At an individual level, the need to be competitive can influence individuals away from being genuinely authentic and demonstrating the values necessary for being a doctor.
The need to be competitive often involves point scoring or seeking out ways in which to distinguish oneself from everyone else, whereas sitting down and speaking with others patients, peers and staff carry value beyond the point systems. Perhaps the most emotive issue around failing and our perception of being a failure is the feeling of shame. Many would agree that a healthy sense of guilt around failure can actually be a driver for improvement on the basis there are always personal lessons that can be learnt from the experience.
However, shame is a more deep-seated feeling which is destructive because it corrodes our belief that we are capable of change. Perhaps the reason medical students feel such shame after poor academic outcomes is because of our fear of how our peers may perceive us; failing an exam is embarrassing.
In some situations, there is also the indirect shaming of those who fail which is where medical schools also need to be aware as well.
It is entirely possible that, as medical students, there are members of our cohorts who have failed examinations, formative or summative, and have never told their peers due to their shame. These same individuals may have also not accessed any of the support available to prevent any further downward spiraling of their academic achievement and their wellbeing associated with repeated failures.
Failing and experiences of feeling like a failure are not uncommon, and are likely to remain present as we continue to assess students in competition with each other. On the one hand there is the need to raise awareness about the impact of perfectionism, competition, shame, or embarrassment, since they are part and parcel of the context of medical education.
However we can minimise the negative impact on the individual, and maximise the opportunity for growth next time around.
You know, you spent six or eight years of your life going to this point, and getting through to be a doctor, and then in two weeks, it all gets stopped. It stops dead in those tracks. My student loans are up in two months. Do you get a job?
Do you go to grad school? Do you go to PA school? Mike: Yeah, so you have three weeks to even decide. Hey, do you do something easy? Do you completely switch paths? Right- Because yeah. Ryan: They say, hope is not a strategy. Like you then have to decide like, am I gonna stick in this, correct?
You now have no job. You have no future. All your friends from college are moving on. They have jobs. They have kids. They have families. All your friends from med school, it just keeps turning. Is that a part of it? Mike: Yeah, because our class was The same thing happened. Ryan: Well, this is- And this is a different era, too. You had assigned seats too, right? And like it was like, you could tell when somebody was gone, and it really stood out, correct? Mike: Yeah, you had your little name tag, and you had your little basket of pencils, and all those things, and those things just stayed almost like a memorial to the people that were gone.
I think a lot of our med students and physicians, at whatever point the crisis point comes along, by and large, not equipped to deal with failure. I mean, sure, I mean, some people are like that. Not equipped for failure, not equipped for how to ask for help, how to seek help, how to to articulate what kind of help you need. Is it a study skills -based issue? Is it a test taking issue? I studied biochem for a while, then I switch over to anatomy. Like, your mom tells you to just do more flashcards, and study more, and work harder, and get more sleep.
No, absolutely. Am I on the right track here? And, you know-. So this is getting close to where you and I met. What year? What year is this, ?
So you ended up coming to town where I live in Huntington, West, Virginia. And so I think you poked around there a little bit. Is that right? Ryan: to prove yourself to be able to get into a med school somewhere. So there were other cardiology, electrophysiology masters. You wanted to only be an emergency medicine doctor, right? Ryan: That was it. And then-. So I was an EMT in college. I did research in first year with the ER residents at the local program.
Ryan: Yeah, that what that was. Mike: It was a three minute walk from his office where I just happened to be meeting with him on a random Tuesday, because I was out of school. So I went up and met with him. Now I cover the same amount of… A lot of different stuff going on in that.
I was like, hey, and you sort of invite yourself in. I was like, yeah, come on, have a seat. I guess I remember how raw it was. And you were in that limbo space. I mean, now, we might say, it was study-based and test taking-based. I have a pretty good radar for these things. He just does not have the skills. He does not have the tools.
I figure this is a guy I can probably help. I can help him unlock his aptitude and really navigate med school and boards. We have a class coming up. Good luck, young man. Mike: No, and I was gonna do your program just for whatever was next. Ryan: Yeah, I think you knew you wanted to be in med school.
