Failed 1st year medicine

[chickengoujon]

I am so upset and just looking for a bit of support really. My dd worked desperately hard to get into uni to do medicine. She volunteered at a local old people's home, worked at the gps, worked at the hospital, etc. She got fantastic A levels: A*, A, A, B in general studies. She is a lovely girl, really home loving and plesant.

When she went off to uni she was sad and then started to really live it up, not working very hard. She failed an exam after christmas but apparently that 'didn't matter'. She then failed 5 exams in the summer and spent all summer revising for her resits, only to fail again. After the uni asked her to leave last week she told me that she hadn't been eating properly for about 6 months. She is 5ft 8 and 7st 10. She is like a stick insect and I have been very concerned about her extreme thinness, but she reassured me that she was fine. She said how she had difficulty concentrating when revising and couldn't remember things - does anorexia do this? We didn't submit mitigations before her exams because I wasn't aware that she wasn't eating and she thought she was fine. Could we appeal? Is it too late? The uni seem totally disinterested and couldn't care less.

I feel so upset. Getting her in was so difficult and now it seems she has lost everything. She is totally devastated. Thanks for reading.

”Remnded me why I rarely visit the site.”

Well, don’t delude yourself that you are greatly missed here. I heard nobody screaming for your return. The trouble is, people take it onto themselves and appoint themselves the guru who knows it all, done it all, and have an answer to everything whilst others are posting rubbish and stupidity.

And why are you so agitated by kids with multiple A* A-Levels and amazing degrees? Did I hit a raw nerve somewhere? It must hurt badly to know there are kids out there who are much cleverer than your DC and mum after all, does not know it all!

And talking about stupidity, one must be very stupid indeed to be threatened by some unknown posters who make all types of claims on the worldwide web. It’s your inferior complex that’s governing your life. Anybody with real substance who needs to boast about anything don’t come on the internet to boast to faceless, nameless and anonymous people whom they’ve never met. They do it in real life, at the school gate, at the Speech & Prize Giving Day, at social gatherings amongst friends and relatives . . .

Yes, racism is in the eyes of the beholder - only that the blind cannot see it!

I think it's well known that certain medical schools take on more students than they can accommodate in subsequent years and then boot them out, seemingly with little compassion. Peteneras says KCL has shed an alarming percentage of its intake in her DS's year, assuming they don't allow any or many of those who failed to stay on. KCL isn't alone. I've no idea how much of this is about finance in general, but presumably something. If it's not about finance then the medical schools are showing remarkably poor judgment at selection. They know very well how many students they can take through and there's bound to be some wastage but certain schools are allowing a huge margin for error and messing up a lot of very worthwhile students' lives in the meantime. It's completely appropriate for a parent to feel upset on a DC's behalf after the slog to secure an offer in the first place. It can't be easy to start over again, psychologically, socially or financially - much better to go in a different direction at the outset. Medical schools should have a duty to only take on the right sort of number at the outset, and if their procedures aren't currently producing a near enough balance in numbers then surely they should review those procedures. They won't of course, if there's something in it for them.

alreadytaken is possibly the most knowledgeable poster on medical school applications that I've come across on MN, in fact I've just referred another poster to her to answer a question that I couldn't, about appropriate schools for a certain applicant, and PBL. One thing I haven't detected in her is an inferiority complex, and isn't her DS at the top medical school in the country? :)

I worked in a medical school.

We did not take more students on to make money, we took as many as we could because of enormous government pressure (at the time) to train more doctors.

Pastoral care was variable and depended on the person offering it but on the whole the 10% who dropped out after year one did so because they discovered that they did not enjoy medicine. Stressful as that was at the time it was much better for everyone for these bright young people to find more fulfilling careers. Anecdotally the main concern failing students had was how to break the news to their families.

Foreign students were the least well supported group of students and often suffered greatly because of it.

But Booboo some schools have a reputation for taking on too many, more than they have space for subsequent years. That's not quite the same. Also, according to MN at least, there are many, many very deserving students who don't get the offer of a place at all, so only getting it 90% right given the vast pool of available and highly qualified applicants isn't really that great. I can't quite believe that selectors get it so wrong so consistently inadvertently in certain schools. The drop out or failure rates at some other schools is very low. If some can get it right, why not all?

a reputation for taking on more than they have space for in subsequent years.

