Anes Harid

Introduction: Why Revisit Intercalation Now?

Taking a year out of medical studies to complete a BSc, MSc or related degree has long been valued for deeper learning, research experience and personal growth (1). However, the removal of “extra points” for intercalated degrees in allocation processes, including the foundation programme and later specialty training, has changed the incentive structure (2).

Uptake has since fallen, with a 2025 nationwide study reporting a marked drop in students choosing to intercalate (3). This makes it important to reconsider intercalation not as a shortcut or points-chasing exercise, but as a potential opportunity. As someone who intercalated externally, I want to share a balanced view, especially for students considering competitive run-through specialties such as ophthalmology.

Why I decided to Intercalate Externally

I completed an external MSc in Clinical Ophthalmology & Vision Science, despite knowing that from 2023 intercalated degrees no longer contributed extra points for specialty training.

I chose it as a form of self-investment. It gave me protected time to explore ophthalmology early, develop research skills and build confidence in a specialty I was passionate about at the time. During that year, I graduated with distinction, delivered national presentations and ranked in the top 10% in the Duke Elder exam. I do not think those achievements would have been possible without the focused time intercalation allowed.

What My Intercalated Year Gave Me: Beyond “Points”

First, it gave me research confidence. I had time to read widely, design projects, write up findings, submit work and present data. These skills in critical appraisal, project planning and scientific communication, are valuable for any clinician, and especially in academic specialties such as ophthalmology.

Second, it provided early specialty exposure. A relevant MSc helped me explore ophthalmology in depth, meet mentors and peers, and confirm if that the specialty was genuinely right for me or not before later career decisions.

Third, it helped with portfolio differentiation. Although the degree itself no longer scores extra points, outputs such as presentations, publications, prizes and exam performance still demonstrate initiative, curiosity and commitment.

Finally, it supported personal growth. Studying at another university broadened my network, exposed me to different teaching and research styles, and gave me space to reflect outside the usual medical school environment.

What to Seriously Consider Before Choosing to Intercalate: The Drawbacks

Intercalation is not for everyone. The main drawback is financial: an extra year can mean tuition fees, living costs and a delayed junior doctor salary. A 2025 survey found that financial pressure was one of the main reasons students chose not to intercalate (3).

It also delays graduation, which may be difficult for students eager to start work or those with family, location or financial commitments. The return on investment is also uncertain. The value usually comes from what you do during the year including projects, presentations, audits or publications, not simply from having another degree. Without clear goals, intercalation can become costly and less worthwhile.

What Intercalation Options Remain Now

Despite scoring changes, many UK medical schools still offer intercalated degrees, including BSc, MSc, MPH and MRes options across science, public health, humanities and specialty-related subjects.

• The University of Manchester offers intercalation for MBChB and Graduate-Entry Medicine students, including undergraduate courses and postgraduate options such as MSc Investigative Ophthalmology & Vision Science (4).

• UCL offers an intercalated BSc programme, with some places available to external students from other UK medical schools (5).

Intercalate.co.uk is also a useful directory for comparing courses by subject, location and institution (6). Students therefore still have flexibility to choose courses aligned with interests such as ophthalmology, surgery, public health, global health or humanities.

Who Might Benefit Most From Intercalation and Who Should Think Carefully

Intercalation may suit students aiming for competitive or academic specialties, those with a genuine interest in research or a particular field, and those wanting a change of environment during medical school.

It may be less suitable for students who want to graduate on time, start earning sooner, face significant financial pressure or have limited interest in research output. For some, electives, placements, audits or extracurricular projects may achieve similar goals without taking an extra year.

My Recommendations for Students Thinking of Intercalating (Especially for Ophthalmology)

• Clarify your goals early. Decide whether you want research experience, deeper subject knowledge, portfolio outputs, personal growth or a break from the usual curriculum. Then choose a course that genuinely matches those aims.
• Explore options carefully using university websites and Intercalate.co.uk. If you are interested in ophthalmology, consider a vision science or ophthalmology-related course. If you are unsure, a broader subject such as neuroscience, biomedical sciences or global health may be more appropriate.
• Plan for meaningful outputs. Aim for a project, audit, presentation or publication, as these are often more valuable than the degree alone. Also plan financially by considering tuition, living costs, funding, part-time work and the delayed year of salary.
• Most importantly, treat the year seriously. Intercalation is most valuable when approached with discipline, purpose and realistic expectations.

Why I Believe Intercalation Still Matters and Why I Wrote this Article

Intercalation uptake has clearly declined since formal point incentives were removed (3). However, this may reflect a shift away from collecting points and toward seeking genuine value.

For competitive specialties such as ophthalmology, intercalation can still be powerful if approached with intent. Research experience, academic output, networking and early specialty exposure remain important, even if the degree itself no longer brings formal points.

My own experience showed that intercalation can be more than an extra qualification. It gave me time to grow academically, explore ophthalmology properly and build skills that will continue to help me throughout training.

Final Thoughts

Intercalation is not essential, and it is not right for everyone. It is a tool, and its value depends on how it is used. For some students, the research opportunities, specialty exposure and personal growth will justify the extra year. For others, the financial cost and delayed graduation may outweigh the benefits.

If you choose to intercalate, choose carefully, aim for real output and approach the year as more than just “one extra degree”. If you choose not to, that is equally valid. What matters is making an honest, informed decision that fits your goals, values and circumstances.

References

1. British Medical Association (2026): “Intercalated degrees”. Available at: https://www.bma.org.uk/advice-and-support/studying-medicine/becoming-a-doctor/intercalated-degrees.
2. The BMJ (2024) ‘A catalyst for the decline in intercalating medical students’, BMJ, 23 February. Available at: https://www.bmj.com/content/384/bmj.q485/rr.
3. Lim, J.J., Roberts, C., Graham, O., Coady, S., Topliss, J. and Staton, C (2025) ‘Understanding medical students’ intercalation decisions to preserve the clinical academic pipeline: a mixed-method survey’, BMC Medical Education, 25, article 1316. Available at: https://pubmed.ncbi.nlm.nih.gov/41039346/
4. University of Manchester (n.d.) “Intercalation”. Available at: https://www.bmh.manchester.ac.uk/study/medicine/your-studies/intercalation/
5. University College London (n.d.) Study Optometry, Ophthalmics & Orthoptics at UCL. Available at: https://www.ucl.ac.uk/brain-sciences/ioo/studying-ophthalmology.
6. Intercalate (n.d.) Intercalate.co.uk. Available at: https://www.intercalate.co.uk/.