This Week in Medicine: NICE Approves Weekly Insulin Injection for Type 2 Diabetes

Hundreds of thousands of people with type 2 diabetes in England could swap daily insulin injections for a once-weekly jab, following a NICE recommendation announced on 20 August 2026. The switch could cut the number of injections each patient needs by 85%, representing a significant quality-of-life improvement for those managing this chronic condition.

This development builds on wider NHS progress in diabetes care and comes as part of the government's 10 Year Health Plan for England. Earlier this year, the MHRA and NICE launched a streamlined aligned pathway designed to bring new medicines to patients three to six months earlier by running licensing and value assessment processes simultaneously, rather than consecutively.

Why this matters for applicants

This approval demonstrates how NICE balances clinical benefit, patient convenience, and cost-effectiveness—a framework you should understand for interview ethics questions. Be ready to discuss not just what gets approved, but how decisions are made: what trade-offs exist between innovation, equity, and affordability? How do you weigh an 85% reduction in injections against NHS budget constraints?

During MMI stations, you may face scenarios where a new treatment offers marginal benefit at high cost. This week's news gives you a concrete, current example to anchor your reasoning. Practice articulating both sides: the patient perspective (reduced burden, better adherence) and the systems perspective (cost per QALY, opportunity cost for other treatments).

For personal statements and work-experience reflections, consider how advancements like this reshape the doctor-patient relationship. Improved medication regimens can transform compliance, reduce clinic visits, and shift conversations from managing side effects to optimising outcomes. If you've shadowed in endocrinology or primary care, reflect on how treatment burden affects patient engagement.

International Overdose Awareness Day falls this Sunday, 31 August. It is the world's largest annual campaign to end overdose, remember without stigma those who have died, and acknowledge the grief of families and friends left behind. This year's theme, 'Together we can,' highlights the power of community action and meaningful connections in preventing overdose deaths.

Opioid-related deaths make up the largest proportion of drug-related deaths across the UK, with an average of 40 deaths a week. In 2022, a total of 2,261 drug-poisoning deaths involved opiates—just under half of all drug-poisoning deaths registered that year. Crucially, most fatal overdoses are unintentional, and overdose does not discriminate: it can affect people using prescription medications, alcohol, or illicit substances.

The NHS and public health teams are expanding access to naloxone, a life-saving medication that temporarily reverses opioid overdose effects. In May 2024, the UK government announced regulatory changes to allow police officers, probation workers, paramedics, and outreach workers to provide take-home naloxone supplies to at-risk individuals and their families—part of the government's mission to prevent nearly 1,000 deaths by the end of 2025.

Critical analysis

This awareness day challenges us to examine the intersection of stigma, public health, and healthcare access. Why do we frame some health conditions as deserving of sympathy while others attract moral judgment? People who use illicit opioids face mortality rates 10–15 times higher than the general population, yet barriers to treatment—both structural and attitudinal—remain pervasive.

Consider the ethical and practical dimensions of harm reduction. Naloxone distribution, safe consumption spaces, and needle exchanges prioritise saving lives over enforcing abstinence. These interventions are evidence-based, cost-effective, and reduce onward harms (HIV, hepatitis C, emergency admissions)—yet they remain politically contentious. Should healthcare be conditional on 'good behaviour,' or is our duty to reduce suffering regardless of its cause?

For interview preparation, this is fertile ground. You might be asked: Should the NHS fund treatment for self-inflicted harms? or How would you respond to a colleague who refuses to treat a patient with substance use disorder? Demonstrate nuance: acknowledge the tension between personal responsibility and structural determinants of health (poverty, trauma, adverse childhood experiences). Reference the biopsychosocial model and the GMC's guidance on treating patients without discrimination.

If you've encountered addiction medicine, mental health services, or A&E in your work experience, reflect on what you observed. Did you notice stigma—explicit or implicit? How did clinicians balance non-judgmental care with safeguarding and capacity assessments? These are the observations that distinguish a thoughtful applicant from one who has merely 'done the hours.'

