Medical students drop out of medical school for any number of reasons. Behind each medical student who makes this difficult decision is a name, a face, and a personal story. Starting and completing medical school is a commitment that can last anywhere from eight to ten years in the United States. During that time life circumstances can change in unexpected ways. The quantity of possible changes is why it can be challenging to pinpoint primary reasons for medical school attrition. However, homesickness, financial concerns, and lack of adequate academic preparedness can contribute to someone dropping out of medical school. Other reasons include absenteeism, feelings of displacement, and overall depression.
Nevertheless, there remains a core of 7 serious reasons medical students drop out of medical school.
Less than 15% of students applying to medical school will be accepted (the figure varies from one medical school to the next – here are the figures as in October 2020 as per individual medical schools). Before choosing medical studies and a medical career, assess your vulnerability to all seven reasons. You may not be able to prevent some of them from happening, but by being aware, you may be able to plan what to do should you encounter any of them.
1 – Changes in life circumstances
Medical students spend anywhere from eight to ten years in medical school.. Your life circumstances at enrollment may change as you progress through different levels of medical studies. Once you finish high school, you’ll have four years of pre-med curriculum at a college or university. This is followed by medical school and then a residency and/or fellowship period.
Think about the last ten years of your life. Is anything the same today as it was ten years ago? Or even five years ago? Entering medical school doesn’t stop life from happening, so you have to make adjustments along the way. Sometimes events in your life can negatively impact your ability to stay in medical school. Finances, the death or severe illness of a family member, or even falling in love are all things that can pull you away from staying in school. Before starting medical school, be sure you have sufficient support, whether that is financial, emotional or both, to get you through moments that may be more challenging than others.
2 – Academic capacity
Academic capacity does not necessarily refer to someone’s academic or intellectual ability. It can mean anything from insufficient academic preparedness in high school and college to an inability to retain sufficient amounts of difficult and complicated material.
The Medical College Admission Test® (MCAT) does a credible job of measuring someone’s “academic ability to be successful in medical school. It assesses problem-solving, critical thinking and knowledge of natural, behavioral, and social science concepts and principles prerequisite to the study of medicine.” (https://students-residents.aamc.org/applying-medical-school/taking-mcat-exam/about-mcat-exam/) By passing it, medical schools know you have the capability needed to become a successful medical student. But this admissions test is not foolproof, nor does it measure your stamina to deal with stress, long periods of study and the other pressures of medical school.
Assessing your academic preparedness
When considering your academic preparedness, take a look at your high school and college curriculum. Did you take a lot of science, biology and chemistry courses? If not, it’s possible your science foundation is not strong enough to enter medical school.
How are you at sitting for long periods of time and absorbing vast amounts of information? While aspects of learning can be enjoyable, the main reason for going to medical school is to learn to practice medicine. Some students enroll only to find, after struggling for a while, that they can’t assimilate all the material. If you are to absorb all the academic material, you must have consistent high levels of focus. You must also be willing to sacrifice personal time in favor of study time.
This kind of requirement leads to intensive studying regimes over prolonged periods of time. In many cases the result is burnout, loss of focus, and even depression. This was also confirmed by a recent study, “Burnout and serious thoughts of dropping out of medical school: Multi-institutional study” . A serious loss of focus and feelings of depression lead to poor academic performance and, in many cases, dropout.
Even if you’re good at a variety of subjects, studying content such as anatomy, physiology, pathology, microbiology, biochemistry, and pharmacology, may prove to be extraordinarily difficult to even the most dedicated medical students.
Talking to a medical school dean or director and reviewing your curriculum first can help you assess your foundation. Further discussion with this same person can help you determine what changes in study habits and life style you may need to prepare for to be a successful and ongoing medical student.
3 – Working part-time to pay tuition fees
When entering medical school, you may have no financial concerns. But over time a previously worry-free financial condition may change into one fraught with anxiety. Worries about money and paying for tuition can impact your focus on classes and clinical work. Money concerns can create sleepless nights, poor nutrition, and even depression.
The Public Agenda Report identifies tuition fees as one of the leading causes of medical students dropping out of school in the United States. Studying medicine is expensive and increases in tuition fees each year can be overwhelming, up to the point where you’re forced to drop out.
Medical students try to finding part-time jobs that can support the cost of medical studies. However, the rigor of medical school both in and out of the classroom makes it almost impossible to juggle both a job and the curriculum. Stress and worry mount until the day comes when there may be no choice but to exit.
4 – Absenteeism and leave of absence
There is little doubt that failure to attend classes, lectures and scheduled labs will result in more time studying and less comprehension about the content. The further behind a student gets, the more overwhelmed a student becomes until catching up feels hopeless. That’s when dropping out may occur.