We took on more than we had space on for the first year, eg lecture theatre sat 240, we had 270, they had to sit on the floor - still anything to do with greedy medical schools but with government pressure and falling HE standards. This severely affects the students's education, eg from two students per cadaver to twelve students per cadaver.

Medical schools are massive loss makes for Unis, they are subsidised by other departments on the grounds that we all need doctors even though it costs a lot to train them.

There are far too many well qualified, passionate, highly motivated kids applying to medical school...there is no magical formula for telling which ones will enjoy the training. If you know how to identify those who will go on to drop out, feel free to share the insight.

Which medical schools do you know with a very low failure rate?

Oxford and Cambridge for starters.

There may very well be others of course.

And you think that this because they have a more discriminating selection policy? Do you think that Oxford's really high suicide rate may be of some relevance? Mightn't Oxford attract more students for whom failure is not an option and why would anyone think this is a good thing?

A slightly less laconic response may be useful as well as in what is their drop out rate and where did you find the statistics?

A zero attrition rate is not feasible - making such a commitment at 17 (ie when choosing university places) is a big deal and inevitably there will be those for whom it is the wrong decision for myriad reasons. It would be more unfair to insist that they stay and drag them through the course.

Booboo I would think that Oxford's higher than average suicide rate is a desperately sad by-product of the type of generally very high achieving student that applies there. Are you suggesting that the suicide rate is higher amongst Oxford medics than in other disciplines? I don't think it is. One thing which comes through repeatedly from parents whose DC have been asked to leave other medical schools is the apparent indifference to the DC's plight and a prior lack of pastoral care. Oxford has really excellent pastoral care and that may be part of the reason why the drop out rate is lower. That's probably far more to do with it than some rather offensive notion that Oxford medics who aren't managing commit suicide rather than 'admit failure' as though that's some kind of weakness. Also, I can't see that your point is in any way related to the very obvious over recruiting in certain medical schools, which leaves far too many highly able youngsters adrift. It seems scandalous to me; I'm simply asking if anyone knows the real policy behind it.

hanahsaunt obviously a zero attrition rate isn't feasible. But there's a huge gulf between zero and the sorts of cull being seen at the medical schools which have a reputation. What exactly are the advantages to the medical schools of that level of cull?

Sure Purple seems to be casting aspersions etc and being pretty silly to do it on MN.....however my point remains. It would have been perfectly possible to say to her that she is barking up the wrong tree, is likely to upset people and to suggest that she tones it down massively - that would have sufficed.
Who knows, her mother could be terminally ill, partner left her whatever...we don't know her circumstances and sadly people do say daft things when they are at a low point.
Plain speaking doesn't mean shouting and being aggressive online. It can be done nicely - it didn't seem to done so here.
It also really doesn't help telling the woman how brilliant your DC and relatives are and how hard they work. Good for them, very happy to hear they are all amazing, but not terribly great to hear when disaster has struck for someone in your family. Believe me, it doesn't help! And perhaps take on board that what goes around comes around - one day some of you may be grateful for a few kind and helpful words even when you are being idiotic.......as I'm sure I was back in 2013.

I looked back the thread and this is really a shoulder to cry on sort of thing - it is a thread about those who failed in med school for whatever reason. I was very grateful that others shared how upset they were when this happened to their DC; made me feel not so alone. Until it happens to you, please don't trample on other people's feelings -you can't know how you would react.
Do also start a new thread so that you can tell everyone else that med school is amazing for some.

Molio you seem to be implying that staff enjoy having students drop out. Let me assure I gained nothing by the students who dropped out, my school didn't make money from them, I didn't enjoy the experience of telling students they had failed and having them burst into tears in my arms, and no one gains a tough reputation from having a high drop out rate.

As I said there has been immense government pressure to recruit more medical students in order to have more doctors. At least that was the case in the 00s.

As for pastoral care we struggled to get clinicians to deliver the clinical parts of the curriculum, getting them to deliver pastoral care when they were unwilling or unable was impossible.

I'm implying nothing of the sort Booboo and don't see how you could infer that. I'm wondering if those who are more knowledgeable than me on med school admissions can shed some light on why certain schools recruiting today grossly over recruit and then get rid of a large percentage of each cohort. Is this just a particularly brutal recruiting technique/ survival of the fittest? There must be a good reason behind it but if that is the reason then I'd suggest given the human cost it isn't a good one. I'd certainly suggest longer interviews and more scrutiny of applications in order to save the heartbreak along the way. It seems extremely irresponsible. The interviews DS had at a couple of universities were very short, lacked all depth and probably revealed nothing of consequence to the interviewers.

