Reasons, descriptions of what it was like to drop out of medical school?
July 7, 2014 7:40 AM Subscribe
I'm writing a short story in which a character drops out of medical school in his third year. I'm wondering if anyone has any firsthand or secondhand experience with this (dropping out at any point). I've never gone to med school and I'm making this all up, but it would be great to get some real-world input.
Step 1 is taken roughly at the end of second year, and failing it could be a pretty strong push to leave med school, especially failing more than once (although I'm not sure you're even allowed to take it more than twice- you can only retake it if you fail it the first time, afaik). Another aspect to consider in your story would be the six figure student loans your character would be saddled with.
posted by MadamM at 8:20 AM on July 7, 2014 [1 favorite]
posted by MadamM at 8:20 AM on July 7, 2014 [1 favorite]
I'm in medical school. Barring truly extenuating circumstances (for example, a terrible motor vehicle accident that left the student with a physical disability), dropping out occurs before third year, because by then, most students will have accumulated substantial student loan debt that can't easily be paid off if they were to drop out of medical school and find another profession. Just to give you an idea of how uncommon dropping out is: I've had students in my school who have been diagnosed with cancer, have had parents pass away, and the like, and they still continued with medical school and graduated on time (they didn't even take time off in their case, but sometimes a student might conceivably take a leave of absence).
Schools like to keep their graduation rates high, as this statistic is something that is tracked by the AAMC. So rather than dismissing a student (unless it were for something really serious like cheating, attempting suicide, or committing a felony), a medical school administrative committee will err towards encouraging a leave of absence. I would imagine that any decision to drop out (or even to simply take a leave of absence) might be surrounded by numerous meetings with advisers and/or administration.
As MadamM mentioned, Step 1 is taken at the end of M2, and I suppose if you fail it (my school technically gives three chances to pass, but nobody really ever needs more than one shot to pass Step 1 at least at my school). The administration (academic advancement committee or something like that) would have picked up on your subpar performance long before it came to something as major as failing Step 1 outright...
Third year is when clinical rotations begin. That's stressful, and a quite a shift from the classroom-oriented curriculum of the first two years of medical school. People get burned out, especially on demanding rotations like surgery and OB-gyn. But this change in pace does not typically cause somebody to drop out.
That said, I have had friends who finished all four years of medical school and then decided that they would just keep the M.D. after their name but not practice medicine. I have also known people who were on the MD-PhD track who decided that clinical medicine was not for them and opted to not finish the M.D. part of their degree and only pursue the PhD track because they enjoyed research more.
Feel free to memail me if you want more thoughts or information.
posted by gemutlichkeit at 8:49 AM on July 7, 2014 [4 favorites]
Schools like to keep their graduation rates high, as this statistic is something that is tracked by the AAMC. So rather than dismissing a student (unless it were for something really serious like cheating, attempting suicide, or committing a felony), a medical school administrative committee will err towards encouraging a leave of absence. I would imagine that any decision to drop out (or even to simply take a leave of absence) might be surrounded by numerous meetings with advisers and/or administration.
As MadamM mentioned, Step 1 is taken at the end of M2, and I suppose if you fail it (my school technically gives three chances to pass, but nobody really ever needs more than one shot to pass Step 1 at least at my school). The administration (academic advancement committee or something like that) would have picked up on your subpar performance long before it came to something as major as failing Step 1 outright...
Third year is when clinical rotations begin. That's stressful, and a quite a shift from the classroom-oriented curriculum of the first two years of medical school. People get burned out, especially on demanding rotations like surgery and OB-gyn. But this change in pace does not typically cause somebody to drop out.
That said, I have had friends who finished all four years of medical school and then decided that they would just keep the M.D. after their name but not practice medicine. I have also known people who were on the MD-PhD track who decided that clinical medicine was not for them and opted to not finish the M.D. part of their degree and only pursue the PhD track because they enjoyed research more.
Feel free to memail me if you want more thoughts or information.
posted by gemutlichkeit at 8:49 AM on July 7, 2014 [4 favorites]
Hey Swheatie,
If would want to hear medical students' reasons for dropping out of US med schools, in their own words, look no farther than the Student Doctor Network's forum boards, here, using the keyword dropping out.
If they dropped out in third year in the US, it would probably be because they couldn't handle their clerkships for some reason. Most medical schools curriculums are organized in a way where the first two years are classroom based, with students mostly taking a wide range of classes considered to be a core curriculum. Years 3 and 4, students rotate in hospitals for weeks or months at a time, in different specialities (OB Gyn, Surgery, etc.) Some are required, like Medicine, and some are by choice - for example, if you want to specialize in pathology, you'd go spend time on that.
Here is a sample core curriculum for medical school to give you an idea.
In my experience, students who drop out in year 1 and 2 got hammered by the incredible amount of information they have to learn. If you don't quickly learn now just the information, but the fact that they way you study for them might be a little different, you'll quickly get behind. Students who drop out/are asked to leave in year three or four have one of a couple of problems.
1. Lack fundamental knowledge: They didn't do fine in year 1-2 and had difficulty learning all of the information, and unfortunately, medical school learning is supposed to be cumulative, with students applying what they learned in years 1-2 in clinical settings in years 3 and 4. And they never learned the basic information well enough so they are lost, which becomes evident when asked questions by attendings or residents.
2. Lack ability to synthesize and apply that knowledge: They were great at learning facts and did do well in year 1 and 2, but their ability to synthesize all that information and apply that knowledge to real world examples isn't there. So they still can't answer a question posed by an attending or resident.
