Dropping out of medical school in the UK: Explaining changes over 10 years

1 2 BACKGROUND In the context of changing admissions criteria and an expanding medical school intake in the UK, we analyse the determinants of the medical school dropout probability. AIMS To analyse the determinants of the probability that a student will drop out of medical school during their first year. To compare the results of this analysis over time. there was a substantial increase both in the size of the entry cohort and in the proportion of students dropping out of medical school. A logit model for the 1990-92 and the 1998-2000 cohorts reveals that the probability of dropping out depends on both the medical school attended and the personal characteristics of the students, including academic preparedness. Almost none of the increase in the dropout rate between the two cohorts can be explained by changes in observable characteristics of the students over this period. Instead, most of the increase in the dropout rate is associated with changes at the level of the institution and in unobserved student characteristics. CONCLUSIONS University effects, rather than changes in observed student characteristics, explain most of the increased dropout rate over the time period considered. Candidate explanations behind these effects include: less effective admissions policies; changing curricula, greater costs of attending 3 medical school and a growing mismatch between student and school characteristics. Testing between these competing hypotheses is left for future work. OVERVIEW What is already known on this subject Recent years have seen increases in the number of students entering UK medical schools and in the proportion dropping out. What this study adds For the 1990-92 and 1998-2000 cohorts we find the probability of dropping out of medical school is lower for students (i) with better prior qualifications, (ii) with a parent who is a doctor, (iii) living on campus. Despite the richness of our data, we find the increase in the dropout rate is mostly explained by changes in unobserved characteristics of students and medical schools. Future work should consider the influence of: admissions policies; changing curricula; social integration, and medical school fees. 5 1. INTRODUCTION In earlier work published in this Journal we investigated the factors affecting the probability of dropping out in the first year of medical school for the full populations of UK medical students over the period 1980 to 1992. 1 However, since 1992 many changes have taken place which are likely to have impacted on dropout probabilities, …