Does everyone graduate medical school?

[MedStudentWanna]

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I know not everyone passes the boards the first time, but does everyone who enters as a MS 1 graduate in four years? I assume schools try to push people through, but are many people expelled? Do many quit like in the foreign med schools?

 

[DrBowtie]

Usually around 95% complete.

 

[vtucci]

No not everyone finishes in four years. There are usually one or two people every year that have to repeat the first year of medical school at my school because they failed two classes. Some students choose to take a year in between second and third for research or joint degrees. Some decide it is not for them. Also, on rare occasions, students get expelled for honor code violations (usually cheating).

 

[Dr. V]

I know not everyone passes the boards the first time, but does everyone who enters as a MS 1 graduate in four years? I assume schools try to push people through, but are many people expelled? Do many quit like in the foreign med schools?

Absolutely not. We started with 60 and finished with 54 and that 54 conisisted of 3 from the classes ahead of us. We had 2 transfer in good standing so basically 7 out of 60 didn't make it.

 

[NonTradMed]

I think there is always a few percentage that 'fail' or whatever every year, but graduation rate for all MD schools are pretty high---about 90% I'd say (perhaps higher). Just remember not everyone fails for academic reasons, there's also honor code violations, emotional/personal problems etc.

From what I've managed to learn, it's pretty hard to fail academically out of med school. Once you're in, med schools try pretty hard to let you stay in.

 

[Zoom-Zoom]

I think there is always a few percentage that 'fail' or whatever every year, but graduation rate for all MD schools are pretty high---about 90% I'd say (perhaps higher). Just remember not everyone fails for academic reasons, there's also honor code violations, emotional/personal problems etc.

From what I've managed to learn, it's pretty hard to fail academically out of med school. Once you're in, med schools try pretty hard to let you stay in.

Yep, the majority of people who don't graduate could have graduated if not for some sort of expulsion (cheating) or a change of heart. The selection process pretty much guarantees that if you are accepted you are smart enough to graduate, so if you really want to you will.

 

[Dr. V]

I think there is always a few percentage that 'fail' or whatever every year, but graduation rate for all MD schools are pretty high---about 90% I'd say (perhaps higher). Just remember not everyone fails for academic reasons, there's also honor code violations, emotional/personal problems etc.

From what I've managed to learn, it's pretty hard to fail academically out of med school. Once you're in, med schools try pretty hard to let you stay in.

Actually no they don't try pretty hard to let you stay in. If you flunk out you flunk out as many people learn the hard way. Also, it's not hard to fail out as they just don't give many "second chances" and the amount of material is unreal. People that never picked up a book in undergrad with a tough major their entire life can study their ass off for an exam and still fail it.

In all truthfulness the selection process is so thourough that IF you get in then you most likely have the ability to pass, not that they allow you to fail and just keep you around with more chances to make themselves feel good.

One of those guys that we lost told a lie. That's it. He didn't cheat etc, he told a lie to a security guard and was caught in it. We signed a statement saying we would not lie, cheat, or steal and would uphold the honor of the school at all times. He was caught in a lie and kicked out for it.

A very small percentage do get through the selection process without the ability to pass. They don't give them extra credit or let them fail multiple times. Tutoring is available but they still have to pass. If they can't pass then they are gone. While they pride themselves on a good graduation rate and provide tutoring etc, they also pride themselves with first time Step pass rates and making good physicians.

They are good about letting you reschedule a test if a crisis occurs, but otherwise don't expect any special favors or second chances. Of course it depends on how bad you fail because sometimes you can remediate one course, but many times they hold you back an entire year. You screw up again and you are gone, you won't be held back again you will be dismissed (aside from extreme circumstances, debilitating car accidents, pregnancy etc). Even still, in no case, no matter how dire, will you be allowed to take more than 6 years to complete the requirements for the MD degree. That is a Nationwide requirement.

 

[nikorette]

I know that at Stanford the majority of students take 5+ years to finish due to extra options.

 

[Law2Doc]

I know not everyone passes the boards the first time, but does everyone who enters as a MS 1 graduate in four years? I assume schools try to push people through, but are many people expelled? Do many quit like in the foreign med schools?

