This article is a submission from José Silva, a Portuguese International Medicine Graduate who studied medicine in Europe; Czech Republic. I reached out to José and asked him if he could share some of his story, particularly his experiences getting into med and studying at Charles University Faculty of Medicine, Pilsen.
Like mine, his story is anything but conventional! But makes great reading for anybody else interested in going into medicine and thinking about alternative routes. Unlike most of what you’ll read on agency sales pages, it’s brutally honest too. So big thanks to José for his candidness.
Over to José.
My Background: Dentistry to Medicine; Portugal & Beyond
I studied dentistry for three years in my home country, Portugal, before I moved to Czech Republic. In Portugal, being admitted to medical school depends exclusively on one’s average grade during high school and then the grades obtained during the final state exams. These count 40% towards the total average grade.
Normally, the minimum grade used to be around 18/20 and unfortunately I never managed to have such high grades, despite repeating the final state exams four times. In the meantime, I went into dentistry.
Looking back, it was worth it because it gave me the opportunity to develop a solid study method as well as obtain a lot of basic medical science knowledge, especially with anatomy, physiology and biochemistry etc.
Exploring My Options & Not Giving Up: Deciding to Study Medicine in Europe
I tried getting into medicine in my home country for four years in a row, unsuccessfully. After the third attempt, while reading on some random Portuguese student forums, I found that quite a lot of students were going to Spain to study medicine. Given that the language is very similar (or so I thought) and the average grade required on the Spanish state exams was much lower than in Portugal (about 16/20), this made sense.
So after dozens of hours searching the internet and speaking with lots of people, I found an exam preparation school for the Spanish exams and started a preparation course that lasted for an entire year. After that year, I went to Madrid and did the exams.
The first time around it didn’t go so well. They made a last minute change on their syllabus that I didn’t expect; an entire section of mathematics on the exam that I wasn’t able to answer. However, I didn’t give up and went there again for the second phase of exams in September. That time, the exam went reasonably well and I thought I’d have a high enough grade to at least gain admission to the less competitive med schools in the country.
After waiting a couple of weeks, I got the results of the exam and found they were borderline compared to grades of the students admitted in previous years. So I applied but didn’t make the cut at the University of Cadiz by a 0.02 difference in terms of exam grades.
Of course I was left disappointed but still, I didn’t give up. The next year, while on my third year in dentistry, I sent some applications to the UK. These were to some of the less competitive schools at the time, like Brighton and Sussex and Bristol.
I didn’t have high expectations but I knew I was at least a decent candidate because I had some aspects on my application that they find valuable; like extensive team sports involvement and volunteering. My high school grades were high enough too – given that the Portuguese state exams didn’t count towards the calculation in England.
I was called for an interview at Brighton and Sussex but it didn’t go great because my English skills were only decent at best and I wasn’t used to the British accent. At this point I started to think that maybe it would be best if I just finished dentistry. My dream of studying medicine? Began to fade away.
One unexpected day however, a random guy sat next to me in an oral cavity histology class at the Dental University I was attending and we started small talk. He got my full attention when he said: “oh you know, I studied medicine in Czech Republic for two years but I gave up and decided to come back to Portugal to study dentistry”. Suddenly, I was like, “wtf, is that even possible? Tell me more about it”. It turned out that his father had a recruitment agency for students to go study medicine at Charles University in Czech Republic. After a couple of months? I did the entrance exams and got admitted.
So I ended up in Czech Republic randomly because of a guy who coincidentally sat next to me in dental class!
(One thing to consider: this all happened between 2009-10, so social networks and the web was nothing like it is today. Nowadays it’s much easier to find options and I’m sure that prospective students are much better informed than I was at that time.)
First Impressions Studying Medicine at Charles University
To be honest, the first year at the Faculty of Medicine in Pilsen was actually quite good with a lot of practical classes in anatomy. You study with real anatomic specimens and even get to watch dissections being performed.
My first year was something like a “honeymoon period”, so all my expectations were matched. I found that medicine at Charles was much more demanding than studying dentistry in Portugal, but that didn’t trouble me. I was already used to studying at university level, so the transition wasn’t bad.
I sailed through the first year at Pilsen very smoothly. Coming from dentistry was definitely a big advantage.
The honeymoon period ended however when studying for the first exam; medical chemistry. This was an exam where we had to memorize over 200 structural formulas of chemical compounds. Something, let’s be fair, that’s completely useless in the day-to-day work of a doctor!
So it was inevitable from that point that I’d start to face further difficulties. Things which weren’t necessarily connected to the difficulty of studying either.
Related: Is Studying Medicine in Bulgaria Good?
