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In the summer of 2018 Alex George had a big decision to make – carry on as a doctor in A&E or enter the Love Island villa.

Being a reality TV star had never been part of the plan. When he was scouted out on Instagram and asked to take part he told family and friends it was a joke.

It has also taken its toll. From "hardly eating" ahead of making his TV debut, to counselling afterwards, things have changed beyond recognition for a relatively unknown medic from Carmarthenshire.

Now, 18 months later, it's only recently he has found his feet – and he's contemplating an exciting career change ahead to swap the wards of A&E for the GP surgery.

(Image: ITV)

Alex, who grew up in Nantgaredig, said: "I was on a dating app or something and someone spotted me from that and found me on Instagram and asked me. I thought it was a prank at first.

"I was asked to have an interview there and I said no for ages. There is a joke still that I was the one person in Love Island who actually, genuinely, did not want to go on the show.

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"My consultants at A&E just said: 'Why don’t you go for it? It’s so different and what’s the harm in a doctor doing it?'

"I should have a relationship just like everyone else does. People in the waiting room today, they all have relationships, they are all having sex and whatever so why shouldn’t you – not that I was going to do that on TV."

Last month Alex hit the headlines after sharing a picture of himself both before and after the eight-week long reality series. While the doctor may have been a picture of health ready to make his entrance the story on the other side of the camera couldn't be more different.

Alex, 29, said: "That [first] picture was actually about four weeks before I went into the villa. I felt I was going to be on TV and needed to be in shape. I would say I was aesthetically getting more and more in shape and my body was getting leaner and stronger but it wasn’t necessarily healthy.

"I look back and I was removing myself from social situations because I couldn’t eat at all and I was on a very strict diet.

"The food I was eating I would say wasn’t particularly nutritious, it was just with the aim of putting on a bit of muscle and cutting fat down as much as possible.

"I was tired, my mood wasn’t good, I was over-training, whereas now I’m not in the same shape I was then but I am much more balanced, I’m quite fit. I cycled 100km on a bike each day in India, I eat a balanced diet, I don’t avoid all fat foods, I enjoy my food."

In the villa things didn't exactly go smoothly for Dr Alex as far as love was concerned. After a number of failed romances he was sent packing from the villa alone with a hefty sunburn after weeks of being filmed 24 hours a day.

If that wasn't bizarre enough it turns out re-entering the real world to face those that have been scrutinising you for all that time is even more overwhelming – something that prompted the doctor to ask for counselling services offered by the reality programme to all its contestants.

(Image: Jessie Whealey)

"I look back now and really I was in an absolute mental whirlwind, good and bad," Alex admitted.

"I was not in the headspace of really knowing what was going on. I can’t ever describe that feeling of turning my phone on.

"It was almost like a kind of weight was added onto your shoulders – you've got a million followers on Instagram and you feel this sudden weight because all these people knew who I am, all these people are commenting on my pictures."

While Alex is quick to stress it has not all been bad, and that his life is now full of opportunities he never would have had otherwise, he added: "I just asked can I have some therapy. Because when you look at mental health as a whole the important things are when you have big changes in your life. Whether they are good or bad changes it can still shake you up.

"Being scrutinised 24 hours a day by people saying all these horrible things about you, and all these amazing things as well, can really shake you up so I wanted to talk through all that stuff and they were good with me.

"I’m not still having therapy now because I’m much more settled and I know what I’m doing and what I want to do, which is a nice feeling, but I’d recommend it to anyone.

"If you feel you need to talk to anyone or you’re going through life changes have therapy. Going to talk to someone who doesn’t know you and can give you a bit of advice independently is actually a really powerful thing."

Today Alex can be spotted back in his blue scrubs at Lewisham Hospital in London whenever he gets the chance.

Thanks to a zero-hour NHS contract that fits around his filming commitments, it means he can switch between seeing patients one hour to appearing on Good Morning Britain or filming his podcast The Waiting Room the next.

