Answer to "What is the influence of medical schools on increasing and reducing the number of students in difficulty?"
There are several risk factors that can influence the number of students in difficulty. The culture and processes of the medical school that can influence these risk factors include selection into medical school and the curriculum.
Most medical schools select students based on their academic performance in high-stakes assessments, particular in science subjects, since it is associated with academic success at university. However, these students may not have the resilience skills to cope with the various stressors at medical school.
The increasing trend to admit students from ‘widening access to medicine’ schemes may lead to the admission of students with lower levels of academic achievement and these students may struggle with both the academic content and the social culture of the medical school.
A range of factors, such as lower marks in the pre-clinical course, non-white ethnicity, and males offered a late place, are at increased risk of academic underperformance and may present with difficulties.
The wide variety of emotionally challenging clinical encounters and the repeated assessment of personal / professional behaviours and academic performance can be highly stressful to some students.
Effective approaches to reduce the number of students in difficulties require consideration of the policies and practices of the medical school, especially in admissions and examination. The availability of student support at key times of transition is important, such as entry to medical school, times of summative assessment, beginning of clinical training and around high emotional challenge clinical encounters (eg palliative care)
Ferguson, E., James, D., & Madeley, L. (2002). Factors associated with success in medical school: systematic review of the literature. Bmj, 324(7343), 952-957.
Finucane, P. M., Bourgeois-Law, G. A., Ineson, S. L., & Kaigas, T. M. (2003). A comparison of performance assessment programs for medical practitioners in Canada, Australia, New Zealand, and the United Kingdom. Academic Medicine, 78(8), 837-84
Woolf, K., McManus, I. C., Potts, H. W., & Dacre, J. (2013). The mediators of minority ethnic underperformance in final medical school examinations. British Journal of Educational Psychology, 83(1), 135-159
Yates, J., & James, D. (2006). Predicting the “strugglers”: a case-control study of students at Nottingham University Medical School. Bmj, 332(7548), 1009-1013.
Yates, J., & James, D. (2007). Risk factors for poor performance on the undergraduate medical course: cohort study at Nottingham University. Medical Education, 41(1), 65-73.