It is by no means necessary for good results. All that's necessary for good results is
Drive
Passion
Valuing Education
Hard Work
Belief
Determination
and a bit of natural ability and luck :)
whilst tutoring can provide for these, it is technically possible for any student to get this...
I would just like to add that some students go to tutoring not because they struggle but also because
1) its a means of reinforcement if they lack confidence. They may not be struggling, but they feel as if they need to cement the ideas better
2) eager students that wish to accelerate but...
Yep, personally I wouldn't consider prestige, but if other people do then it doesn't matter if they're competent doctors who can adequetely care for a patient at the end of the day.
Yep, you also have to consider that some people find it difficult to travel to certain unis and thats why they reject it, its not necessarily that they are doing medicine for the prestige