He said: "I try to do a couple of shifts a week. Some weeks I’m crazy and I’m away and filming stuff so I don’t get a chance but when I do I try and fit some shifts in but I’m not trying to work full-time.

"One of the hardest things and biggest dilemmas I’ve had since doing the show, and I still have it a bit, is that it’s difficult to really know what’s the right and important thing to do.

"Outside A&E I can probably have a bigger impact than I can truly have than inside the department because I can speak to a lot of people but then I also enjoy my job and I want to keep doing that to an extent as well so it is a bit difficult trying to find that right balance."

Acknowledging his new-found fame after the villa, he added: "In A&E it can be challenging because, without being selfish, my focus there is doing my job and doing it well. So when I’m there I always say 'Hi, how are you?' when people recognise me but I try to avoid behaving any differently and being treated any differently.

"Generally I get treated like anyone else but that’s because I’ve known [the team] from well before it all went ridiculous and it all changed and that stuff.

"But in all honestly when someone focuses on doing their job everything else kind of falls by the wayside. Ultimately Love Island, TV, all this stuff, it’s just a show. It’s not that important when you compare it to life and death and that’s what really matters."

(Image: Jessie Whealey)

As well as the pressure of saving lives, for Alex there is also the responsibilities that come as an social media "influencer" in a world where, in his words, body shaming among men is worse than ever.

Last week the Mail on Sunday raised concerns after revealing how NHS staff are making thousands of pounds from promoting red meat to cars and snacks among other products.

With 1.3m followers on Instagram alone, it's a pressure Alex is acutely aware of.

Alex said: "The amount of products that I turn down – I can confidently say I would never have left Love Island and done a club PA (public appearnace) because I don’t want to encourage that kind of thing and to seem to be encouraging drinking in that way as a doctor. I didn’t want to do it as a principle.

"I thought: ‘What can I do with this platform that is meaningful?’ Whether it’s Instagram, my podcast the Waiting Room, or YouTube I have tried to focus on health issues that affect millennials.

"My mission for myself is to be one of the voices of trust in healthcare for millennials and to try and support millennials in their health and not just about traditional medicine but about wellness, about physical fitness, about mental wellbeing, and all the different aspects that play a part into that.

(Image: Tim P. Whitby/Getty Images)

"It’s not just the stuff people would think about initially. [In the Waiting Room] we’ve covered financial health. The next episode is coming out with Chris Robshaw.

"He’s had a very interesting journey because he had the Rugby World Cup in 2015 and made a big decision of kicking to touch rather than kicking for the post so he had a huge amount of scrutiny, and he had to have a lot of mental resilience, so the episode is about sport and what we can learn about mental resilience and how we can apply that in life."

He adds: "I am very conscious and aware of my responsibilities in my role and I make sure I only work with brands who I actually believe in and believe in either what their project or mission is – 90% of the content I produce, 90% of the charity work I do, I don’t get anything for.

"I give away a huge amount of my time to support things that I don’t get any financial gain out of it. I do it because I genuinely want to help and do something good. I also have to make a living – I think people are shocked by that sometimes but I am very, very careful and conscious that I work around products that I genuinely believe in."

So what is next for the Love Island doctor?

As a Swansea City fan he can be spotted in the Liberty Stadium stands when he can while he'll also head down the M4 to visit his family in Glangwili.

As well as continuing his podcast and his YouTube channel it's his aim to swap hospital for the GP surgery to fit his new lifestyle.

Alex said: "I think probably for me moving into training and general practice in less than full-time training is probably the route I’m moving to to be a GP because it’ll allow that flexibility.

"It’s exciting, it’s good. The biggest challenge I’ve had is to change the shape of what people see me as from the show and for people to trust that what I’ve got to say about health I’m saying for the right reasons and that’s something I’ve been working hard on."

You can catch former England captain Chris Robshaw with Dr Alex on the Waiting Room podcast now.