Relatively few people actually manage to totally fail out of school, but some percentage each year do fail individual courses and are required to retake them during the summer or subsequent year. You do usually get second chances to get through it, and most of those accepted have the brain power to graduate, eventually. Expulsions may occur for cheating and other unethical behaviors, but that is not too frequent. Some percentage of people bail after the first year, once they decide perhaps the reality of med school isn't quite what they had in mind. And as a prior poster indicated, taking a year off to research isn't that unusual, so many people will be on the 5-6 year plan for this reason.
Unlike foreign (offshore) med schools, where admissions standards are lower and folks can get in but fail out, the adcoms do a nice job of making those cuts before you start.

 

[neutropenic]

Second chances are common, even third chances. Most everyone gets through it though some people quit for personal reasons. They try really hard to keep you in and going.

 

[Dr. V]

Second chances are common, even third chances. Most everyone gets through it though some people quit for personal reasons. They try really hard to keep you in and going.

How can you have more chances if you are already on the 5 year or 6 year program due to research etc? You can't because it is a Federal requirement that you finish all MD degree requirements within 6 years no matter what.

I don't know how it was where you guys went to med school but pretty much flunking down one year was all you got where I graduated, after that you were dismissed without some extreme circumstance because it would be virtually impossible for you to meet the 6 year requirement.

They were great about helping you and doing whatever it took BEFORE you failed, but the line was drawn with the failure (not talking about a test here, talking about failing a course).

While I agree 100% that the great majority have the ability to pass due to the way people are selected for med school, my med school didn't give multiple "second chances", they gave one unless something truly extreme occured and even then sometimes they still only got one.

 

[dbhvt]

How can you have more chances if you are already on the 5 year or 6 year program due to research etc? You can't because it is a Federal requirement that you finish all MD degree requirements within 6 years no matter what.

I don't know how it was where you guys went to med school but pretty much flunking down one year was all you got where I graduated, after that you were dismissed without some extreme circumstance because it would be virtually impossible for you to meet the 6 year requirement.

They were great about helping you and doing whatever it took BEFORE you failed, but the line was drawn with the failure (not talking about a test here, talking about failing a course).

While I agree 100% that the great majority have the ability to pass due to the way people are selected for med school, my med school didn't give multiple "second chances", they gave one unless something truly extreme occured and even then sometimes they still only got one.

I don't know where you are getting this 6 year requirement thing. MDPhD candidates have 7+ years from the start to finish of their MD.

 

[Dr. V]

I don't know where you are getting this 6 year requirement thing. MDPhD candidates have 7+ years from the start to finish of their MD.

I got that straight from a person that can't fail even one regular exam much less a course (plus I think I saw it in the requirements somewhere in our handbook or with the USMLE or something). There were some very, very serious medical problems in his family and he had to miss a semester after already being on the 5 year plan. He is now on a very, very tight timeline for the 6 year plan. That requirement was quoted to him by the administration who was very sympathetic, but basically their hands are tied on the issue.

There may be a caviat that the PHD portion of the MD/PHD program doesn't count (he was not MD/PHD), but the administration said that medical students had 6 years max, regardless of the reason (he had a damned good reason and it still wouldn't fly. The reason was so good he is the only person I know of that actually was allowed more than one drop back year).

 

[NonTradMed]

Actually no they don't try pretty hard to let you stay in. If you flunk out you flunk out as many people learn the hard way. Also, it's not hard to fail out as they just don't give many "second chances" and the amount of material is unreal. People that never picked up a book in undergrad with a tough major their entire life can study their ass off for an exam and still fail it.

In all truthfulness the selection process is so thourough that IF you get in then you most likely have the ability to pass, not that they allow you to fail and just keep you around with more chances to make themselves feel good.

.....

They are good about letting you reschedule a test if a crisis occurs, but otherwise don't expect any special favors or second chances. Of course it depends on how bad you fail because sometimes you can remediate one course, but many times they hold you back an entire year. You screw up again and you are gone, you won't be held back again you will be dismissed (aside from extreme circumstances, debilitating car accidents, pregnancy etc). Even still, in no case, no matter how dire, will you be allowed to take more than 6 years to complete the requirements for the MD degree. That is a Nationwide requirement.

