2018-2019 School Attrition

[WoundupKnight]

Source: https://www.aacom.org/docs/default-...-2018-19-comattritsumm.pdf?sfvrsn=a4416197_12 , page 12

Any guesses which schools 21, 26, 27 and 34 are?

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[CJhooper123]

View attachment 260365

Source: https://www.aacom.org/docs/default-...-2018-19-comattritsumm.pdf?sfvrsn=a4416197_12 , page 12

Any guesses which schools 21, 26, 27 and 34 are?

I'd like to think NYITCOM would be one of them... maybe WCUCOM?

 

[Wjldenver]

You know what is a lot worse than attrition? ...Allowing marginal students with one or more red flags to graduate, and then go unmatched. Review the SOAP threads, and the looking for a residency position threads, to see some disheartening posts like the ones below (from both MD & DO graduates).

From an Unmatched MD Grad:

I am a American medical graduate from University of Texas Health Science Center at San Antonio, class of 2014, seeking PGY 1 position in FM, IM, Pedi or Psych, even Pre-lim. I have passed all my Steps, including Step 3 with attempt in step 1 and step 2. However, I am very hard working, resilient, dedicated and compassionate when it comes to patient care and medicine. Please give me a chance. Even willing to do intern year for FREE!

Please contact me at [email protected], if you know any program or know of any available position. Moving or location is not an issue.

Thank you,

Marriyam Jawad, MD

From an Unmatched DO Grad:

Willing to work for work.

There are many more examples like this on the SOAP and looking for a residency position threads.

 

[Roxas]

You know what is a lot worse than attrition? ...Allowing marginal students with one or more red flags to graduate, and then go unmatched. Review the SOAP threads, and the looking for a residency position threads, to see some disheartening posts like the ones below (from both MD & DO graduates).

From an Unmatched MD Grad:

I am a American medical graduate from University of Texas Health Science Center at San Antonio, class of 2014, seeking PGY 1 position in FM, IM, Pedi or Psych, even Pre-lim. I have passed all my Steps, including Step 3 with attempt in step 1 and step 2. However, I am very hard working, resilient, dedicated and compassionate when it comes to patient care and medicine. Please give me a chance. Even willing to do intern year for FREE!

Please contact me at [email protected], if you know any program or know of any available position. Moving or location is not an issue.

Thank you,

Marriyam Jawad, MD

From an Unmatched DO Grad:

Willing to work for work.

There are many more examples like this on the SOAP and looking for a residency position threads.

I'm going to have to disagree. I'd much prefer to have my degree and use that as a way into non-clinical jobs if unmatched as opposed to 1-3 years of medical school debt and the blemish of being dismissed and no diploma or show for it.

Neither is an ideal situation, but I refuse to acknowledge that schools kicking students to the curb only because they speculate that they may not match is anything other than sadistic, although it's frequently touted as if they're being merciful.

Eff that noise.

 

[Goro]

I'd like to think NYITCOM would be one of them... maybe WCUCOM?

I concur

Neither is an ideal situation, but I refuse to acknowledge that schools kicking students to the curb only because they speculate that they may not match
Students aren't dismissed because of fear they won't match. They're dismissed because they FAIL. Multiple times. They're simply people who, for whatever reason, shouldn't be doctors.

 

[Goro]

You know what is a lot worse than attrition? ...Allowing marginal students with one or more red flags to graduate, and then go unmatched. Review the SOAP threads, and the looking for a residency position threads, to see some disheartening posts like the ones below (from both MD & DO graduates).

From an Unmatched MD Grad:

I am a American medical graduate from University of Texas Health Science Center at San Antonio, class of 2014, seeking PGY 1 position in FM, IM, Pedi or Psych, even Pre-lim. I have passed all my Steps, including Step 3 with attempt in step 1 and step 2. However, I am very hard working, resilient, dedicated and compassionate when it comes to patient care and medicine. Please give me a chance. Even willing to do intern year for FREE!

Please contact me at , if you know any program or know of any available position. Moving or location is not an issue.


From an Unmatched DO Grad:
Willing to work for work.

There are many more examples like this on the SOAP and looking for a residency position threads.