On your last point Booboo, I don't think there's any excuse for not providing decent pastoral care, particularly in a high pressure discipline such as medicine. If the clinicians aren't available, other staff should have been recruited as a priority - certainly the 10% drop out rate would suggest your institution needed to do more than it did.

Would anyone mind sharing the names of the medical schools which have a reputation for 'culling' please? It seems that this is well known only to those 'in the know'.

Molio you don't seem to know anything about how medical schools work and you are spreading silly misinformation.

There is no policy to over recruit and then cull. Over recruiting doesn't make any sense on its own, numbers of student admissions in all subjects are decided in advance with the government. Even if you could over recruit you would not gain anything - medicine is a loss maker. Pouring money into a medical student to have them drop out is even more of a financial disaster than subsidising the medical students who continue.

Medical students drop out because nothing prepares you for the experience of medicine other than trying it out. It is an extremely academically intense degree which demands a lot of maturity and some students decide this does not interest them.

Medical schools have block agreements with the NHS to provide teaching, however this does not identify particular individuals to do the teaching,they have to, in effect, volunteer. Given how overworked doctors are, many of them feel they cannot fit teaching duties into their days as a result it is difficult to even find tutors for clinical topics, much less something considered secondary like pastoral care. Who are the other staff who will be recruited for pastoral care and who will pay for them? This is the stuff of fantasy that could not be funded even during the golden years of HE much less now that everything is grossly underfunded. If we can't find anatomy demonstrators, cadavers and anatomy equipment do you think money will be spent on recruiting pastoral care tutors?

Booboo I don't know anything about how medical schools work I simply know a large number of current or recent medical students/ their parents who share their experience. I'm not a medic. I don't claim insider knowledge which is exactly why I asked the question. I'm interested in the reason why certain schools shed such a large number of their cohort each year and why those same schools appear to have been doing this for years. And that's because this thread shows the fall out, and that seems avoidable or at least capable of being reduced. I'm wondering if your knowledge is current, because you mention the state of things in the medical school you worked in fifteen years ago? Perhaps things have changed? Anyhow, if my impression is 'misinformed' then it's at least shared by a number of people I know whose DC have been through the process and in some cases whose jobs enable them to know more than mere parents.

I'm well aware of funding issues. They're hitting everyone in education and have been widely reported/ discussed/ debated. Nevertheless I also understand about running things on a tight budget and while there are bound to be difficult decisions to be made, what you admit about the woeful state of pastoral care at your institution is shocking. Any well run medical school would be aware of the vital importance of pastoral care given the pressures of medical training. Leaving students without any preventative or ameliorative pastoral care until it was too late is utterly appalling and you've stated here quite clearly that that was the case where you worked. Really dreadful.

On an irrelevant point, I don't agree that the content of a medical degree is more challenging than many other degrees, there's just rather a lot of it, which obviously creates a pressure all of it's own. But it's not difficult per se - other subjects are far more intellectually challenging.

My direct experience is from 10 years ago, then I moved from teaching medical students to teaching doctors. Can you please provide some evidence for your claims? Which are these medical schools, what are the numbers of drop outs, where did you find the numbers and where is the huge increase in the last few years you imply exists?

Do medical students drop out? Yes at about 10%
Is that welcome? No, not by anybody. It makes no sense financially for the Unis, it is a waste of resources, but it may be better for a student to move to another field if medicine is not the right career choice for them.
Should something be done about it? Sure, of course all students should have excellent pastoral care, as well as all professionals having support to avoid high MH rates and suicide rates in medicine.
Can something be done about it? Feel free to donate your extra cash as HE is as cash strapped as the NHS.

Pastoral care was not bad only at my institution, it is bad in all medical schools. I explain how it is organised and why it is bad, please explain your solution and how you would fund it. You also need to fund office space and office supplies for all these hundreds of tutors, don't forget.

Pastoral care is poor in other areas, e.g. in my next job I had 28 pastoral care students, an impossibly large number considering that pastoral care is only effective if you have a personal relationship with the students. Colleagues had up to 60 students and this was in the humanities.