Informed consent is a cornerstone of medical ethics and law, yet emergency medicine routinely forces clinicians to act without it. When a patient arrives unconscious after a road traffic collision, or a child presents in anaphylactic shock, there is no time for a detailed discussion of risks, benefits, and alternatives. Doctors must intervene based on the principle of necessity: acting in the patient's best interests when consent cannot be obtained.

But where do we draw the line? What counts as an emergency? And who decides what is in the patient's 'best interests' when the patient cannot speak?

The legal framework

In UK law, treating a patient without consent is battery—unless an exception applies. The key exception is the doctrine of necessity, enshrined in common law and the Mental Capacity Act 2005. If a patient lacks capacity and treatment cannot wait, clinicians may proceed if the intervention is:

• Necessary to save life, prevent serious deterioration, or alleviate serious suffering;
• In the patient's best interests; and
• The least restrictive option available.

Best interests are determined holistically, considering the patient's known wishes, values, beliefs, and the views of those close to them. Advance decisions to refuse treatment (if valid and applicable) must be respected, even in emergencies.

The grey zones

Emergencies are rarely as clear-cut as the textbooks suggest. Consider:

• A patient with a Jehovah's Witness card arrives exsanguinating after trauma. They are unconscious. Do you transfuse? (Answer: Generally no—an advance directive takes precedence, even if life-saving treatment is refused. But if there is doubt about the card's validity or applicability, act to preserve life and seek urgent legal advice.)
• A 16-year-old is brought in after an overdose, unconscious and requiring intubation. Their parent arrives and refuses consent for mechanical ventilation, citing religious beliefs. Do you proceed? (Answer: Yes. Parental refusal does not override the clinical duty to act in the child's best interests when life is at immediate risk.)
• An elderly patient with advanced dementia and a DNACPR form is choking on food in a care home. Paramedics are unsure whether the DNACPR applies to choking. What do they do? (Answer: DNACPR means do not attempt cardiopulmonary resuscitation—it does not mean 'do not treat.' The Heimlich manoeuvre is appropriate. Confusion here is common and costly.)

Discussion points for interviews

• Balancing autonomy and beneficence: How do we respect patient autonomy when the patient cannot communicate? Should we always assume the patient would want life-saving treatment, or does that impose our values on them?
• Shared decision-making under time pressure: In a true emergency, there is no time to share decisions. But many so-called emergencies involve some degree of choice (e.g., which antibiotic, which surgical approach). How do we preserve patient involvement even in acute settings?
• Capacity vs. competence: Just because a patient disagrees with medical advice does not mean they lack capacity. But in the heat of an emergency, how do we rapidly assess whether a refusal is informed and capacitous, or driven by confusion, fear, or delirium?

Practice articulating both sides: the clinician who says 'we had no choice, we had to act' and the ethicist who asks 'are we too quick to bypass consent because it's easier?'

Useful frameworks

• The four pillars of medical ethics: autonomy, beneficence, non-maleficence, justice.
• GMC guidance on consent (2020): Emphasises the duty to presume capacity unless proven otherwise, and to involve patients in decisions wherever possible.
• Mental Capacity Act 2005: The statutory framework for best-interests decision-making in England and Wales.

Most applicants treat silence in an interview as failure—a gap to be filled, a void that signals you've run out of things to say. But strategic silence is one of the most underused tools in interview technique, and learning when not to speak can be as important as knowing what to say.

Why silence works

Interviewers are trained to wait. After you finish an answer, they may pause for two, three, even five seconds before moving on. This is deliberate: they want to see whether you'll sit comfortably with the pause, or whether you'll panic and fill it with waffle. Confident candidates let the silence sit. Nervous candidates rush to add something—often undermining the answer they've just given.

Silence also creates space for reflection. If you're asked a challenging ethical question, taking three seconds to think is not a weakness—it's a sign of intellectual honesty. It shows you're engaging with complexity rather than reaching for a rehearsed script.