100000000% agree. I'm more than willing to accept a higher attrition rate for MS1 and 2 than let someone get mired in four years of med school debt and never be a doctor. It's cruelty to allow people to do this.

At least at my school, we're now more ruthless is getting people out at end of OMSI Fall who should be out. It's about 2-3% of the Class.

Overall, the attrition rates above are very similar to MD schools.

 

[Roxas]

I concur

Neither is an ideal situation, but I refuse to acknowledge that schools kicking students to the curb only because they speculate that they may not match
Students aren't dismissed because of fear they won't match. They're dismissed because they FAIL. Multiple times. They're simply people who, for whatever reason, shouldn't be doctors.

Preclinical course failure is a bar that varies wildly between schools, and therefore cannot be the most reliable metric of who makes a good doctor. And don't forget about the complete nonsense that is the COMLEX PE. Acting school rejects who grade 3 of the 4 components of that exam should not be the gatekeepers of medicine.

 

[Goro]

Preclinical course failure is a bar that varies wildly between schools, and therefore cannot be the most reliable metric of who makes a good doctor. And don't forget about the complete nonsense that is the COMLEX PE. Acting school rejects who grade 3 of the 4 components of that exam should not be the gatekeepers of medicine.

Can't comment in full right now, cuz I have to take my son to work. But not everyone is entitled to be a doctor

 

[Drrrrrr. Celty]

Can't comment in full right now, cuz I have to take my son to work. But not everyone is entitled to be a doctor

I think this is somewhat of a cop out comment that's extra administrative. Medical school is hard, but what's harder is to deal with the fact that life easily throws you slip ups that our curriculums rarely seem to be able to cope with.

 

[Roxas]

Can't comment in full right now, cuz I have to take my son to work. But not everyone is entitled to be a doctor

This was never my assertion. I'm saying YOU admitted them, seemingly for a reason, to your school so I think more care should be taken before wantonly destroying someone's life. My initial point was I'd rather be unmatched with a degree in hand than dismissed, so let the residency selection process or residency itself decide who is truly unfit. Pre-clinical coursework is a far cry from the actual practice of medicine so that's mighty arrogant of you to think you can make that distinction so early on and then brag on here about how many you let go. Particularly when mere months prior you were welcoming them to your school as a qualified applicant. Your m.o. sounds suspiciously similar to what the Caribbean schools are doing.

 

[BorntobeDO?]

I concur

Neither is an ideal situation, but I refuse to acknowledge that schools kicking students to the curb only because they speculate that they may not match
Students aren't dismissed because of fear they won't match. They're dismissed because they FAIL. Multiple times. They're simply people who, for whatever reason, shouldn't be doctors.

I agree with Roxas, the ultimate reason students are kicked is because the schools are afraid they won't match. If you could match with 5 failed classes and repeated boards, I imagine there would be many DO schools willing to keep taking your tuition money. Its when you look like your in danger of not being able to complete in 6 years (i.e. no more fed money) or will not match thus discouraging future students from coming that this becomes a real issue.

DO schools know the only thing between them and the Carribbeans is that 98% placement rate. If that drops to a simular number as the carribbean, why would people put up with the extra OMM nonsense. The Carribs are often cheaper as well.

 

[BorntobeDO?]

View attachment 260365

Source: https://www.aacom.org/docs/default-...-2018-19-comattritsumm.pdf?sfvrsn=a4416197_12 , page 12

Any guesses which schools 21, 26, 27 and 34 are?

Dumping 10%+ of third year students is fairly horrendous. I have to imagine that has more to do with failing boards and counting that as a third year loss rather than actual clinical failures.

 

[Roxas]

Dumping 10%+ of third year students is fairly horrendous. I have to imagine that has more to do with failing boards and counting that as a third year loss rather than actual clinical failures.

If 10% of your class is failing boards enough times to warrant dismissal (I'd guess most have a 3 strike rule, although mine is 2) then the school is admitting too many academically weak students or doing a piss-poor job of preparing their students (or both). Either way they need to change the playbook.

 

[Goro]

If 10% of your class is failing boards enough times to warrant dismissal (I'd guess most have a 3 strike rule, although mine is 2) then the school is admitting too many academically weak students or doing a piss-poor job of preparing their students (or both). Either way they need to change the playbook.