I didn't mean that people don't flunk out or that med schools won't fail people, but many med schools' policy is to let you repeat a course if you fail the first time, repeat the year if you fail more than one class. I think that policy may vary from school to school but they are certainly very generous considering these are core courses we are speaking of. They are certainly much more generous than grad school. The med school I'l be attending have a remedial summer sessions available for first years that have failed a class (or more)....my college never had remedial classes available (they expected everyone to be college ready when they....go to college).

Frankly, I think being given these second chances DOES show that med school wants to keep you around. Considering how difficult it is to get INTO med school, the fact that they do let you repeat courses does imply a certain about of coddling. Not all graduate programs are that nice.

Also, I'm not sure saying that one has to graduate within six years (for a four year program) implies that med school is difficult per se....?

I mean.....allowing for up to six years to finish a four year program seems to imply that that med schools DO work with you to let you graduate.

Perhaps you are used to a more flexibile policy regarding school policy but I consider med schools allowance for repeaters to be very generous.

 

[Dr. V]

Perhaps you are used to a more flexibile policy regarding school policy but I consider med schools allowance for repeaters to be very generous.

In undergrad you can take off as many semesters as you want to and all is well it just takes longer to get your degree. You can flunk as many classes as you want as long as your GPA is high enough to take it and all is well. Undergrad is very, very generous where failing is concerned.

If you will notice I said this one person is the only person I know that they allowed to try and make the 6 year cut. The others were all kicked out after they flunked down one year and messed up again. GPA didn't matter for them either, I know one that had a passing GPA but flunked after going on the 5 year plan and they were dismissed. They didn't even complete the year they were in. They got one "second chance" and that was it.

The people I know in grad school say you really gotta screw up bad to get less than a B- (I believe a C is flunking though). I don't know how flexable they are with regard with family disasters and time to completion though.

The case above I am talking about was indeed a family disaster and even I would have missed the semester he missed and they have told him in no uncertian terms that is the only reason he is being allowed to try and graduate on a 6 year plan.

It just seemed to be implied that if you got in they would "make sure" you passed and that nobody actually flunked out they left because they wanted to. I was disagreeing, at least where I went to med school was concerned, because while they did do everything within their power to help you to BEFORE you failed they were not big on "third" chances.

 

[8744]

"Look to your left. Now look to your right. Uh, Okay...now look behind you and a few rows back. Farther back. See that group in the back....now look behind them and slightly to the right...yes, in the hallway too."

"One of you is not going to be here next year."

 

[Dr. V]

"Look to your left. Now look to your right. Uh, Okay...now look behind you and a few rows back. Farther back. See that group in the back....now look behind them and slightly to the right...yes, in the hallway too."

"One of you is not going to be here next year."

LMBO Panda

One of my classmates had a husband that went to medical school at a different place and they gave him that speach. "Look to your left, now look to your right, only one of you three will graduate" or "One of you three won't be here" whichever they said. The way she talked it was a malignant school and if they gave that speach I don't doubt it was hell to be there.

 

[AmoryBlaine]

Almost everyone graduates. My experience has been that poor grades/repeating classes etc usually has more to do with personal crisises than anything else.

Keep in mind that there's a big difference between squeaking through med school by the skin of your teeth and doing the specialty/residency of your choice. There's the old joke...

"what do they call the guy who graduates last in his med school class?"
"Doctor"

But keep in mind they probably dont call him "Otolaryngologist," "Orthopaedic Surgeon," or "Anesthesiologist."

 

[Law2Doc]

My experience has been that poor grades/repeating classes etc usually has more to do with personal crisises than anything else.

I doubt that. In med school "poor grades" are pretty common, and are masked by the fact that most schools use a P/F system. As far as repeating classes, some percentage each year have to, because some do not make the transition from college to med school as well as others, don't get into good study patterns, have bad luck on med school tests and the like, or just don't put in the work. A relative minority of those who struggle have bona fide personal problems.
But most schools let you repeat a class or two if you fail, so yes, you get second chances. If you fail all your classes, or still can't get through it on a second pass, you could fail out, but that happens more in theory than in practice at any school I've come across. Bottom line, very few actually fail out of school.

