School of Medicine, College of Medicine and Health, Brookfield Health Sciences Complex, University College Cork, College Road, Cork, Ireland.
BMC Med Educ. 2013 Jan 31;13:13. doi: 10.1186/1472-6920-13-13.
Medical school attrition is important--securing a place in medical school is difficult and a high attrition rate can affect the academic reputation of a medical school and staff morale. More important, however, are the personal consequences of dropout for the student. The aims of our study were to examine factors associated with attrition over a ten-year period (2001-2011) and to study the personal effects of dropout on individual students.
The study included quantitative analysis of completed cohorts and qualitative analysis of ten-year data. Data were collected from individual student files, examination and admission records, exit interviews and staff interviews. Statistical analysis was carried out on five successive completed cohorts. Qualitative data from student files was transcribed and independently analysed by three authors. Data was coded and categorized and key themes were identified.
Overall attrition rate was 5.7% (45/779) in 6 completed cohorts when students who transferred to other medical courses were excluded. Students from Kuwait and United Arab Emirates had the highest dropout rate (RR = 5.70, 95% Confidence Intervals 2.65 to 12.27;p < 0.0001) compared to Irish and EU students combined. North American students had a higher dropout rate than Irish and EU students; RR = 2.68 (1.09 to 6.58;p = 0.027) but this was not significant when transfers were excluded (RR = 1.32(0.38, 4.62);p = 0.75). Male students were more likely to dropout than females (RR 1.70, .93 to 3.11) but this was not significant (p = 0.079).Absenteeism was documented in 30% of students, academic difficulty in 55.7%, social isolation in 20%, and psychological morbidity in 40% (higher than other studies). Qualitative analysis revealed recurrent themes of isolation, failure, and despair. Student Welfare services were only accessed by one-third of dropout students.
While dropout is often multifactorial, certain red flag signals may alert us to risk of dropout including non-EU origin, academic struggling, absenteeism, social isolation, depression and leave of absence. Psychological morbidity amongst dropout students is high and Student Welfare services should be actively promoted. Absenteeism should prompt early intervention. Behind every dropout statistic lies a personal story. All medical schools have a duty of care to support students who leave the medical programme.
医学院学生的淘汰率很重要——进入医学院校是很困难的，高淘汰率会影响医学院校的学术声誉和教职员工的士气。然而，更重要的是学生退学带来的个人后果。我们研究的目的是考察在十年期间（2001-2011 年）与淘汰率相关的因素，并研究学生退学对个人的影响。
本研究包括对已完成的五个队列进行定量分析和对十年数据进行定性分析。数据来自于学生个人档案、考试和录取记录、离职面谈和员工面谈。对连续的五个已完成的队列进行了统计学分析。对学生档案中的定性数据进行了转录，并由三位作者进行了独立分析。对数据进行了编码和分类，并确定了关键主题。
在排除转学到其他医学课程的学生后，当将学生从科威特和阿拉伯联合酋长国排除在外时，这五个已完成的队列中有 5.7%（45/779）的淘汰率。与爱尔兰和欧盟学生相比，来自科威特和阿拉伯联合酋长国的学生淘汰率最高（RR = 5.70，95%置信区间 2.65 至 12.27；p < 0.0001）。与爱尔兰和欧盟学生相比，北美的学生淘汰率更高；RR = 2.68（1.09 至 6.58；p = 0.027），但当排除转学时，这一比率并不显著（RR = 1.32（0.38，4.62）；p = 0.75）。男生比女生更容易退学（RR 1.70，0.93 至 3.11），但这并不显著（p = 0.079）。有 30%的学生缺勤，55.7%的学生学习困难，20%的学生社交孤立，40%的学生出现心理困扰（高于其他研究）。定性分析揭示了孤立、失败和绝望等反复出现的主题。只有三分之一的辍学学生寻求学生福利服务。
虽然淘汰率往往是多因素的，但某些危险信号可能会提醒我们注意淘汰的风险，包括非欧盟出身、学业困难、缺勤、社交孤立、抑郁和请假。辍学学生的心理困扰率很高，应该积极推广学生福利服务。缺勤应促使及早干预。每个淘汰统计数据背后都有一个个人故事。所有医学院校都有责任照顾离开医学课程的学生。