No argument here

 

[Goro]

I think this is somewhat of a cop out comment that's extra administrative. Medical school is hard, but what's harder is to deal with the fact that life easily throws you slip ups that our curriculums rarely seem to be able to cope with.

That's what LOAs are for

 

[BorntobeDO?]

Knowing my school admin, it probably went along the lines of:


Admin 1: Hey, our level 1 pass rate is 92%. How do we increase it?
Admin 2: Let's make class attendance mandatory.

[Following year]
Admin 1: Our pass rate dropped to 85%. what are we doing wrong?
Admin 2: I think we give them too much dedicated time off. Let's cut it from 5 weeks to 3 and put in a mandatory ACLS/BLS
course during dedicated.

[Following year]
Admin 1: Whoops, it's 80% now.
Admin 2: Clearly, the students are getting lazier. They're not fit to be doctors. They should be dismissed.

[Following year]
Admin 1: Now that the level 1 problem is taken care of and they're all dismissed. What are we gonna do to increase our 94% level 2 pass rate?
...

too real, I am dying over here. I could totally see my admin doing this.

 

[Drrrrrr. Celty]

No one wants to take a LOA. They need people to check in on them when they start to slip and make sure they are supported through things and then lastly be encouraged to take an LOA.

That's what LOAs are for

 

[Dr. Death]

Idk what they mean by attrition here, but OSU just graduated 103 from a class of 115. We just keep passing students down to the class below, racking up those tuition $$$. One student that was in class of 2019 is now in class of 2021 due to repeated years. The class of 2020 has lost about 10% to the class below and inherited 10% from the class above. Not a great look for any school, even when you consider a couple PhDs in those numbers.

 

[Goro]

No one wants to take a LOA. They need people to check in on them when they start to slip and make sure they are supported through things and then lastly be encouraged to take an LOA.

Here is the sad voice of experience, not authority. There are simply too many students who do NOT seek out help when they are flailing and floundering, because they view this as a loss of face, a sign of weakness or they're afraid that somehow PDs will find out about thier mental health issues and deny them and won't invite or rank them.

We can't make them go for help. All we can do is encourage.

Now layer onto this the denial that tons of people indulge in, and then you have failing students who think "if I get a 98 on the final exam, I'll pass the course!"

And just to verify something, attrition does NOT solely mean dismissal or withdrawal. It means, as define in the attached PDF in the OP "who take a leave of absence or withdraw from their medical school" Withdrawal or dismissal is the LESS common of the two attrition criteria.

So take a step back and what we're seeing is more accurately [for the majority] "delay in graduation". We see this in MD schools as well. and people delay for the following:
pregnancy
illness (physical and mental)
injury
research fellowship (more common for MD students)
teaching fellowships
Step failures
Course failures
family issues (I had a student who suffered not one but two deaths in the family in a short period of time). Clobbered them for two years. Managed to graduate and is now in private practice.

Now Roxas, I vehemently disagree with you that it's less cruel to cut students loose early on than letting them go all the through when we know that they'll never match. These kids will have debt to the tune of 3-4 Tesla's and won't be able to practice Medicine. At that point, it's a worthless degree. I mean, how HMOs are going to need administrators with such a terminal degree?

When my Dean first came on board, he thought exactly like you like you...we need to do everything in our power to get them to graduation.

But in seeing the human wreckage that resulted from this, he changed his tune and we feel that it's more humane to cut them loose early.

Do some COMs take in students they shouldn't? Of course? there's a limit to how many med school capable there are in this country. And the newest schools in the southeast seem to be the biggest culprits. I'm talking at you, LMU and WCU.

 

[deleted600623]

As an incoming MS1, this thread scares the **** out of me.

 

[Drrrrrr. Celty]

As an incoming MS1, this thread scares the **** out of me.

I wouldn't be scared. It's not hard to be average in DO school and match averagely. However this depends on a lot of things going right too, which usually for the average middle class student they should.

 

[deleted600623]

I wouldn't be scared. It's not hard to be average in DO school and match averagely. However this depends on a lot of things going right too, which usually for the average middle class student they should.