When to use silence

• After answering a question fully: If you've given a complete, structured answer and the interviewer pauses, resist the urge to keep talking. Let them process what you've said. If they want more, they'll ask a follow-up.
• Before answering a difficult question: Particularly in MMI stations, you may face a scenario with no obvious 'right' answer. Pause. Acknowledge the tension ('This is a difficult situation because…'). Then structure your response. Interviewers value thoughtfulness over speed.
• When you're unsure: If you don't understand a question, or you're not sure what the interviewer is asking for, say so. 'Could you clarify what you mean by X?' or 'I want to make sure I've understood the question—are you asking about Y or Z?' is far better than guessing.

*When not to use silence*

• At the start of an answer: A long pause before you begin can read as unpreparedness. If you need a moment, signal it: 'That's a great question—let me think for a second.' Then pause briefly and start.
• In group tasks or discussions: If your MMI includes a group station, silence can make you invisible. Contribute early and constructively, even if it's just to build on someone else's point.
• When the interviewer is clearly waiting for you to continue: If they've asked 'Can you tell me more about that?' and you've only given one sentence, they're prompting you. Silence here looks evasive.

How to get comfortable with silence

Practice with a timer. Answer a mock question, then sit in silence for five seconds. It will feel excruciating at first. Do it ten times and it becomes normal. Record yourself: you'll notice that pauses feel longer to you than they do to a listener.

In your next interview prep session, focus on pacing. Aim for answers that are complete but not exhaustive. If the interviewer wants elaboration, they'll ask. Trust the process.

A final note

Medical consultations are full of silence. When a patient tells you they've been diagnosed with cancer, the worst thing you can do is immediately respond with reassurance or solutions. Silence gives space for emotion, for processing, for the patient to lead. Interviewers are testing whether you can tolerate uncertainty and discomfort without filling every gap. Show them you can.

If you're submitting on or near the 15 October deadline, your personal statement is likely in its final draft. These three targeted edits can sharpen your narrative without requiring a full rewrite.

1. Cut one 'I learned' sentence from every paragraph

Most first drafts over-explain. 'This taught me that…' or 'I learned the importance of…' is usually redundant—your reader can infer the learning from the experience itself. Compare:

• Weak: 'Volunteering at the dementia café taught me the importance of patience and empathy.'
• Stronger: 'At the dementia café, I spent twenty minutes helping a woman find the right word for 'daughter.' When she found it, her face changed. That moment—small, specific, hers—reminded me why clarity matters.'

The second version shows patience and empathy. The first version tells the reader you possess these qualities. Trust your reader to do the interpretive work.

2. Replace one generic claim with a precise detail

Scan your statement for sentences that could appear in anyone's application. 'Medicine combines science and patient care' or 'I am fascinated by the complexity of the human body' are true but empty. Find one such sentence and replace it with something only you could write.

For example:

• Generic: 'I enjoy the problem-solving aspect of medicine.'
• Specific: 'On my GP placement, I watched the doctor piece together a diagnosis of coeliac disease from a teenager's fatigue, a family history of autoimmune conditions, and a set of blood results that didn't quite fit. It was detective work, but the stakes were someone's health.'

Specificity signals genuine engagement. It also makes your statement more memorable.

3. End with a forward-looking sentence, not a summary

Many statements close with a recap: 'In conclusion, my work experience, academic achievements, and personal qualities have prepared me for a career in medicine.' This adds nothing. Instead, gesture toward the future:

• 'I know the next six years will be challenging, but I am ready to learn, to fail, and to grow—not into the doctor I imagine now, but into the one my patients will need.'

This frames your application as the beginning of a journey, not the end of a checklist. It also signals maturity and self-awareness.

One more thing

Read your statement aloud. If a sentence makes you cringe, rewrite it. If you stumble over phrasing, your reader will too. The best personal statements sound like you—not like an applicant trying to impress.

Need a second pair of eyes? Our Personal Statement Review Service offers line-by-line feedback from tutors who've read thousands of successful statements.

King's College London (KCL) is one of the UK's most competitive and prestigious medical schools, located in the heart of London with clinical placements across some of the country's busiest and most renowned teaching hospitals—Guy's, King's College, and St Thomas'. For 2027 entry, KCL expects A*AA at A-Level (including Chemistry and Biology), a competitive UCAT score, and success at a rigorous Multiple Mini Interview (MMI).

