Medicine From The Trenches

Experiences from medical school, residency and beyond.

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.

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30 January, 2007 - Posted by | failure, medical school, study skills

267 Comments »

  1. I failed a course and had a withdraw for other course in same semester and I didn’t see their dismissal email in between my junk mails. so I am dismissed from a caribbean medical school. If I apply to a better Caribbean medical school, will they know about my dismissal. Both have government loans. Will they find out about my dismissal through my loan.

    Comment by SHABNAM | 11 September, 2016 | Reply

    • To Shabnam,
      Yes, they will know because you will be asked about previously attending medical school and you have to tell the truth if asked. Also, as you state, financial aid will also disclose thus you always have to be truthful. In medicine, there are always challenges and times when things are tough but you always tell the truth, if asked and you learn from your experiences good and bad. Good luck, be positive and remember that your word is you.

      Comment by drnjbmd | 11 September, 2016 | Reply

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    Comment by dick. | 4 June, 2016 | Reply

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    Comment by recessmed | 4 July, 2015 | Reply

  4. Thanks so much.
    I know where I went wrong and I’ll seek help before joining either course.
    I just needed to confirm since failure in med school is rare if there is any hope past it. But you’ve cleared this for me and I’m grateful.

    Comment by Kkkk | 13 September, 2014 | Reply

  5. Thanks for your quick response.
    Final question. Your opinion please, as a lecturer. If I feel indifferent about anatomy I.e don’t enjoy it… Could it be an indication that I won’t enjoy the rest of the course plus the practice?! I know so far I enjoyed chemistry and physiology.
    And the fact I had trouble with my 1st year and fell behind my classmates does this mean I’ll always require “extra time” to digest the information?

    Comment by Kkkk | 13 September, 2014 | Reply

    • I’m sorry I know my question is quite complicated but I’ll appreciate your insight.

      Comment by Kkkk | 13 September, 2014 | Reply

      • And to clarify I loved the clinical aspect of anatomy. Just had trouble memorising the basics which are essential to passing the exam.

        Working hard has never been an issue for me. I’m quite precise hence enjoy chemistry. But the fact I was unable to adapt as fast as the average med student to the course worries me. Could this mean I’m slow and would make a dangerous physician?!

        Comment by Kkkk | 13 September, 2014

      • To Kkkk:
        It would be good for you to stop comparing yourself to others. Anatomy, chemistry and pharmacology are tools that we use to treat patients. Your mastery of these subjects do not indicate (or negate) your fitness to practice medicine. Yes, you have to master them but there is always someone who will master these things (and other things in medicine) faster. You can only compare yourself to you because you are the only person that you can change. Yes, you have to be efficient in terms of your studies but you don’t have to enjoy every single subject (just master them) or ace everything that you encounter in school (you have to get through school and pass). If memorization is an issue for you, seek out a professor or counselor who will help you with your special needs. Perhaps, you need to adjust your study tactics; perhaps you need more group study (or less group study). Again, figure out what you need, without commentary on likes and dislikes or comparisons to others, and get what you need to solve the problem at hand. Good luck.

        Comment by drnjbmd | 13 September, 2014

  6. Hi
    I’m a 1st year medical school student.
    I begun as a pharm student as I had not received my acceptance letter from med school so I assumed I was rejected.
    My 1 week of pharm school was a pleasant experience even if we hadn’t learnt much.
    My father found my med school admission letter at the p.office and I immediately joined the course because it was my first option.
    Ever since I’be been struggling with one unit, anatomy and pass in all the other units. This made me feel very stupid as all my other friends passed extremely well in this unit without much struggle.
    In my university we study the whole human anatomy, 3/4s of bchem and physio as the main units within 30 weeks=1 academic year, b.science and IT as the minor. The rest of bchem and physio 1/4 is completed in 2nd year.
    During the year I’d feel out of place, and different from other med students who seemed to enjoy human anatomy and pass it while I felt practically blank in the subject.
    I was ill with a flu during my end of year exams and failed badly enough not to qualify for a supplementary but made to repeat the year. But I remembered my exams were extremely fair and all my friends passed.
    My dilemma is… Since I struggled with anatomy through out the year and acheived borderline scores with diligent study, should I retreat back to pharmacy…?
    Even if I repeat the year and pass well, because I found the 1st year hard, does this automatically mean the other years would be a struggle too?!
    Please help as I’m really confused and quite disappointed with myself.

    Comment by Kkkk | 10 September, 2014 | Reply

    • To Kkkk,
      When one fails (or struggles with) anything, the item to keep in mind is how success and overcoming your struggles will depend on how you learn from them and keep moving forward. Look at the things that troubled you and see which ones were totally under your control. For example, if you feel that you are “out of place” then change those feelings to feeling that you are just where you belong because you can’t know how the other students feel or think. The feelings or thoughts of others have no bearing on what you are doing. If you feel “stupid”, the change your thinking to “I am not stupid, I just need a bit more time to get this material mastered as best I can”. Did you consult your instructors? Did you ask if one of your fellow students might want to study with you? When one struggles, one has to find a way to navigate through those struggles. If you throw your hands up and say, “I’m not good enough” or “I will never get this done”, you will find yourself moving toward your negative thoughts and feelings. Only you can change those thoughts and feelings.

      Other things to think about are “What are your motives for studying pharmacy?” and “What are your motives for the study of medicine?”. In order to do well in any profession, you have to enjoy the preparation for that profession and you have to enjoy the scope of practice for that profession. Neither pharmacology nor medicine are professions where one can easily “coast through school” and “coast” the rest of one’s life. Medicine and Pharmacology demand precision and knowledge. In order to gain, that knowledge, one has to learn the tools and how to use them properly. Check your motives and make sure that you love what you are going to study. If you can’t do that, then you will continue to struggle with either of these courses/professions.

      Finally, take a break if your health and sanity demand it. Do this before you fail out or get yourself into a situation where you can’t complete school (either of them). Sometimes getting away from a competitive, fast-paced curriculum will allow you to focus on what you want and need so that you can come back refreshed and ready to go. Finally, your parents (no matter how much they love you) can decide what you need to do with your life. It’s your life and you have to decide how you want to live it. Good luck.

      Comment by drnjbmd | 11 September, 2014 | Reply


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