30 January 2007

Why Students Fail in Medical School.

One of the biggest myths in the medical school process is that once you get into medical school, it is relatively easy to STAY in medical school. Each year, approximately 5% of those who enter fail one or more courses or fail out of medical school entirely. Why does this happen after being subjected to a selection process that is very stringent?

The biggest reason for students failing a course or failing out of medical school is an inability to put in the study time that a very competitive medical school curriculum demands. A sizable proportion of freshman medical students may have been able to get through their undergraduate studies by the "last minute knowledge cram" method, only to find that they are in deep trouble fast.

Most of these students will adjust their time management skills and do well enough to pass their coursework but some are not able to make the transition from undergraduate to medical school. These folks find themselves behind their class very quickly and fail to catch up enough to pass. Courses like Gross Anatomy and Biochemistry quickly knock them out of the freshman class.

Another small proportion of students will have too many personal demands to keep up with their studies. They may be parents or spouses or they may have personal illness that actually prevent them from the mastery of their work. In these cases, a wise Dean of Students will offer a Leave of Absence before the student finds himself/herself in academic difficulty. It pays to alert your Dean of Students at the first sign of personal trouble. Often the Dean can alleviate the problem and get the student back on track. Again, sometimes the problem is so pervasive, that only a Leave of Absence will allow the student to take care of personal matters and return to academics without penalty.

Few medical students are intellectually unable to master the curriculum. While the amount of information to be mastered is massive, the difficulty of the material is fairly average. This means that the key to keeping yourself academically sound is disciplined study habits that enable you to digest this large body of information in a short period of time. Most students study daily and keep a rigorous study schedule even on weekends.

Many students will become caught in the "no one else is struggling so I must be stupid" trap. Every medical student from time to time will struggle with something. Most students figure out what they need, ask for help and get the task accomplished. Some students will become depressed and procrastinate. Procrastination is the enemy of good scholarship and leads to more depression. Again, chatting with a few classmates or the Dean of Students can often put your problems into perspective and give you new ides that get you on your way.

Here are a couple of examples that illustrate my points above:

Janet A. was newly married and entered medical school. Her husband worked as a high school teacher and had a eight-year-old daughter by his previous marrige. Two months into medical school, Janet discovered that she was pregnant. Her pregnancy zapped her energy level and made the demands of medical school more difficult. In addition, she was having difficulty getting along with her new step-daughter who was unhappy that they had moved from another state. She got behind in her studies, especially Gross Anatomy, and struggled with her other courses. She ended up failing both her Gross Anatomy lab and lecture exams and barely passed her Biochemistry exam. On top of her worsening academics, she miscarried and was absent from class for one week.

Solution: The Dean of Students recommended a medical Leave of Absence for Janet. She started with the next year's class and did very well. She was able to take the time for family counseling and was able to devote full time to her studies.

Chris P had eagerly awaited his medical school acceptance. He had been happy and enthusiastic during orientation week attending all of the social events and developed a lively group of friends and study mates. When classes started, he kept up but partied very hard on the weekends spending Saturday night in the clubs and Sundays recovering from his Saturday night partying. Few people were able to keep up with him. By the second block of exams, Chris found himself just barely passing his coursework yet he continued his active social life. He always said that he "needed to let off steam" in order to concentrate on his studies.

By the end of the first year, Chris found that he needed to take two courses in summer school in order to be promoted with his class. He was able to pass one summer course but failed the other summer course and was dismissed from his class.

Solution: Chris applied for readmission at the end of the summer and was denied. He applied for re-admission after sitting out for a year and was re-admitted. When he returned to school, his discipline and study skills were outstanding. He was able to finish medical school and enter residency.

James P had entered medical school witht he idea of becoming a child psychiatrist. He had extensive experience teaching inner city children (had been a high school teacher) and was the author of several books on innovative teaching methods for children at risk. He embraced his studies and did well on his first block of exams. About halfway through the material for the second block of exams, James decided that he was not interested in medicine at all. He went to the Dean of Students and withdrew from medical school. He later completed his Ph.D in clinical psychology and very happily practices his vocation.

The three medical students above, illustrate the most common reasons that medical students fail. It becomes very difficult to catch up with your studies if you get behind. Many people are overwhelmed with the sheer volume of material to be mastered but make the adjustments necessary to do what is needed. A small proportion of medical students do fail and fail out of school. An even smaller proportion decide that medicine is not what they thought it would be and elect to leave.

The bottom line is that medical school demands a student with good study skills and a strong work ethic. While having a photographic memory will help with pre-clinical materials, the strong work ethic will get the student through the clinical years and through residency.


Jacqueline said...

In a previous post you mentioned your engagement. If I may ask, what has been your experience in balancing med school & a surgical residency while in a long-term relationship?

Anonymous said...

I am having trouble in school for the exact reason you mentioned. It is difficult balancing the needs of family and the needs of school.

I was wondering if you had any inspirational stories to tell of people repeating a year and doing well.

I am in the dummps and would like to have something to hope for.

Drnjbmd said...

To Jacqueline & Anonymous:

I am going to post a couple of stories, one about my best friend who struggled at a couple of points and made it through.

I am will also write about balancing my homelife with a very demanding professional life. I am still making adjustments (it's life after all) but the longer I do this, the better I get at adjusting.