Is it assumed that if you work hard and take care of your mental health, you’ll be fine?

 

[Drrrrrr. Celty]

my recommendation is let yourself have the small wins. Don't compare yourself to others. and in the end work towards growth in yourself. If you do that your mental health will flourish.

Is it assumed that if you work hard and take care of your mental health, you’ll be fine?

 

[Chibucks15]

@georgia_boy1 ^ Definitely good advice. The big thing for me was accepting being average/slightly below. It took me a bit and messed with me a little. But I knew early on I wasn't going for anything super competitive. Prioritize things you like to do and seeing family and such when you can. This is a job and don't let it take over your life (beyond reason)if you aren't that kind of person. Some people are, more power to them, but the majority of people outside this site aren't

 

[NecrotizingFasciitis]

I'm going to have to disagree. I'd much prefer to have my degree and use that as a way into non-clinical jobs if unmatched as opposed to 1-3 years of medical school debt and the blemish of being dismissed and no diploma or show for it.

Neither is an ideal situation, but I refuse to acknowledge that schools kicking students to the curb only because they speculate that they may not match is anything other than sadistic, although it's frequently touted as if they're being merciful.

Eff that noise.

Ya kinda going off of this, there are a lot of things you can do with a medical degree without practicing medicine.

e.g.) if - god forbid - I end up not being able to land a residency program, I'm going to sell useless collagen supplements to rich middle-aged women.

 

[Hippocrates II]

Is it assumed that if you work hard and take care of your mental health, you’ll be fine?

Not to scare you, but no. There are no guarantees in medicine/medical school. I have classmates who work tirelessly and then go on to fail nearly every test. I don't know if it's bad study habits, aptitude, or what, but some people simply cannot keep up with the rigors of medical school. That said, I would say the overwhelming majority of people who work hard and study smart will be fine in medical school. At the end of the day, the material isn't difficult, it's just overwhelming and unrelenting, so you need to have good strategies to stay on top of it.

 

[Scrubs101]

Ya kinda going off of this, there are a lot of things you can do with a medical degree without practicing medicine.

e.g.) if - god forbid - I end up not being able to land a residency program, I'm going to sell useless collagen supplements to rich middle-aged women.

My question is does the DO degree market itself well enough compared to the MD degree to do informercials??

Like if i wanted to put my support down behind multivitamins and vitamin C shots should i go by Dr scrubs or scrubs DO?

All jokes aside word on the street is even the secretaries at the NBME get paid 160k (so thats what theyre doing with all that step 2 CS moneyz...) so thats always a good backup plan or work for some sort of med tech company doing consulting or something. Some people say 6 figures at EPIC is possible on reddit. Administration/research is always an option as well.

Im sure the good jobs for non-residency trained docs are probably incredibly rare and if we get flooded with graduates without residencies most would eventually end up in completely unrelated fields starting from scratch. But as of right now def sounds like theres at least some options.

That being said id way rather be cut lose after first year than be carried into 3-4yrs of debt if there was no hope for me to make it. 60k of debt is way more manageable with a standard job than 300k at 7-8% interest

 

[Goro]

Is it assumed that if you work hard and take care of your mental health, you’ll be fine?

Yes, exactly!

 

[Roxas]

Is it assumed that if you work hard and take care of your mental health, you’ll be fine?

The good news is your school will definitely make it a priority to tell you to take care of your mental health, while simultaneously going out of their way to do things that destroy your mental health.

 

[Roxas]

Here is the sad voice of experience, not authority. There are simply too many students who do NOT seek out help when they are flailing and floundering, because they view this as a loss of face, a sign of weakness or they're afraid that somehow PDs will find out about thier mental health issues and deny them and won't invite or rank them.

We can't make them go for help. All we can do is encourage.

Now layer onto this the denial that tons of people indulge in, and then you have failing students who think "if I get a 98 on the final exam, I'll pass the course!"

And just to verify something, attrition does NOT solely mean dismissal or withdrawal. It means, as define in the attached PDF in the OP "who take a leave of absence or withdraw from their medical school" Withdrawal or dismissal is the LESS common of the two attrition criteria.