We knew that you wanted to be in medicine. So I felt bad. And you made like a very, like, serious appeal to me. Ryan: Yeah, 10 chairs. That was how things were done. I already had people on the wait list. I was like, huh, could I do 12? But you left an impression, and you laughed.
But you were like number I think there was somebody in front of you? Ryan: And- What happened was, I thought about it. I think I poked around. I think I went in the classroom, and was like, yeah, you can do this.
And then I guess I called you later, right? What do you remember about that? Mike: Yeah, I remember we laughed, and it was, you were gonna to see what happened. You basically told me, if somebody dropped, I could be the 10th if somebody dropped, and the person on the wait list decided not to come. Mike: We left it up in the air. If somebody dropped, there was room, if not, then I could take the class in six months the next time, which was in-.
Ryan: But that would be- But that would only work if you were not back in med school. Mike: And so I went home. I continued to look for grad schools. My meeting for my appeal kinda came through. You had to put in a letter, and go through a formal appeal process, and go back through a different Student Promotions Committee. And so at that time, right in that area, you decided that you could make room in the class. I had to go back through the committee.
And so right in that area was when you decided that I could take the class, whether I got back into school or not. And fortunately, the appeal was successful. I went through the meeting, and I had a plan. I used your program-. Ryan: Yeah, we talked about… Hold on, Mike.
Let me just interject. Yeah, so you wrote your silver bullet let me try to get back into school letter, right? I think part of what you did, was you convinced them that if they let you back it is not gonna be the same thing, in part, because you were gonna go do this class, and this class was gonna directly impact the negative outcomes you had.
It was gonna teach you ways to manage the information, ways to organize it, ways to encode it, ways to be active, ways to move away from passive studying. But I think you were able to use whatever stuff I had at the time to make that argument.
We can speculate that that was part of why they let you back. Is that fair? Mike: But you know you have. I had to… It was three hours away from my house. I had to go live someplace else to do this class, so it was a financial investment. It was a time investment. And then what? Mike: Yeah, so you go through this meeting again. You sell yourself. You do sell the new plan. It certainly seems like that, right?
Your chances are much fewer. And so-. Ryan: Oh, yeah. I mean, yeah, now your margin… And the criteria for what constitutes being in trouble. And then just real briefly, so you did the class, which is sort of a proto, I mean, sort of a different version of the STATMed class that we do now, Study Skills class. So you sorta came in, and I think like based on what I recall… Like I said, you are a hardworking guy, a smart guy, but you really did a lot of stuff that I think led to what we call the trap of familiarity and the illusion of productivity.
Very common issues. Lots of reading and rereading. Findings vary depending on circumstance, but overall, roughly In contrast, around So, how long is medical school? Taking on too much work at once can burn out some students. Conversely, remaining in school for too many years will take its toll on others. Those entering medical schools who are committed to completing the program are So, what is the dropout rate for medical school?
In a standard, single four-year program, that would put the medical school dropout rate at between While those who enter medical school mainly end up in the majority of students graduating, this rate is notably lower than those who take an extra year or an additional four or five years in the case of combined majors.
Well over 90 percent of medical students in five-year programs graduate. Aside from those in combined MD-PhD majors, taking five years instead of four had a significant boost in graduation rates—roughly 45 percent to around 92 percent in the case of MD-MBA combined majors. Even in the case of single majors, a notable boost happens around the five-year mark. There is roughly a 20 percent increase consistently between graduation rates of four-year graduation rates and five-year graduation rates, according to AAMC data.
Compared to students who went through a four-year medical school program and graduated at a rate between Medical school dropout rates vary quite a bit for students in combined degree programs, such as a combined MD-PhD.
Between and , only 63 percent of combined-program students graduated within eight years of matriculation. However, when students in combined programs took ten years, the medical school graduation rate went up to The type of program matters when it comes to the length of school for successful medical students.
Just over 40 percent of students who earned an MD-MBA graduate within four years, but that number jumped to around 98 percent at eight years.
Conversely, less than 5 percent of students earning an MD-PhD graduated within four or five years. That number went up to just over 60 percent at eight years and around 94 percent at ten years.
As intimidating as medical school can sound, surprisingly, most students drop out for non-academic reasons. Between and , the motive for medical students dropping out came close to an even split between academic and non-academic reasons.
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