Medicine is a degree like no other. It makes incredible academic demands, from punishing contact hours to a wide range of academic challenges, from memorising facts, to developing diagnostic skills, to writing a concise summary of a medical history. They are taught pathology, chemistry, anatomy, but also languages, communication skills, law and ethics. In addition character development is crucial from day one; our students met volunteer patients in semester one and needed the maturity to deal with real people with real problems. Tell me one other subject that is even close to that.

Pastoral care is not bad at all medical schools Booboo and I'm not sure how you can claim that. It's very good at Oxford for example. I understand it's excellent at Cambridge too. You didn't actually explain how pastoral care was organised at the place you used to work at, you merely said it didn't exist and it couldn't exist because there was not the available funding. My solution, obviously, would be to re-organise funding and re-prioritize but without looking at the books I couldn't tell you how exactly, obviously. It's just so blindingly obviously necessary that I'm amazed you can be complacent about it especially given how tough you say a medical degree is, which I accept (I only quibbled with the idea that it's intellectually harder, which it isn't).

Mindgone the statistics will be out there somewhere and might well be useful to read before your DC makes a decision. 'Dropping out' because a student doesn't like the course or can't cope or gets depressed is not quite what this is about; it's about being failed and being required to leave. Current students will be well aware which schools have a reputation, so it's worth asking around, or asking the schools who make offers before your DC accepts.

”. . . and isn't her DS at the top medical school in the country?”

Molio, I don’t keep a record of whose DC goes where and to what medical school. I have much more urgent things to deal with as it stands.

And which is the so-called, ”top medical school in the country”? Please enlighten us.

”But Booboo some schools have a reputation for taking on too many, more than they have space for subsequent years.”

By what authority and on what evidence have you to come out with such outrages statement, Molio? I hate to say this (honestly) but you’re allowing your imagination to run wild again. It is not the first time nor the second time but on numerous occasions here and elsewhere you have said the same that there are medical schools reputed to so-called ‘cull students’. Say it too often and it becomes the (unfounded) belief in the minds of new readers and prospective medics that your assumption is now ‘factual’. I see there is already a poster asking precisely about this very subject less than twelve hours ago.

Booboo knows his/her stuff and one of the very few ( funnyperson, are you there?) who talks absolute sense and facts here. His/her postings on this page deserve a place on MN’s ‘Hall of Fame’! As opposed to others suggesting doing graduate medicine to someone who’s already failed school-leaver medicine.

thank you, molio, but I'm no longer as well informed as I was on the admission process as I'm not involved with it this year. When I was first asked, many years ago, to help a friend's child I soon discovered that they knew more than I did, The best source of information is geenerally current applicants because the most committed know the odds and research well. There is a great deal of information out there and the Student Room website is a good place to start.

Yes I have a medic child at Cambridge, where all first year medics passed last year. There is academic research linking drop out rates to A level grades and you would therefore expect a higher pass rate at Cambridge with its higher grade requirements. I know some students have to resit exams but I supect resitting an entire year may be less common than in other medical schools. It is a very pressurised environment and the colleges seem to differ in the quality of pastoral support.

It's extremely difficult to get information from medical schools about failure rates but if pushed hard enough they may say at open days. In my view it would be a legitimate use of the Freedom of Information Act to find out. We went to one medical school that were open about setting a pass rate in some years to deliberately fail a percentage of students, most did pass the resits. Not sure I can remember which one it was, my OH may.

The medical edcation process gives students the confidence to take difficult decisons quickly when necessary believing they will do more good than harm. The need for that in general practise, where most doctors work, is less than in hospital and some of the drop-outs might possess qualities that would make them better gps than some of those who pass. Doctors can rationalise the failure rate as a necessary evil - and the medical school justified their policy as "maintaining standards", ignoring any fluctuations in the standard of admissions between years. We were not impressed.

There is some academic research about drop out rates showing that the best predictor of who will stay the course is A level grades, perhaps because the highest grades are usually a proxy for organisation and hard work. With increasing competition for places in medical schools the drop out rates ought to be falling. I think I had some figures at one stage showing that was the case overall.

There are GMC reports on medical schools, infrequent but you might find them interesting. www.gmc-uk.org/education/medical_school_reports_full_list.asp
National Student Satifaction surveys will also highlight problems, students at Kings complained of the Colleges response to that.

No FoI required - go to Unistats. Select medicine courses and look at continuation rates. (NB medicine continuation rates across the sector are higher than for any other subject area.)