost of $20-100 per tonne.One potential obstacle to afforestation is land availability and suitability. This depends on a range of factors, including global population, diet, the efficiency and intensity of agriculture, and rising competition from bioenergy. Planting vast areas of forests could also cause complex changes in cloud cover, reflectivity, and the soil-water balance. All of these could also have an impact on the Earth’s climate.BiocharBiochar is the name given to charcoal that is added to soils rather than burned as a fuel. The charcoal is produced by burning biomass, such as wood, crop wastes and manure, while cutting off the supply of oxygen. This process is known as pyrolysis.The carbon in the resulting biochar is very slow to break down. This means the carbon it absorbed from the atmosphere while it was mere biomass is locked up for – potentially – hundreds or even thousands of years.GlossaryCO2EQUIVALENT: Greenhouse gases can be expressed in terms of carbon dioxide equivalent, or CO2eq. For a given amount, different greenhouse gases trap different amounts of heat in the atmosphere, a quantity known as… Read MoreMaking and using biochar can serve several purposes in addition to sequestering carbon. Adding it to soils can improve its fertility – acting as a slow-release sponge for water and nutrients – and boost crop yields The most famous example of this is the Terra Preta (“black earth”) soils in Brazil, which get their name from the charcoal that Native Indians added to the otherwise poor quality soil over 2,500 years ago.Other benefits include biochar being a convenient way of disposing of agricultural wastes, and producing heat and biofuels as by-products during pyrolysis. Biochar has also recently been mooted as a way of helping trees resist ash dieback.GlossaryALBEDO: This is a measure of how much of the sun's energy is reflected by a surface. It is derived from the Latin word albus, meaning white. Albedo is measured as a percentage… Read MoreA recent study found that biochar has the potential to sequester up to 4.8bn tonnes of CO2e per year. It has “fewer disadvantages than many negative emissions technologies,” the paper says, with limited need for additional land and water. However, as adding biochar makes soil darker, it reduces its albedo, meaning the land will absorb more of the sun’s energy and warm more rapidly. In addition, one study found that charcoal might not stay in soils as long as scientists think, and instead much of it dissolves and is washed into rivers, wetlands, and eventually the oceans.The UK has its own Biochar Research Centre (UKBRC) based at the University of Edinburgh, which was launched in 2009.BECCSBioenergy with carbon capture and storage – more commonly known by the acronym BECCS – is widely viewed as the negative emissions technology offering the most promise of drawing significant quantities of CO2out of the atmosphere at the lowest cost.Put simply, BECCS achieves net negative emissions through sequestering underground the emissions resulting from the burning of biomass for power. Negative emissions are achieved because of a “double gain” with the biomass, as it grows, having already drawn CO2out of the atmosphere before the CCS process begins at the power plant.In the video below, Prof Mike Stephenson, director of science and technology at the British Geological Survey, explains how BECCS produces negative emissions.Over the past decade, as climate scientists has attempted to present scenarios whereby the world manages to limit warming to below 2C, they have tended to include BECCS within their modelling assumptions. For example, in the latest Intergovernmental Panel on Climate Change assessment report published in 2014, 101 of the 116 scenarios that achieved a “likely” chance of staying below 2C relied on BECCS. And 67% of these scenarios said BECCS would represent at least 20% of the world’s primary energy by 2100.A recent study suggests BECCS could be used to sequester around 12bn tonnes of CO2e per year globally.Despite a small handful of demonstration projects in the US, BECCS has yet to be proved at a commercially viable scale. Deploying BECCS at such an epic global scale also leaves many unanswered questions about the implications for land and water use. For example, would harvesting such vast quantities of bioenergy compete with food crops and biodiversity conservation? Also, opinions differ on whether there is enough capacity, and in the right locations, to store captured CO2underground.A commentary in Nature Climate Change published in 2014, authored by many scientists who have examined BECCS, urged caution:“Its credibility as a climate change mitigation option is unproven and its widespread deployment in climate stabilisation scenarios might become a dangerous distraction.”