 

[neutropenic]

Almost everyone graduates...But keep in mind they probably dont call him "Otolaryngologist," "Orthopaedic Surgeon," or "Anesthesiologist."

This is not necessarily true either, especially at some P/F institutions where there is no true grading. There have been people who matched all these specialties from my school with the lowest reommendation "word" in the MSPE, our only psuedoranking.

Frequently the most competitive candidates on paper go into something relatively easy to match into like peds or IM, though admittedly they may do that somewhere competitive like Boston Children's.

This abstract is a bit dated, but I don't believe that the system has changed that dramatically (where the fail rate is now 5x as great or something like that).

Undergraduate medical education
A. E. Crowley, S. I. Etzel and E. S. Petersen


There were 31,323 applicants to US medical schools for the 1986-1987 academic year. Of this number, 17,092 were accepted by at least one school. First-year enrollment equaled 16,779. Because some students were repeating the first year, the number of first-time enrolled students was 16,206. This represents a decrease of 131 from the previous year. The number of students enrolled in 127 US medical schools in 1986-1987 was 66,142; of this number 22,082 (33.4%) were women. The estimated number of graduates in 1986-1987 was 15,872. The total enrollment of students from underrepresented ethnic/racial groups was 6650 (10.1%), of which 3853 (5.8%) were blacks not of Hispanic origin. The number of new entry first-year students from underrepresented groups was 1679 (10.4%), of which 987 (6.1%) were blacks. The number of full-time medical school faculty was 63,991; another 130,379 were part-time and volunteer faculty. Medical school faculties also have teaching responsibility for a variety of other students, in addition to patient care and research responsibility. The average time needed to complete the curriculum requirements leading to the MD degree is 152 weeks. Twenty-two medical schools offered a combined college-medical school program. The length of these combined programs averaged 254 weeks. More than 93% of students entering medical school in 1986-1987 had completed at least four years of college. More than two fifths of students had a premedical grade point average of 3.50 or higher. The number of schools offering a Fifth Pathway Program has decreased and the number of applicants for these programs has also declined. The net attrition rate, which excludes students who withdraw temporarily to pursue advanced study or research, has remained at about 2%. Only half of 1% of students were dismissed because of poor academic standing.

A. E. Crowley, S. I. Etzel and E. S. Petersen. "Undergraduate Medical Education." JAMA. Vol. 258 No. 8, August 28, 1987
http://jama.ama-assn.org/cgi/content/abstract/258/8/1013

As far as six years, many people take more than that, especially women who decide on starting families while in medical school or those who do research and/or volunteer work abroad or at home. A year off between M2 and M3 is common too. I have not heard of the six year nationwide requirement and my school is LCME accredited.

Some states require USMLE steps 1-3 be completed within 7 years of the first step taken but not all.

 

[Dr. V]

This is not necessarily true either, especially at some P/F institutions where there is no true grading. There have been people who matched all these specialties from my school with the lowest reommendation "word" in the MSPE, our only psuedoranking......
......As far as six years, many people take more than that, especially women who decide on starting families while in medical school or those who do research and/or volunteer work abroad or at home. A year off between M2 and M3 is common too. I have not heard of the six year nationwide requirement and my school is LCME accredited.

Some states require USMLE steps 1-3 be completed within 7 years of the first step taken but not all.

Maybe my school is just different but they still have grades, number grades. Those number grades are converted to the 4.0 scale after each class and they go on your permanant record as well as any remediations.They still send out class rank and GPA on the Deans Letter as well as charts breaking down the number grades in the entire class and where you fall into that graph to show how your A's and B's etc compared to the rest of the class. The only thing that is Pass/Fail is 4th year rotations, even the third year rotations get number grades that are reported on your deans letter. I can't imagine a small, state allopathic school is that much tougher than the rest of the med schools. I just figgured we were about average.

The administration told us the 6 year requirement was a National standard and couldn't be avoided even if you got pregnant etc. which is why they didn't approve anyone going on the 5 year plan unless they absolutely had to because you never know when something unexpected happens. I don't believe the administration lied.