Challenges Studying Medicine in Czech Republic
The biggest challenges involved being a med student abroad are certainly the language and the culture. The language barrier is not felt too much if you choose to study in Prague, which is a very international city (so everyone speaks at least a bit of English). In Pilsen however, the same cannot be said.
Pilsen only started to open up to tourists (and therefore English) in 2015, after the city became the European Capital of Culture. As a result, more services opened up and started to hire locals able to speak English. Before that, everything was a huge difficulty – even ordering food at a restaurant was difficult due to the lack of English menus! Basic services like water, gas, electricity or even Vodafone, were hard to use too.
In the beginning there was even a slight xenophobia when you tried to ask for something in English. Pilseners weren’t used to having foreigners around and the University didn’t offer support for anything outside their remit. Even going to the hospital was a problem if a professor from the English division was not on call.
Once I had to be seen by an orthopaedic surgeon because of a maxillary sinus infection I had. As there was no one that could (or didn’t bother) to speak English in the ENT department that day, support actually came from older students who’d grasped a few words in Czech.
Without older colleagues? Everything would have been a nightmare because the school provides zero support.
Luckily I made friends with other Portuguese people who already spoke some Czech and they helped me a lot. Otherwise I wouldn’t even be able to find an apartment myself or even buy a SIM card at Vodafone.
Nowadays a lot has changed and the city has adapted much better to foreigners. This could be down to the fact they started to receive more tourists visiting the Pilsner beer breweries!
The other big challenge is the culture. Czech Republic left their oppressive communistic days in 1993, so only 17 years had passed before I first started to study there in 2010.
I don’t want to be mean here but the truth must be said: there are still remnants of authoritarianism left behind from those days.
The way things are organised, plus the way things are decided in the university, all sound pretty authoritarian for someone who comes from a super liberal country like Portugal. Most of us felt, very early on, that we couldn’t complain too much. Otherwise professors would feel challenged in their views and ways of doing things.
The way things are dealt with at Charles are way too authoritarian for my taste though. For example, not all rules pertaining to studying are documented on paper, but the Dean must always “decide” on top of whatever rules already exist. Often the Dean’s decision has more value than what is written.
The organisation implies that everything is under the decision of a single person, who holds total power and cannot be challenged. When someone complains, or better said, asks why a given exam has to be so big and not divided into two sections (like it is in other countries), the most common answer is; “if it worked for me, it will work for you”.
Even friendly suggestions and constructive criticism is unwelcome as a challenge. This inevitably leads to a lack of progression and innovation. Some study materials, for example, still date back to 1993. This is something every prospective student must take into consideration when applying to Czech Republic – especially at Charles!
The best student at Charles is the one that doesn’t cause “problems”. The one that stays quiet and manages to pass exams without speaking too much.
This, of course, can be hard to accept but your desire to become a doctor needs to speak louder!
The Drawbacks of Studying Medicine Abroad: Czech Republic
Compared to med schools in other countries, Germany for example, my degree in Czech Republic lacks a lot in terms of practical skills pertaining to small procedures. During my entire stay in the hospital, I drew blood only once and placed a urinary catheter only once. We were not allowed to place peripheral IV catheters, a very common procedure that is done by doctors on a daily basis in Germany.
Another drawback is the program at Charles itself. Personally, I felt it was very old-school and borderline inappropriate for the modern doctor.
The exams are too big and not subdivided into components, as is standard in many other European countries. Anatomy means anatomy from head to toe while physiology means studying every single system in the human body in one exam – definitely not favoring long term retention!
Related: Medical School Curriculum Types
Also, some subjects, like pathology and pathophysiology are very badly organised. A lot of information overlaps, pointing to a lack of coordination between departments. There’s also huge lists of items to memorise. With some teachers (pathology for example) caring more about your memorisation skills rather than critical thinking.
Another major drawback is that there are zero research opportunities at Charles. I knocked on basically every door asking for an opportunity to research. At some point, I was willing to accept whatever they had to offer but unfortunately, every single door was closed. Even for native Czech students this is a rarity.
Research, as medical student, can be key to gaining work opportunities you might not get otherwise. Not even a final degree thesis is required at Charles though, as it is standard in other countries.
The epidemiology class? This was more about infectious diseases than about understanding how epidemiology works. The statistics class was another joke. They didn’t even bother to explain basic statistical values that help a lot when reading scientific papers.
The bottom line is this. Charles offers a medical degree fit for doctors living 30 years ago. Not now.
Would I Choose to Study Medicine in Czech Republic If I Had My Time Again? An Alternative Suggestion
Knowing what I know today, I wouldn’t have chosen Charles as a place to study medicine. In all honesty? It wouldn’t be anywhere near the top of potential choices. Such is the fact there are more problems than advantages studying there.
