Note: This post was submitted to Student Caffé by Jennifer Clarke. We would like to thank her for her submission and credit her as the author of this blog post.
Medical studies are rigorous and call for a committed and well-prepared learner. A medical school only accepts students who have proven throughout the application process that they have what it takes to complete the curriculum and succeed in their studies. There are many resources for students once they reach campus, from mentoring programs to lifestyle management and wellness lectures. Despite the school’s support, some learners find it challenging to complete the education necessary for their medical careers. What causes this? What would make a student drop out of medical school?
1. Deciding to Attend Medical School for the Wrong Reasons
In some cases, family or friends inspire students when it comes to choosing their career. Instead of considering their own desires and the best profession for themselves, students may succumb to this external pressure. After enrolling in medical school, some cannot manage the intense workload and level of knowledge that medical professions demand and others may find it a challenge to participate in practical classes, such as those that would require dissecting corpses. These students cannot keep up in their classes and may not want to continue after realizing they’ve chosen the wrong career path. As a result, they begin to slack off and do poorly, which could (and should, in this case) lead to them leaving their programs.
Furthermore, after a few years as a premed student, those who stick it out realize that the amount of money that medical professionals earn depends on their location and area of specialization. A dermatologist’s salary varies considerably between countries, for example. After finding out their projected annual compensation, students may decide that they’ve made the wrong choice and their passion or inspiration to pursue a medical career could decline. In such scenarios, some students opt to drop out of their initial studies. Before applying (or committing) to medical school, do the proper research so you avoid making the wrong career choice.
2. High Tuition Costs
In the 2017-2018 school year, the average cost of tuition for students attending public medical schools was $43,121. For students attending private medical schools, the average tuition cost jumped to $53,236. This puts the cost of tuition for four years of medical school between $172,000 and $212,000. These numbers don’t include a student’s housing, any fees that are charged by the school, and health insurance. The high cost of tuition, then, is not only one of the main reasons that students withdraw from medical school, but also a deterrent that prevents otherwise qualified students from applying. Tuition costs rise every year, and at some point, students stop being able to afford the cost, even with financial aid.
To try to afford their education, students may turn to part-time jobs. However, juggling a job and the academic workload presented to medical students can be overwhelming. Generally, either work or school will take priority. If a student chooses work over school, their academics will suffer because they don’t have the time needed to focus on their studies. If a student chooses school over work, they may be asked to leave their job, making affording medical school difficult. Either choice could lead to a student dropping out.
3. Lack of Academic Ability
Maybe you struggle when you’re asked to answer a question and haven’t had time to prepare. Maybe you aced the MCAT, but when it comes time to actually apply that knowledge, you go blank. We all have different capabilities. Some students may enroll in medical school only to find that they’re much better at being “book smart” than they are “street smart.” This isn’t to say that anyone who managed to get into medical school isn’t smart. They are. However, there are different kinds of smart, and whether you want to be a gynecologist or cardiologist, you have to be all types of smart. Being book smart won’t help you when you’re in an exam room facing something you’ve only read about. Being street smart won’t help you write accurate prescriptions. Know your abilities (and your limits) before you apply to medical school. You don’t want to be surprised if it turns out you can’t think on your feet or retain any of the vocabulary.
4. Mental Health Stigma
An article in The Harvard Crimson by Drew C. Pendergrass states: “At the [Harvard] Medical School, problems with mental health are not unusual. In a March 2016 survey conducted by [Harvard] Medical School students, 20 percent of third-year respondents said they had experienced either suicidal or self-harming desires within the last two weeks...The same survey revealed that mental health problems are not limited to students on medical rotations. Among Medical School respondents of all years, one in five screened positive for depression. Of those students, only one in five reported that they had been treated.”
Medical students clearly experience mental health challenges. This is made worse by the mentality that when a student seeks medical attention, it means that they have failed in some way or aren’t actually cut out for medical school. There may be a lack of peer support groups or a complicated student health system that stands in the way of treatment. Many students end up not finding someone whom they can comfortably approach with their fears and worries, which is stressful and can lead to further anxiety and depression. These effects escalate until a student becomes unable to handle their workload. This demoralization combined with poor mental health can lead to a student choosing to leave school. Know that if you feel sad, depressed, stressed, or just need to talk, there are resources that can help you. Reach out to your school’s health clinic or a health professional in the community.
5. Length of Medical School
Medical school generally lasts four years, followed by three or more years of residency. A student’s life situation (marriage, kids, housing, health, etc.) is likely to change during this period. Any change has the potential to distract a student from their studies. Frankly speaking, then, medical school requires a lot of sacrifice and only dedicated students will be able to follow through on their commitment. Others may find that when they get married, have a child, or are required to take on the responsibility of caring for an ailing family member, medical school becomes less important. Dropping out, then, may feel like the only option.
6. Unable to Cope with Stress
We’ve mentioned it once, but we’ll say it again. At medical school, you’re going to study...a lot. The material is technical and difficult, and medical students are expected to know it all. You wouldn’t want a doctor who’d never seen mononucleosis before, would you? The work-life balance of medical students, then, tends to lean more in the direction of work than of life. This can cause students to feel overwhelmed, leading to anxiety, depression, and loss of focus. Together, these cause students to burn out. Those who don’t immediately burn out may develop poor coping mechanisms such as drug addiction or alcoholism. Ultimately, students who cannot cope with the stress induced by the pressure of medical school see their grades begin to slide. If not addressed, this decreased academic performance, combined with unhealthy habits, can force the student to drop out.
In conclusion, there are many challenges to becoming a doctor, surgeon, radiologist, or any of the other careers that one could pursue in medicine. For committed students who want a medical career, though, they are worth it. Students who are struggling should seek assistance from their academic advisor, professor, or (if necessary) a mental health specialist. Once a student is back on the road to academic success, he or she will experience increased motivation and self-discipline, which are required for a successful medical career and will help prevent the student from dropping out.
Students who do leave school may experience the emotional and mental side effects of dropping out: low self-esteem, depleted morale, and embarrassment. Their dropping out also affects their institution's academic reputation and could demoralize teaching staff.
Medical schools should have a plan to curb the rate at which students drop out. Perhaps the administration could review and revise their student support programs or teaching and curriculum strategies. It is also important to review the admission policies that are in place. While they shouldn’t necessarily be more stringent, a method to determine whether a student is applying to school for the right reasons and whether they have the mental toughness to stick out the program could be helpful. Once the school has determined where it is slacking (whether in academic support, mental health support, or in another area), the administration can reach out to professionals to revise any policies that may be contributing to a student’s decision to drop out.