3. Failed Step I three times: you get three shots after second year and before graduation to pass the first part of your boards, Step I. I've seen people fail step one, not because they wouldn't be great doctors, but usually because they aren't great test takers, and the pressure gets to them. It's stressful. If you fail three times you can't get your degree, and you can't go to any other US medical school either. It's over. So if your character failed step I three times, they'd have to drop out.
4. They lack or don't enjoy the interpersonal skills that go with being a clinician. Up until year 2 in medical school, most things were classroom based, which means that year three is the first time that they get to do full time something that they may have been preparing for for at least 6 years, if they went the premed route in undergrad. And now that they see it for what it is, they realize they liked the idea of being an "MD", but not the day to day realities of it.
5. Burnout: Medical school can be like becoming a new parent: little sleep, huge learning curve, total dedication, and some of the people who are supposed to be your teachers with in the field act like narcissistic babies. It's hard, and easy to ask yourself if it will ever get better, because if it doesn't do you want a lifetime of this medical culture? But students have invested so much time and money, and often are too afraid to drop out because they also have no idea what else they would do, so dropping out in the US is rare. Usually you go because you were asked to leave.
good luck!
posted by anitanita at 9:25 AM on July 7, 2014 [1 favorite]
If would want to hear medical students' reasons for dropping out of US med schools, in their own words, look no farther than the Student Doctor Network's forum boards, here, using the keyword dropping out.
If they dropped out in third year in the US, it would probably be because they couldn't handle their clerkships for some reason. Most medical schools curriculums are organized in a way where the first two years are classroom based, with students mostly taking a wide range of classes considered to be a core curriculum. Years 3 and 4, students rotate in hospitals for weeks or months at a time, in different specialities (OB Gyn, Surgery, etc.) Some are required, like Medicine, and some are by choice - for example, if you want to specialize in pathology, you'd go spend time on that.
Here is a sample core curriculum for medical school to give you an idea.
In my experience, students who drop out in year 1 and 2 got hammered by the incredible amount of information they have to learn. If you don't quickly learn now just the information, but the fact that they way you study for them might be a little different, you'll quickly get behind. Students who drop out/are asked to leave in year three or four have one of a couple of problems.
1. Lack fundamental knowledge: They didn't do fine in year 1-2 and had difficulty learning all of the information, and unfortunately, medical school learning is supposed to be cumulative, with students applying what they learned in years 1-2 in clinical settings in years 3 and 4. And they never learned the basic information well enough so they are lost, which becomes evident when asked questions by attendings or residents.
2. Lack ability to synthesize and apply that knowledge: They were great at learning facts and did do well in year 1 and 2, but their ability to synthesize all that information and apply that knowledge to real world examples isn't there. So they still can't answer a question posed by an attending or resident.
3. Failed Step I three times: you get three shots after second year and before graduation to pass the first part of your boards, Step I. I've seen people fail step one, not because they wouldn't be great doctors, but usually because they aren't great test takers, and the pressure gets to them. It's stressful. If you fail three times you can't get your degree, and you can't go to any other US medical school either. It's over. So if your character failed step I three times, they'd have to drop out.
4. They lack or don't enjoy the interpersonal skills that go with being a clinician. Up until year 2 in medical school, most things were classroom based, which means that year three is the first time that they get to do full time something that they may have been preparing for for at least 6 years, if they went the premed route in undergrad. And now that they see it for what it is, they realize they liked the idea of being an "MD", but not the day to day realities of it.
5. Burnout: Medical school can be like becoming a new parent: little sleep, huge learning curve, total dedication, and some of the people who are supposed to be your teachers with in the field act like narcissistic babies. It's hard, and easy to ask yourself if it will ever get better, because if it doesn't do you want a lifetime of this medical culture? But students have invested so much time and money, and often are too afraid to drop out because they also have no idea what else they would do, so dropping out in the US is rare. Usually you go because you were asked to leave.
good luck!
posted by anitanita at 9:25 AM on July 7, 2014 [1 favorite]
Response by poster: Holy Smokes! Thanks, anitanita, for pointing me to that board! I heart mefites!
posted by swheatie at 9:44 AM on July 7, 2014
posted by swheatie at 9:44 AM on July 7, 2014
SDN is a good resource for your question, but be aware that it has a reputation for being a haven for "gunners": students who pursue high grades and success hypercompetitively and at the expense of others. It does not represent all med students, or all pre-meds.
A less easily searchable, but more supportive community can be found on tumblr (look for posts tagged "medblr").
posted by ocherdraco at 10:51 AM on July 7, 2014 [2 favorites]
A less easily searchable, but more supportive community can be found on tumblr (look for posts tagged "medblr").
posted by ocherdraco at 10:51 AM on July 7, 2014 [2 favorites]
I know someone who dropped out of Nursing school after doing some time at the local VA hospital. It was just too much for her.
posted by Mr. Yuck at 11:48 AM on July 7, 2014
posted by Mr. Yuck at 11:48 AM on July 7, 2014
This thread is closed to new comments.
The second dropped out because their advisor (don't know what their actual title was) told them in no uncertain terms that they were highly unlikely to get the grades to complete the course and it might be better to jump now than wait to be pushed. This friend knew that this was the case, but was not keen to do so because of family expectations (he is now a very happy sys admin).
posted by threetwentytwo at 8:12 AM on July 7, 2014 [1 favorite]