Common Reasons Students Leave Medical School

Students who enter medical school have excelled in college courses in the sciences and other subjects, and are studying to work in a highly respected field with great personal rewards in the professional experience of being a physician. The income of doctors varies by specialty, but is generous by most measures. Why would someone want to leave med school?

Students entering med school to fulfill someone else’s dreams may encounter setbacks. Not every med student will become a doctor. Although not a frequent problem, about 4% of U.S. med students who are not in a combined degree program do not graduate within six years of starting med school, according to an October 2018 report by the Association of American Medical Colleges.

That report noted that 3.3% of medical school students dropped out over a 20-year period from 1993-1994 through 2012-2013. By the end of the fourth year, 81.6% to 84.3% of students graduated. By the end of the sixth year, the graduation rate was 95.9% for those not in combined degree programs.

For the years 2003-2004 through 2012-2013 combined, a dual bachelor’s degree and M.D. had the highest attrition rate at 4.8%. M.D. combined with MBA degrees had the lowest attrition at 0.8%. Students in the M.D.- Ph.D. programs graduated at a 93.5% rate by the 10-year mark.

Roughly half to two-thirds of those who left medical school did so for nonacademic reasons. This was not an inability to handle the material, as admissions committees in the U.S. do not accept candidates they believe will fail to become doctors.

Lack of Desire to Become a Doctor

In some cases, students leave med school because there is a conflict as to whose career goal they are actually fulfilling. Medical school requires great discipline and steals most available free time. If a student is living out the parents’ dream instead of his or her own, the inner conflict can lead to unconscious sabotage.

[Read: 10 Red Flags That Medical School Isn’t Right for You]

Parents dream of their children having lives equal to or better than their own. In some cultures, bright students are expected to study either medicine or engineering. I was at first surprised to hear this, but now understand its seriousness in some families.

Students who don’t want to disappoint their parents, or have no plan of their own, may go along with their parents’ wishes initially. Although medical school admissions committee members try to discern if it is the student’s own desire to go to medical school, they can be fooled as a student tries to convince himself or herself that this is the career path he or she wants.

If you aren’t sure, you shouldn’t attend. Try something else that you might prefer. The cost, emotionally and financially, is great, and dropping out doesn’t come without disappointing yourself or others.

Medical research is a frequent alternative for students. Multiple students I know have gone that route; some decide medical school is what they want for themselves and about half prefer research.

Others have chosen to go into a program to become a physician assistant or nurse practitioner. Just because they achieved a dazzling score on the MCAT doesn’t mean that med school will be their cup of tea. Although they like patients, they may not like the length of time as it finally sinks in — or what they are giving up in their personal lives.

Competition in some med schools is more stressful to some students, and they choose a kinder environment.

Others I have known have said, “I need to live my life for myself” and have gone to business school, entered the entertainment industry, enrolled in a cooking school or chosen to become a stay-at-home parent. As I reflected on the fact that the M.D.-MBA programs had the lowest attrition rate, I wondered if perhaps students believed the joint degree kept options open for them.

[READ:3 Types of Students Who Should Consider a Joint M.D. Degree]

Mental Illness or Learning Disorder

A lack of desire to become a doctor isn’t the only reason medical students are unsuccessful. An untreated or undertreated mental illness — be it an eating disorder, panic or other anxiety disorder, major depression, bipolar disorder or other mental illness — can also be a roadblock to success in med school.

Newly discovered or untreated learning disorders also contribute to students dropping out of med school. Students may deny their symptoms or be discouraged by others from seeking help. This is especially true in the first year, and they may wait until it is too late to get help. They may hear comments like, “Everyone is stressed in medical school. ”

Many students fear that there is a stigma associated with seeing a mental health professional, and some families strongly encourage that thinking. Other students are even afraid to confide in their parents that they have been referred for an evaluation, for fear of disappointing them. This has a snowball effect, with symptoms increasing steadily until the student is no longer able to complete course assignments or report to class.

The student may be able to ask for a leave of absence, but this will not necessarily solve the problem, as the stress of medical school will still be there when he or she returns.

The bottom line is that psychological and psychiatric help is needed if the student is to return to school successfully. It is particularly distressing when a student takes a leave of absence and the therapy recommended does not occur, or is initiated half-heartedly because the pressure is off. Sadly, that student can be throwing away his or her dream.

[READ: How to Discuss Mental Health Issues in Medical School Applications.]

During a leave of absence, a student can work with a tutor or learning specialist and discover more successful ways to study than in the past. Maybe the student can be encouraged to undertake a project that he or she has been fearful to start or hesitant to ask for help to begin.

If a leave of absence is granted, there is a limit to the amount of time off that students can take. If they have made no effort to face their challenges and get help, they will eventually come to the end of the grace period. Promotions committees will dismiss them or, in some instances, allow them to withdraw.

Some students come to medical school already knowing their vulnerability to a particular mental illness and will seek a referral early in the first year so that there is no break in treatment. Students have come to me during orientation week requesting contact information for good mental health professionals.

These students have a high rate of success. When they notice they are starting to slip, they immediately go for an appointment. If they are on medication, they take it regularly and get adequate sleep, allowing them to keep stability in a stressful life. If a student decides to go off the medication against medical advice or without medical supervision, there can be serious ramifications.

However, many disorders often present for the first time with students just beginning med school and under increasing amounts of stress. As a result, students may not have developed good coping skills and could be at risk of developing negative habits such as not getting enough sleep or increasing their alcohol consumption. Such things can lead to disorders like depression, mood swings and panic attacks.

If a future physician wants to help others, he or she must be willing to look at himself or herself and correct damaging and unprofessional behaviors. Self-discipline, personal motivation and willingness to seek help are the best defense against failure.

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