So take a step back and what we're seeing is more accurately [for the majority] "delay in graduation". We see this in MD schools as well. and people delay for the following:
pregnancy
illness (physical and mental)
injury
research fellowship (more common for MD students)
teaching fellowships
Step failures
Course failures
family issues (I had a student who suffered not one but two deaths in the family in a short period of time). Clobbered them for two years. Managed to graduate and is now in private practice.

Now Roxas, I vehemently disagree with you that it's less cruel to cut students loose early on than letting them go all the through when we know that they'll never match. These kids will have debt to the tune of 3-4 Tesla's and won't be able to practice Medicine. At that point, it's a worthless degree. I mean, how HMOs are going to need administrators with such a terminal degree?

When my Dean first came on board, he thought exactly like you like you...we need to do everything in our power to get them to graduation.

But in seeing the human wreckage that resulted from this, he changed his tune and we feel that it's more humane to cut them loose early.

Do some COMs take in students they shouldn't? Of course? there's a limit to how many med school capable there are in this country. And the newest schools in the southeast seem to be the biggest culprits. I'm talking at you, LMU and WCU.

I've yet to see a shred of evidence that it's about the human wreckage or being merciful at all. Sounds like your dean realized (like every other school admin) that they want to doctor their numbers to look as good as possible and the best way to do that is get suspected trouble makers out. They don't care whether it's 1st year or 4th year, or how many Teslas in debt that can buy.

And maybe landing a decent job as an unmatched graduate is difficult. But at least that person has options instead of the person having to fight the uphill battle of explaining to every other graduate program they apply to why they were dismissed from medical school. The latter person is at a much bigger disadvantage.

I'm not even making the argument that every matriculant deserves to graduate. There are definitely people that genuinely can't hack it and fall by the wayside. However, the above data regarding attrition is downright disturbing and, as I said, is starting to make DO schools look no better than the Caribbean. @Goro if that's how you want your school to be I guess that's fine, but own it. Don't pretend you're doing anything remotely altruistic here.

 

[Goro]

I've yet to see a shred of evidence that it's about the human wreckage or being merciful at all. Sounds like your dean realized (like every other school admin) that they want to doctor their numbers to look as good as possible and the best way to do that is get suspected trouble makers out. They don't care whether it's 1st year or 4th year, or how many Teslas in debt that can buy.

And maybe landing a decent job as an unmatched graduate is difficult. But at least that person has options instead of the person having to fight the uphill battle of explaining to every other graduate program they apply to why they were dismissed from medical school. The latter person is at a much bigger disadvantage.

I'm not even making the argument that every matriculant deserves to graduate. There are definitely people that genuinely can't hack it and fall by the wayside. However, the above data regarding attrition is downright disturbing and, as I said, is starting to make DO schools look no better than the Caribbean. @Goro if that's how you want your school to be I guess that's fine, but own it. Don't pretend you're doing anything remotely altruistic here.

You've never taught, I see. And spare us the "we as bad as the Caribs!" hysteria. We're not failing out 50% of the Class and then having only half of the survivors go on to residency. If we got even remotely close to that COCA would shut us down.

 

[Roxas]

You've never taught, I see. And spare us the "we as bad as the Caribs!" hysteria. We're not failing out 50% of the Class and then having only half of the survivors go on to residency. If we got even remotely close to that COCA would shut us down.

The numbers aren't there yet (insert Mathew McConaughey meme) but it's trending that way and the attitude is clearly the same. I would be delighted to be shown I'm wrong, but I won't hold my breath.

 

[Rekt]

It's either going to be placement rates dropping or increased attrition. I agree with the above and increasing attrition will be the likely answer to decrease the amount of unmatched and soaping. I'm sure COCA will get rid of any attrition standards just as they got rid of the placement rate standard.

 

[Kalam]

Knowing my school admin, it probably went along the lines of:


Admin 1: Hey, our level 1 pass rate is 92%. How do we increase it?
Admin 2: Let's make class attendance mandatory.

[Following year]
Admin 1: Our pass rate dropped to 85%. what are we doing wrong?
Admin 2: I think we give them too much dedicated time off. Let's cut it from 5 weeks to 3 and put in a mandatory ACLS/BLS
course during dedicated.