 

[Booyakasha]

Maybe my school is just different but they still have grades, number grades. Those number grades are converted to the 4.0 scale after each class and they go on your permanant record as well as any remediations.They still send out class rank and GPA on the Deans Letter as well as charts breaking down the number grades in the entire class and where you fall into that graph to show how your A's and B's etc compared to the rest of the class. The only thing that is Pass/Fail is 4th year rotations, even the third year rotations get number grades that are reported on your deans letter. I can't imagine a small, state allopathic school is that much tougher than the rest of the med schools. I just figgured we were about average.

It sounds like your institution is very old school. All of the top-ten places I interviewed at this past fall (Harvard, Duke, and Penn) had some sort of pass/fail system during the first two years rather than a 4.0 scale or similar means of grading. Although Penn does go from a pass/fail system to a HP/P/F after 4 months, this is certainly not A/B/C/D/F (including +/- ?). I am not sure if we will be compared to our peers as you are being compared (if we were, it wouldn't be nearly as extensive due to the nature of the grading system), but again it seems that your med school is just very traditional when it comes to grading.

Here's a quote from UVA's P/F curriculum FAQ page:

In the latest data from the AAMC, 23 of the top 25 ranked medical schools reported on their grading system in the first year. Of these 23 highly rated medical schools, 11 use P/F (48%), 6 H/P/F (26%), 2 use H/HP/P/F (9%) and 4 use A/B/C/D/F (17%). The vast majority of these schools used the same grading system for both the 1st and 2nd years.

H/HP/P/F is pretty much the same as A/B/C/D/F, but lumping those together, that highly separated style of grading is only used by 26% of the sampled med schools. A whopping 48% (almost half) use the straight P/F system during the first year, and presumably during the second year.

 

[Dr. V]

We were also required to pass step I, II and CS for graduation requirements so we had to schedule CS before December to make sure they got the results back in time to allow us to graduate.

Here is the passage out of our handbook.

"Satisfactory Academic Progress
Federal law and regulations governing the Title IV student financial assistance programs require students to maintain satisfactory academic progress in order to receive assistance..........................

1. Dismissal
a. If in the opinion of the Student Promotions Committee a student’s academic performance does not meet the institutional requirements for continuing registration, the committee may, at any regular or extra called meeting, recommend that further registration of the student be denied. Students are subject to dismissal if they have one or more F grades atany time, fail a course while on academic probation, fail a course for a second time, fail to
meet the requirements of remediation, or demonstrate any other evidence of poor academic performance.
b. The faculty believes that to be a physician positive evidence of competency is required. A student whose performance, albeit passing, is borderline or marginal in several courses will be subject to dismissal. Similarly, a student whose performance, although passing, consists of a record of multiple failures with subsequent remediation will be subject to dismissal.

4. The student must be eligible to be promoted to the junior year of the curriculum within four academic years from the date of first enrollment. An exception to this policy will occur when a student, in addition to the medical curriculum, is involved in other programs of academic study (such as study leading to a Ph.D.). In this circumstance, a student must pass all academic work attempted.
...................

B. Number of Deficiencies
1. A student who has one or more F grades is subject to being dropped from registration.
2. A student who has two deficiencies at any given time will be placed on academic probation."

It should be noted here that a deficiency is a D, not an F. It only takes one F. If you get a D (which is not good enough for advancement) and have to remediate no matter what you get, even if it's an A, the D only gets changed to a C with an asterik beside it and an explanation on your deans letter that you failed the course the first time.

I had never heard of the 6 year provision either until one of my classmates got pregnant and the other person with his problems having that provision cited to him as to why he was on such a strict time table with no vacation time and that it was a Federal law or standard etc.

I don't want anyone to think I disliked my med school or that it was malignant or TRIED to fail people. I wouldn't change where I went to med school for anything. I love the school that much, it's a great school that provides a great education and I don't think students are treated better anywhere in the US. They bent over backwards to assist a struggling student in every way they could without giving "extra credit" or other unethical things. The entire administration seemed to have the attitude of "how can we help you today" to all us med students whether we were struggling or at the top of the class (heck they even provided free tax service for us so that wouldn't be on our minds). However, AFTER you failed they still bent over backwards and tried to help the student in any way but they were very strict with dismissal interpretations for any subsequent problem, as I have already stated didn't make a habit of giving a "third" chance, if you screwed up again they dismissed the student.