‘Blue carbon’ habitat restorationSalt marshes, mangroves, and seagrass beds act as natural defences against climate change, capturing CO2 from the atmosphere – even faster than terrestrial forests – and storing it in their leaves, stems and in the soil. Carbon stored in coastal or marine ecosystems is known as ‘blue carbon’.Globally, the destruction of a third of coastal and marine wetlands to make way for houses, ports and other commercial activity is shrinking the size of the ‘blue carbon’ sink. Exposed soils also release CO2, turning coastal ecosystems from net absorbers of greenhouse gases to net sources. Carbon emissions from degraded mangroves, tidal marshes and seagrasses are thought to be equivalent to 3–19% of those produced annually from deforestation, though some large uncertainties still remain.Conserving and restoring coastal ecosystems so that they can continue to draw CO2 out of the air has been suggested as a way to mitigate climate change. Global projects to coordinate research and raise awareness about so called ‘blue carbon’ habitat restoration highlight the many benefits on top of reducing emissions, such as providing nursery grounds for wildlife and offering protection against coastal storms.Building with biomassPlant-based materials can be used in construction, storing carbon and preserving it for as long as the building remains standing. For example, timber and bamboo can be used for structural elements, hemp and wool for insulation, and hemp-lime for walling.These materials provide an alternative to standard construction materials, including steel and concrete, which are typically carbon-intensive to produce. Natural materials have additional benefits, such as the ability to regulate moisture and absorb pollution.Architects are starting to incorporate natural construction materials into their designs. In 2015, seven townhouses made of straw went on the market in Bristol, for instance. However, lack of investment, certification and expertise in the UK are currently obstacles to large-scale deployment.Cloud or ocean treatment with alkaliWhen CO2 dissolves in water it makes carbonic acid, removing CO2 from the air. The reaction explains why rising CO2 levels are making the oceans more acidic.CO2 is not very soluble in water, but the reaction can be enhanced by adding alkali. This provides the inspiration for two related ideas for creating negative CO2 emissions.Two Russian scientists suggest adding strong alkali to clouds to create alkali rain that washes CO2 out of the atmosphere. A second paper says adding “an acoustic influence” could help trigger rainfall.It suggests current global CO2 emissions could be offset by spraying 56m tonnes of potassium hydroxide into clouds across 0.4% of the Earth’s surface. That’s the area of Greenland.The second idea would see large quantities of lime (calcium oxide) added to the ocean. The lime would be made by heating limestone (calcium carbonate), a well-known industrial process. Adding lime to the sea would increase its capacity to absorb CO2, while also part-offsetting ocean acidification.The lime would need to be spread over a wide area to avoid saturating the water. At saturation, limestone would re-form, rendering the effort worse than pointless. One study estimates the costs at a relatively modest $72-159 per tonne of CO2captured. However, the amount of limestone needed would be very large.To remove a billion tonnes of CO2from the atmosphere would require roughly 2.5bn tonnes of limestone. The current global coal mining industry produces around 8bn tonnes per year.Adding alkali to clouds or oceans at such large scale is likely to be frowned on under international law. It would also have uncertain environmental impacts.Direct air captureDirect air capture, sometimes referred to as DAC, means sucking CO2 out of the air. It can then be buried underground or used in chemical processes to make anything from plastic to fuel.There are several ways to capture CO2 from air. The most common approach is to pass air over a special liquid. CO2 sticks to this mixture while the rest of the air does not. The mixture is then recycled by releasing the CO2, using heat.Direct capture devices are sometimes likened to artificial trees. Unlike a real forest, they would need little land. It is still an open question whether there would be enough capacity to store all the captured CO2 underground.Estimates suggest direct air capture could sequester all the CO2 currently emitted each year. The barriers to this are practical and financial.The concentration of CO2 in air (0.04%) means it theoretically need many times more energy to capture than the CO2 in a coal plant chimney, where the concentration is around 300 times higher. This would make direct capture costly. Some firms say they will be able to capture CO2 from air for $25 a tonne. Other estimates for capture, storage and regeneration of the capture medium range from $400 to $1,000 per tonne of CO2.Most of the energy needed by direct capture schemes is for separating the CO2 from the capture mixture, usually by heating. This energy could come from waste heat or evaporation, rather than electricity.To give a sense of the amount of energy required, it can be compared to the electrical output of power stations. Capturing a billion tonnes of CO2 a year from air would need the energy equivalent of 16 gigawatts (GW) of power plants running 24/7, if the system was perfectly efficient. This is impossible.Under more realistic