[Following year]
Admin 1: Whoops, it's 80% now.
Admin 2: Clearly, the students are getting lazier. They're not fit to be doctors. They should be dismissed.

[Following year]
Admin 1: Now that the level 1 problem is taken care of and they're all dismissed. What are we gonna do to increase our 94% level 2 pass rate?
...

You're literally my classmate I think. I hype our school up way too much sometimes, particularly due to the fantastic clinical education we get. But damn, none of that matters when they treat board studying as an "inconvenience" instead of a priority.

 

[ricksimmonsrafowens]

how can there be a 10%ish attrition rate in MS3? making it past MS1 & MS2 should be an almost guarantee of graduation. Name and shame guys!

 

[Osminog]

Why are the schools in the study anonymous? Why are they not required to identify themselves and publish their attrition rates for prospective students to see?

And why is "total attrition" just the average of the percentages for each year? What sort of lousy trickery is that?

 

[zero0]

Not much to add here other than the administration at my school is also a steaming pile of garbage (recommending against USMLE, non-transparent grading policies, backing malignant clinical preceptors, unhealthy obsession with OMM, blatant lies about the world post-merger, pretty much the usual...). Let this thread serve as yet another cautionary tale about joining the cult of AT Still. Now if you'll excuse me, I have to get ready for my SP remediation because I refused to do OMM on a patient with likely disc herniation before getting imaging. It's my fault really. I should know by now to at least do a little MFR and sprinkle some fairy dust for each MSK chief complaint. Wish me luck!

 

[MedicineZ0Z]

Can't comment in full right now, cuz I have to take my son to work. But not everyone is entitled to be a doctor

Of course, but a 20 year old who couldn't get into acting school and has 0 qualifications can decide if someone is fit to be a doctor?

 

[Goro]

Of course, but a 20 year old who couldn't get into acting school and has 0 qualifications can decide if someone is fit to be a doctor?

If you can't follow a simple script for a clinical encounter, why should you be a doctor?

Aren't those encounters filmed and reviewed?

 

[MedicineZ0Z]

If you can't follow a simple script for a clinical encounter, why should you be a doctor?

Aren't those encounters filmed and reviewed?

The actors grade the history and physical. No one double checks it.

 

[Espressso]

Knowing my school admin, it probably went along the lines of:


Admin 1: Hey, our level 1 pass rate is 92%. How do we increase it?
Admin 2: Let's make class attendance mandatory.

[Following year]
Admin 1: Our pass rate dropped to 85%. what are we doing wrong?
Admin 2: I think we give them too much dedicated time off. Let's cut it from 5 weeks to 3 and put in a mandatory ACLS/BLS
course during dedicated.

[Following year]
Admin 1: Whoops, it's 80% now.
Admin 2: Clearly, the students are getting lazier. They're not fit to be doctors. They should be dismissed.

[Following year]
Admin 1: Now that the level 1 problem is taken care of and they're all dismissed. What are we gonna do to increase our 94% level 2 pass rate?
...

lmao I think I know what school you're talking about.....

 

[Goro]

The actors grade the history and physical. No one double checks it.

The actors have a rubric that you, as the testee have to follow. Sounds simple to me.

At my school, in our clinical medicine labs, we film our student encounters with standardized patients.

The ones who who have the most trouble with these exams are the ones most likely to fail CE.

We conclude that these kids have difficult to treat humanistic domain defects, despite interventions!

Also , your slam on the actors brings to mind a concern that you do not like being judged.

IF I'm correct, keep.in mind that you will be judged for the rest of your professional career.

 

[fldoctorgirl]

The actors grade the history and physical. No one double checks it.

You mean no one will double check if you fail a domain based on an actor's scoring? Seems sketch, considering how often our SPs don't give us credit for something we explicitly did (and is seen on the video that we did). At my school when we have graded SP encounters, if anyone fails the faculty will review the videos to make sure that the SPs graded correctly.

 

[Cath Up]

Why are the schools in the study anonymous? Why are they not required to identify themselves and publish their attrition rates for prospective students to see?

And why is "total attrition" just the average of the percentages for each year? What sort of lousy trickery is that?