As a medical student, although you are old enough to make your own decisions and determine your schedule, you are also old enough to make your own rules. Successful medical students make allowances for a social life but always put the classroom and homework first. You are paying for a medical school education. So skipping classes and not taking advantage of every opportunity to learn is throwing away that money. Medical students who remain in school and achieve academically sometimes view the link between tuition and education with a sense of consumer savvy. They are going to get what they are paying for. So they spend their time learning.
What is a leave of absence?
You may also hear of something called a leave of absence. A leave of absence is a period colleges, and universities allow students where they take a break from medical school. But they must return by a predetermined date. During a leave of absence, the stress and pressures of medical school are absent. Life is simpler and students frequently succumb to a more relaxed lifestyle and just don’t go back. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565981).
When committing to medical school, controlling what you can control is often the difference between failure and success. Attendance rests with you. So, make a promise to attend all your classes. And, avoid taking any leave of absence.
5 – False perception of their medical specialty before enrolling
Favorite medical television shows, pressure from friends or family to enter what is perceived as a lucrative profession, or even inspiration from books and articles can spur you to go into medicine. You may also imagine yourself being a surgeon or oncologist because you like a specific character on television who performs that kind of work. While all these subtleties can lead you to making good choices about a medical career, they can also lead you into making those decisions without knowing how such a long-term goal is achieved. When we see doctors, even those on television, they are accomplished physicians. We forget they didn’t start out that way. They all began as students without any knowledge or experience.
Is becoming a medical student right for you?
So, how do you know if you’ll like medicine or not? One thing you can do is shadow someone in the field for a week or so. Get an idea of what it’s really like. Talk to the dean or the director of a medical school. See if you can audit a class. Interview some medical students. Most people are willing to help you by providing accurate information.
If none of those tasks are possible, consider your characteristics. Do you like studying for long periods of time? Is school something you enjoy? Does learning something new energize you? A “yes” to these questions are signs that you possess the right perspective to be successful in medical school.
Next, consider the physical demands. There are long hours of sitting and standing. There is a certain amount of stress to learn, compete and achieve. Social life is minimal. Are these sacrifices you can manage for multiple years? If so, you may be someone who can make it through medical school.
Lastly, consider your sensitivity to human anatomy. What is your response, or reaction, to needles? What about the sight of blood? If you’ve ever dissected anything, what was your reaction? You’re required to go to anatomy dissection halls, which are specific rooms filled with cadavers (human corpses) specially prepared for medical students’ practical classes. Some students are repulsed by the smell of certain chemicals like formaldehyde and human body parts, etc. Although continued exposure can desensitize some students, others can’t get past feeling ill. You have to figure out which kind of person you might be.
Occasionally students in medical school struggle with the dawning realization that they just don’t like it. Maybe they don’t have the right passion, or the motivation to become a doctor. Some students in this situation continue their studies, and incur additional expenses, even if they don’t like it. Pressure from family or fear of disappointing them contributes to this kind of a decision. But in most cases, without enjoyment or passion for the field, most students choose to dropout early in their studies.
6 – Lack of discipline and self-organization
When graduating from high school, you may have a general idea that college is a place to have fun and make lifelong memories. While this is true, you need to be aware that in medical school you are often pushed to your limit. To do well as a medical school student, you need to dedicate plenty of time, focus, and energy to study. If you are aiming at a competitive residency, such as neurosurgery, you will have to ensure that you are in the top 5% of academic excellence in your class.
As a medical school student, you must be very disciplined and well-organized to succeed. This is critically important for those medical students trying to balance work, family, and studies.
When enrolling in medical school, do so accepting the fact that you will have very little free time, especially during surgical rotations. If a carefree, fulfilled life is your preference, then pursuing a less demanding career path may be a better decision for you. Talking with friends and family who can be honest with you, and not project on you what they would do, can often help you make this significant decision.
7 – Behavioral related reasons: drug addiction, alcoholism, illegal activities, conviction
As unlikely as it seems, there is one final group of reasons that contribute to dropping out of medical school – chemical dependency, engaging in illegal activities to gain financing for studies, and potential legal issues, which may include one or more bouts with the criminal justice system.
Students may view these activities as ways to cope with the financial hardship, long hours, stress, and pressure inherent in medical school. Even if none of them cause a student to drop out, they can result in permanent expulsion from medical school, without forgiveness of any debt incurred.
Although these seven reasons can cause someone to drop out of medical school, awareness of them before starting can help you prevent some of them. Without awareness, they can sneak up on you and overtake you before you realize it. If that happens, one or more of them can be difficult to manage and overcome.
The Public Agenda Report found that 65% of medical school dropouts think about returning to college or medical school. They feel that they failed to accomplish something important in their lives by dropping out of school and want to return. However, life obligations sometimes prevent that from happening, and they experience a certain sense of loss and regret. They may like their second best career choice, but it may never measure up.
Although there are many challenges on the path to becoming a doctor, most physicians will tell you the ultimate achievement is well worth the sacrifices. There are very few professions that can give you both the personal and professional rewards that being doctor provides.
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