So you want to be a doctor? Here are the routes you could take

If the news that stethoscopes are on their way out hasn't put you off being a doctor – apparently they use hand-held devices to listen to chests and hearts these days, which may not have quite the same cachet – then what are the routes into medical school, and what career options do you have once qualified?

How to get in

If you're applying straight from sixth form, it's straightforward: do chemistry at A-level. "A lot of medical schools are looking for biology too," says Dr Karen Grant, deputy director of medical studies at Lancaster University.

You'll typically be asked for three As, but Keele, for example, allows for some flexibility: if you drop to a B in one subject, you may still get in if you get an A* in another. You'll need a spread of excellent marks at GCSE too, Grant explains.

Nobody wants a science nerd for a doctor, so breadth of ability, interests and a decent dollop of empathy are now required, as well as top marks in your A-levels.

Each medical school, however, has slightly different requirements, "so you can't assume that what applies for one applies for another," she warns.

Admissions officers at some institutions will make offers taking into account what's known as "contextual data". This might include looking at whether you come from a family where nobody has yet been to university or if you live in a socio-economically deprived area, but the criteria are not in the public domain, so there's no way of knowing what "context" really means.

If you find yourself halfway through sixth form before deciding you want to go into medicine, and find you aren't taking the right A-levels, don't despair.

"Most places will take you if you take a third year to take the right subjects," says Grant. "Some universities have a pre-medical studies course for exactly that situation." That costs an extra £9K of course, so it's likely to be cheaper to do those extra A-levels while living at home.

Doing medicine as a postgraduate is possible, but you'll need a high 2:1: this is, however, a good route for someone who studied the right spread of A-levels but didn't quite get the grades they needed for entry to medical school first time around.

Applying to a private medical school is a possible alternative route worth investigating.

Career options

So, having got past all these hurdles, assume you're in. Where might a medical degree take you? There are 70 odd clinical specialisms, but in terms of career progression there's thankfully no rush to decide in your first year – or even your fifth – which you want to focus on.

"Doctors don't specialise until their second year of foundation training – two years after graduation – so we advise prospective students to keep an open mind about careers and explore all options as they train," says Sara Doherty, director of student services at St George's, University of London.

"We find that if students come with a clear idea, they often change their minds as they experience new areas of medicine."

Medical students can however start to develop their personal interest in a subject specialism in the final two years before graduation through an assessed project and a practical placement called an "elective".

If you have ambitions to work overseas, particularly if you're interested in medicine in developing countries, this is the time to start showing your commitment says Ahmed Gomaa, medical director for the Orbis Flying Eye hospital, an international sight-saving charity that works to prevent blindness in developing countries.

He advises students to start early if they want to work overseas. "Get to know more people and have good networks you can rely on. Use your time efficiently – read a lot, travel, develop your understanding of different cultures and people."

The requirement to be excellent at your specialism is a given when working in a developing country, but personal attributes are hugely important too if you're to flourish in this type of work.

"Be a change agent, self-motivated and flexible, and believe in a better life for all," says Gomaa. That commitment is vital, he says. Because while the work is immensely fulfilling, "it is not a straightforward hospital job. The rule is, expect the unexpected and make it work."

How far can you take it? You could do anything from a short stint as part of your career in your home nation to dedicating your life to working in developing countries, says Gomaa. "Some pioneers in this field have managed to change health care systems at national and international levels; others started their own projects and charities.

"There's no limit to what you can achieve in this job. Whatever you do you will be rewarded for it: it can be as simple as a smile on a child's face when you enable them to see for the first time, or an international award for your hard work."

A UK medical degree is recognised in most countries across the world, so you can apply for jobs abroad with ease. If you do stay in the UK, however, as most doctors who qualify here will, it's important to be realistic; there will always be more need for GPs than for heart surgeons.

If you've discovered that you don't want to be treating patients every day, it doesn't mean you've chosen the wrong career: there are other avenues open to even very recently qualified doctors. Choosing to specialise in public health policy is one of them: medically qualified staff are needed to inform decisions about the nation's health and funding priorities. Medical research is another.

According to Dr Graham Wylie, chief executive officer at the Medical Research Network, opportunities in this sector range "from a dedicated research career through to a medical safety specialist, a regulatory physician working for the government reviewing pharmaceutical company submissions at the technical end, right across to a full commercial business career running and creating companies, dealing with financial experts and venture capitalists."

While a few years working at the sharp end is common for a doctor progressing into medical research, it's not essential, Wylie says. "The exposure to cutting edge medical developments is spectacularly interesting and objective-based science," he enthuses. "Driving towards a specific goal, whether commercially orientated or not, is a very rewarding type of science to undertake."

A final word of advice: "Don't be worried by the commercial nature of the industry – and have an aptitude for science. Experimentation is what we do, so you need to be interested in it and how to do it well."

For doctors, then, it seems the possibilities for career development are wider than is commonly thought, and depending on your appetite for challenge, exciting and varied too. So – anyone for medical school?