assumptions, energy equivalent to the output of around 500GW of nuclear or 1,200GW of onshore wind would be needed. To put this in perspective, there is 345GW of nuclear and 432GW of wind power capacity around the world today.Enhanced ocean productivityJust like land plants, marine plants absorb CO2as they photosynthesise. Artificially increasing the rate at which tiny microscopic plants photosynthesise could, in theory, accelerate the removal of atmospheric CO2and slow the pace of climate change.One idea is to inject the nutrient iron into parts of the ocean where it is currently lacking, triggering a “bloom” of microscopic plants called phytoplankton. As CO2is removed from the surface ocean, more can enter from the air above it. And when the plants die, they fall to the bottom of the ocean and lock carbon away in the sediment for hundreds or thousands of years.Other studies suggest fertilising the ocean with nitrogen or pumping nutrient-rich, deep water into the nutrient-depleted surface ocean could do a similar job in terms of stimulating plant growth. As well as drawing down CO2, it’s thought ocean fertilisation could increase the amount of dimethyl sulphide marine organisms release, altering the reflectivity of clouds and potentially slowing temperature rise that way, too.In the clip below, Prof Richard Lampitt, marine biochemist at the National Oceanography Centre, Southampton, explains the theory behind ocean fertilisation to Carbon Brief:While private companies and research organisations have carried out a number of trials, big questions remain about the huge scale of ocean fertilisation required, the cost, regulation under international law and the possible unintended consequences of interfering with the natural marine carbon cycle.Enhanced weatheringNatural rock weathering absorbs around 3% of global fossil fuel emissions. The process begins with rain, which is usually slightly acidic having absorbed CO2from the atmosphere on its journey to the ground. The acidic rain reacts with the rocks and soils it lands on, gradually breaking them down and forming bicarbonate in the process. Eventually, this bicarbonate washes into the oceans, where the carbon is locked up in the sea floor.Enhanced weathering ramps up this process. Pulverising rocks bypasses the slow weathering action, and spreading the resulting powder on large areas of agricultural land makes use of microbes in the soil to speed up the chemical reactions. At the same time, adding minerals to the soil boosts nutrient levels in the soil, providing a benefit for crops. The powder can also be spread directly onto the ocean surface.One of the by-products of this process is to make water more alkaline, thus enhanced weathering has an additional benefit of partially counteracting ocean acidification.According to one paper, enhanced weathering could be used to sequester up to 3.7bn tonnes of CO2eq per year globally. Closer to home, another paper says the UK has “substantial” resources of rock that are suitable for enhanced weathering, and calculates that the UK could capture a total of 430bn tonnes of CO2at a cost of between £15 and £361 per tonne.Enhanced weathering is a research focus of the Oxford Geoengineering Programme, and the University of Sheffield recently announced plans for a new £10m Leverhulme Centre for Climate Change Mitigation to develop and test enhanced weathering techniques.Soil carbon sequestrationModern farming methods, such as intensive ploughing, crop burning and the application of industrial fertilisers, have led to huge amounts of carbon in the soil being oxidised when exposed to the air and entering the atmosphere as CO2.Advocates of soil carbon sequestration propose that making some fairly simple changes to farming methods could reverse this process and return agricultural soils to being carbon sinks.Since the start of the Industrial Revolution, scientists have estimated that converting natural ecosystems into farmland has released 50-100bn tonnes of carbon from the soil into the atmosphere. However, through measures such as grassland restoration and the creation of wetlands and ponds, large amounts of carbon in the atmosphere could be sequestered, even exceeding the earlier carbon that had been lost.Earlier this year, scientists published a paper arguing that Brazil could increase its beef production at the same time as reducing emissions through the use of soil carbon sequestration.As Carbon Brief explained at the time:“Most pastures are planted with tropical grasses of the genus Brachiaria, which are very effective at absorbing CO2from the atmosphere and storing it as organic carbon in its roots. Studies have shown that, when well managed, these grasslands can be used to sequester carbon in the soil. Higher demand for beef pushes farmers to get the most out of the grass on their pasture and boosts how much carbon it stores, the papers says, while low demand has the opposite effect.”One negative aspect of soil carbon sequestration is that scientists are still uncertain how soils will react to a warming world, particularly in areas where water supplies might be at risk.ThanksRegardsGoogle