Entry requirements

KCL's standard MBBS (A100) requires:

• A-Levels: A*AA, with grade A in both Chemistry and Biology. General Studies, Critical Thinking, Thinking Skills, and Global Perspectives are not accepted.
• GCSEs: Grade 6/B in both English Language and Mathematics.
• UCAT: All applicants must sit the UCAT. There is no published threshold, but the typical home applicant cut-off is around 2130/2700 (non-contextual), with the mean offer holder scoring approximately 2250. Contextual applicants (those from low-participation areas, care-experienced backgrounds, or participants in KCL's K+ or Realising Opportunities programmes) may be considered with scores around 1900+.
• SJT: The Situational Judgement Test is factored into shortlisting, with Band 1 generally required for competitive applicants.

KCL uses a points-based ranking system (out of 150, with up to 20 additional contextual points). UCAT contributes 100 points, GCSE performance 40 points, and SJT 10 points. Interview thresholds typically sit at 135–140 for standard applicants.

KCL also offers an Extended Medical Degree Programme (EMDP, A101) for students from widening participation backgrounds, requiring ABB at A-Level and meeting specific eligibility criteria (non-selective state school education since age 11, or participation in Realising Opportunities). The EMDP provides a six-year programme with a foundation year offering additional academic and pastoral support.

Interview format

KCL uses a Multiple Mini Interview (MMI) format, with stations typically covering:

• Ethical scenarios (resource allocation, consent, confidentiality)
• Communication tasks (explaining a concept to a layperson, role-play with an actor)
• Situational judgement (responding to a colleague's mistake, handling conflict)
• Motivation and reflection (discussing work experience, understanding NHS challenges)

Interviews take place between December and February, with final decisions released from March onwards.

Curriculum and clinical experience

KCL's MBBS is an integrated five-year programme combining medical science and clinical teaching from Year 1. Early patient contact begins in the first term, with students visiting GP practices and community settings before progressing to hospital-based placements. The curriculum emphasises problem-based learning (PBL), interprofessional education, and global health.

Clinical placements span central London (Guy's, St Thomas', King's College Hospital) and district general hospitals across South East England, plus over 350 general practices. This breadth exposes students to diverse patient populations and pathologies—urban, suburban, and rural—preparing them for practice anywhere in the UK.

KCL is also a research-intensive institution, offering intercalated BSc options and opportunities to engage with cutting-edge research in life sciences, neuroscience, and public health.

Location and student life

KCL's medical campuses are based at Guy's (London Bridge) and St Thomas' (Westminster), both in Zone 1. Living in London is expensive—expect accommodation costs 30–50% above the national average—but the city offers unparalleled clinical, cultural, and professional opportunities. Many students live in Southwark, Lambeth, or further south in Zone 2–3 to balance cost and commute time.

KCL has a vibrant student body (around 350 medical students per year) and a strong network of student societies, from King's Surgical Society to global health and widening participation initiatives.

What makes KCL distinctive?

• Central London location: Proximity to major teaching hospitals and research institutions.
• Clinical breadth: Placements across tertiary centres and community settings from Year 1.
• Research strength: Global leaders in life sciences and medical research as teaching faculty.
• Widening participation: Robust contextual admissions via EMDP and K+ pathways.

Should you apply to KCL?

KCL suits applicants who thrive in fast-paced, urban environments and want exposure to high-acuity medicine and diverse patient populations. The UCAT threshold is steep, and the points system heavily weights both UCAT and GCSE performance—if you have eight or more grade 8s at GCSE and a UCAT above 2200, KCL is within reach. If your profile is strong but not exceptional, consider whether you meet contextual criteria, which can significantly lower the bar.

For more strategic guidance on whether KCL fits your profile, explore NextGenMedPrep's school selection tools and TrueScore UCAT predictions.

NextGenMedPrep TrueScore for King's College London: ~2150/2700 — the UCAT score we predict you'll need to reach interview (2027 entry). See all predictions and check our Medical School Rankings.