I pretty well remember emailing someone from AACOM asking about why the residency match rate data presented by AACOM was school-specific but anonymous (I am thinking of this thread: One school only placed 91.91% of grads into residency) and I recall being told that if they had required schools to be identified then they wouldn't give the data or would fudge the numbers. I looked for the post where I talked about this and the email where I asked them though, and couldn't find either, so maybe I made it up. But I think it happened...

Regardless, schools should clearly be required to post accurate outcomes.

 

[Osminog]

Regardless, schools should clearly be required to post accurate outcomes.

I agree. It's basic consumer information, and prospective students deserve to know.

 

[NukHopkins]

.

 

[Stagg737]

I'd guess 21 or 36 is KCU. My class lost a lot of students during pre-clinical years (although a good number were held back instead of being dismissed or left by choice) and the current graduating class was the same, but to my knowledge neither lost nearly as many during clinical years. For example, my class started with 276 and was down to around 255 by the end of 2nd year and we graduated around 242 or 243. I know that 4 of those we "lost" during clinical years were because they expanded the number of fellowship positions and those students joined the class under mine and I also know 3 who took LOAs for personal reasons (and I believe joined the class under me) and 2 who took a year off for research, while only 1 person from the class above joined mine. Idk how many my class actually lost due to academic reasons after fall of 2nd year, but I believe the number was very small.

Dumping 10%+ of third year students is fairly horrendous. I have to imagine that has more to do with failing boards and counting that as a third year loss rather than actual clinical failures.

I'm with Goro that I think it's far better to cull the herd during M1 year when people are failing multiple classes, unable to keep up with the work, or are just plain poor students. I've already encountered too many attendings (both in med school and residency) who made me say "what the ****" to their treatment plans and legitimately scare me that they're actually treating patients. So while I'm all for providing as much support to students as possible, I'm also a proponent of holding students to a high standard and dismissing the ones who can't handle it (before they rack up 6 figures in debt).

That being said, I agree with the above that by the time 3rd year rolls around the attrition rates should be minimal and that 10% is outrageous. By that time every medical student should have proven that they are capable of interacting appropriately in a clinical environment and that they have the foundational knowledge to learn how to become a competent physician. Those who leave in clinical years should be those who do so by choice or do something so egregious that they cannot be trusted as a physician. At that point academics should not be an issue, and I can't imagine classes having attrition rates as high as 10% without academics being a major factor in their decisions.

And maybe landing a decent job as an unmatched graduate is difficult. But at least that person has options instead of the person having to fight the uphill battle of explaining to every other graduate program they apply to why they were dismissed from medical school. The latter person is at a much bigger disadvantage.

Ehhhhhh, disagree with this a bit. I went to grad school before med school and it's not as hard as one would think to get accepted into a master's program and then move onto a PhD after failing professional school. Plus, if one fails out of med school early the debt is still (relatively) manageable. Completing 4 years of med school and accumulating $200k+ in debt with no ability to be a practicing physician is hell. Yes, there are plenty of non-clinical jobs that physicians can go into, but the ones that are good are going to the people who were superstars and either chose to take that position instead of residency or did residency first. They are not going to the people who barely got by and couldn't match. The jobs available for those individuals are typically pretty mediocre and are often 5-figure jobs, which is far more problematic for someone with massive amounts of debt as opposed to leaving school M1 with less than $50k in debt and then finding a job making nearly as much as the unmatched medical graduate.

 

[Oh_Gee]

The actors grade the history and physical. No one double checks it.

there's no physician (watching the camera) doing part of the grading?

 

[Osminog]

Greater attrition is also better, IMO. Fewer applicants for Match positions that are (arguably) weaker in the classroom and at bedside who may snag a residency position from someone who is (arguably) more qualified.

Yeah, you're right. It's better when more people get kicked out of medical school, saddled with six-figure debt, an enormous gap in their resume, and feelings of intense dread, because that means less competition for the survivors. That's definitely not a scummy, tactless thing to say.

 

[Roxas]

there's no physician (watching the camera) doing part of the grading?

It is my understanding that the SP alone grades 3/4 of the encounter, and the camera is to only help watch for any sort of academic dishonesty.