The programme is outdated, very little effort is placed into teaching and the cultural aspects are very difficult to deal with on a daily basis. On top of that, it’s very expensive to study at Charles, especially in Prague.
If I could go back in time and choose again, knowing what I know now, I would focus completely on doing the IMAT in Italy and try to get admitted in their public universities. The tuition fees are much cheaper, there is less authoritarianism and Italy has much higher medical education and healthcare standards than any country in eastern Europe.
On top of that I would get to live in a beautiful country, with great food and cultural offerings. If Italy proved difficult to get in after doing the IMAT, I would place Poland, particularly Poznan and Lodz as my second choice. Poznan is known for innovation in medical education. Another pro for Poznan and Lodz, is that they offer 4 year medical degrees similar to the ones in the US – a reason why many Americans go there to study and then head back to the US after.
Poland, as a country, is more progressive too – something that can be seen in their huge economic growth over the last decades.
If not Poznan or Lodz, I would still consider other Polish med schools before starting to think about the Czech Republic.
Advice for Future Students of Charles University
There are a lot of things that prospective students need to know about Charles University. Both things they don’t tell you or things you end up finding out when you’re already well into your degree.
Firstly, as I already mentioned, the degree is outdated and the way exams work can sometimes be unfair towards people who study a lot and try their best. To start with, all your exams have an oral component that dictates if you pass or not as well as determines your grade. There are also exams with a written multiple choice test and a practical component but these parts generally count for zero on your final exam.
To study for any exam, you get a syllabus beforehand, with a list of topics that can come up during the oral examination. This list of topics can be as long as 200 topics in certain exams!
At the beginning of the exam, you have to pick two, three or sometimes four topics from those 200 out of a “lucky bag”. This is where the unfairness starts.
Out of 200 topics, if you get a four-topic oral exam, you are technically only evaluated on 2% of the entire information you study. 2% is too small a sample size to test your general knowledge fairly.
So say you studied 200 topics and you get one you’re really not comfortable with (trust me, all of us have those topics). As a result? You risk failing the exam and messing up your entire examination period. One exam is enough to ruin your entire year because if you don’t pass everything at your first attempt, you will have to change your study schedule to fit around the next available exam dates.
With more than one exam left to be done after the examination period, it can sometimes happen that dates coincide in the same week (or fall really close to one another) given there’s no coordination between the different departments. This then gets you thinking; “should I study for the exam I have left or for the next ones?” If you ever have to ask yourself this question at Charles, you’re already screwed and on the road to failing the year. Carrying over a failed exam (to a new academic year) places you on a “study plan”. This could involve you having to pay the total amount of the tuition fee while having to repeat the one subject you left behind. This is the way Charles makes money.
Another thing is if you don’t pass an exam for the second consecutive year. Here you’re basically kicked out of the University. So when you hear that Charles has a big “drop out rate”, students aren’t really dropping out but rather being expelled for not meeting requirements. This is also why there is constant pressure to pass exams on time at Charles and why it can be such a stressful university to study at.
Future people studying here should be aware; they won’t make it easy for you to achieve your dreams of becoming a doctor. They are a business – a very good one – and they are there to make money.
They do this not only from those who pass all the exams and graduate, but mainly from those who fail and have to repeat study years. The latter is where they make the biggest profit because you’re paying full tuition fees and not occupying a seat in the class or a place in the hospital.
Current Plans Now Graduated: Did Studying Medicine in Czech Republic Prepare Me For Life as a Doctor?
My plan now is to do my residency training in Germany. I’m currently in the final steps of learning the language to a B2 level so that I can start applying to residency programs there. The current state of healthcare in Portugal is far from good, or even acceptable, so that leads to me to consider moving abroad again to search for better opportunities.
In terms of feeling well prepared, I can’t say my experiences at Charles has too much to do with it. Most of what I’ve learned regarding medicine? I’ve done at home, studying at my desk.
Nowadays a medical student doesn’t need to depend on their teachers. We have amazing online resources like Medscape or UpToDate that bring excellent point of care knowledge to our fingertips.
Studying medicine in today’s climate is much more about the student and whether they really want to study and excel. It’s also about how curious they are to learn.
Don’t give up if you’re not admitted into medicine in your home country. It’s not the end of the world. You have dozens of options to study medicine in Europe – and some of them are excellent options (like Italy) too.
As for me? I didn’t give up and I’m here today with a medical diploma in my hands.
What’s important is you make conscious and informed decisions about where you want to study. It’s not about which university is “better”. But more about which gives you the best conditions to become a great doctor.
So although Charles University isn’t ideal it’s still somewhere that offers a degree.