Apparently not all med schools are this strict based on the information provided by other posters. I had just assumed we were the "average/normal" medical school.

I'm just saying don't count on them "not failing" anybody. You just might go to a school like mine that sincerely wanted everyone to pass and helped in every way they could but were not hesitant to pull the trigger on a dismissal after giving them a chance to shape up.

 

[Nexus777]

I know that at Stanford the majority of students take 5+ years to finish due to extra options.

This is also true for Yale, Harvard-MIT HST (even more due to the # of students who pick up a PhD), and even Columbia. Most will do non-degree granting options like an extra year of research to make their apps more competitive for top residencies. Otherwise, they are getting a dual degree (PhD, MBA, MPH, MS, etc.).

 

[Bluntman]

How can you have more chances if you are already on the 5 year or 6 year program due to research etc? You can't because it is a Federal requirement that you finish all MD degree requirements within 6 years no matter what.

Perhaps these years-off for various reasons (research/MPH/etc.) do not count towards that 6 year requirement?...cause MSTPs are already 7-9 years without causing any problems.

 

[Dr. V]

Perhaps these years-off for various reasons (research/MPH/etc.) do not count towards that 6 year requirement?...cause MSTPs are already 7-9 years without causing any problems.

Yes, when I looked in the requirements in our handbook getting a PHD allowed a student to take more than 6 years, but if you went down that road you must never have a failing grade or you are out. The exception being listed is one of the reasons I posted the exerpts from our handbook. (Not that failing would be a problem for someone qualified to get a MD/PHD except for family crisis etc).

I don't know if the "must pass all academic work attempted" clause is part of the Federal exemption to the 6 year requirement of if it is something that our school just requires above the federal requirement as someone failing in the MD/PHD program has never come up. I would have never even have known the 6 year requirement even existed if it hadn't came up for the student I know.

 

[45408]

"Look to your left. Now look to your right. Uh, Okay...now look behind you and a few rows back. Farther back. See that group in the back....now look behind them and slightly to the right...yes, in the hallway too."

"One of you is not going to be here next year."

hahaha

 

[Hope2010]

"Look to your left. Now look to your right. Uh, Okay...now look behind you and a few rows back. Farther back. See that group in the back....now look behind them and slightly to the right...yes, in the hallway too."

"One of you is not going to be here next year."

A friend of mine says that they did something similar on her first day of law school:
"Look to your left. Now look to your right. One of you is an insufferable prick. If you can't figure out who it is, then it must be you."

 

[Hoberto]

4. The student must be eligible to be promoted to the junior year of the curriculum within four academic years from the date of first enrollment. An exception to this policy will occur when a student, in addition to the medical curriculum, is involved in other programs of academic study (such as study leading to a Ph.D.). In this circumstance, a student must pass all academic work attempted.

So, 4 years to do 2 years of coursework? Sounds extremely generous to me. Not only that, but you can take additional years if you are pursing other academic study. Even with time off (Two years!) for familial catastrophes a student should be able to do this. If not, then there's something else going on.

 

[Dr. V]

So, 4 years to do 2 years of coursework? Sounds extremely generous to me. Not only that, but you can take additional years if you are pursing other academic study. Even with time off (Two years!) for familial catastrophes a student should be able to do this. If not, then there's something else going on.

I could see where it seems generous if you ignored the rest of the rules, namely that one F or two D's is grounds for dismissal from the program, if you struggle in more than just couple of classes it's grounds for dismissal even if you NEVER failed or got a D in a course, and the fact that almost nobody actually does get the 6 year option. It's also not like undergrad where it would truly be 4 years to do 2 years of coursework, if they fail a couple of classes they must repeat the entire year, so while they were only deficient in a few hours worth of course work it sets them back an entire year.

Oh yeah, something else they have there too, if you ace the first couple of exams and decide to slack off on the last couple and fail them by a few points you can get a D or an F for the course even if your average was a B. You had two failures in one course and the instructors have the right to subjectively give you the D or F regardless of your true average.