Increasing numbers of medical school
administrators are beginning to view such activities
as an integral component of medical education,
rather than merely an extracurricular activ-
ity. Medical schools are starting to support
such programs both financially and by granting
academic credit for community service. Some
schools are engaged in formally integrating
community service into their curricula. Schools
such as Dartmouth, University of
California (Davis), and the University of Miami
have large numbers of their first-year stu-
dents participating in community service
projects. Thousands of fourth-year students are
involved in service as community health
educators or as volunteers in clinics for under-
served populations.
Community service is also reflected in the
activities of medical students (and physi-
cians) at the hundreds of free clinics located
in urban and rural areas across the country.
Medical students can thus gain hands-on
experience under supervision in primary care.
Both this and nonmedical-oriented service
projects offer students an opportunity for a
brief respite from the rigors of formal
lectures, labs, and exams. It also serves as a
reminder about the humanitarian goals of
medicine as a caring profession.
Legislation that is part of the National
Community Service Trust Act supports the
award of grants to schools to facilitate
service learning. The extent of funding for this
and similar programs remains uncertain in an
era of budget tightening.
ATTRITION IN MEDICAL SCHOOL
If you have been accepted to a U.S. medical
school, you are one of a select group of stu-
dents who have survived the successive academic
prunings of elementary school, high
school, college, and medical school selection
procedures. In addition, you rank in the
upper 50% of all students entering graduate and
professional schools. Medical schools
seek to graduate as many of their entrants as
possible; therefore you stand a better
chance of successfully completing your medical
education than students in other profes-
sional schools in the United States or medical
students in practically every other coun-
try. While the attrition rate in American
professional schools is relatively high, that for
medicine has consistently been relatively low.
Nevertheless, any loss of medical stu-
dents is a loss to society and is especially
painful when one considers the many quali-
fied applicants who were rejected and thus
denied an opportunity to study medicine.
It is therefore encouraging to report that the
overall dropout rate has remained very
low over the years. The withdrawals from the
total student enrollment in a recent year
were 751, or 1.85% of the enrollment. Moreover,
even this figure may in reality be artifi-
cially high because one-fifth of the students
(143, or 0.35%) withdrew to pursue
advanced study and are expected to return to
medical school. In addition, less than one-
third of the withdrawals or dismissals (223)
were for academic reasons, the remainder
(385, or 1%), for other reasons, making, in
actuality, the true attrition rate closer to 0.5%.
This means that admissions committees have been
able to select from the large pool of
qualified applicants those most likely to
succeed. If accepted, you should feel confident
that with consistent hard work you will most
likely complete your course of studies.
An analysis of student records over an extended
period has provided significant
information regarding the relationship of
various student characteristics to attrition that
can help you assess your own chances for
success and indicate when extra care and
effort may be called for. Successful students
are more likely to have attended an under-
graduate college with a sizable premedical
program that they found to be both difficult
and competitive. The premedical grades of
academic dropouts are substantially lower
than are the grades of both successful students
and nonacademic dropouts. The average
test scores for dropouts are much lower than
those of successful students. Unsuccessful
students report almost twice as many personal
problems as do successful students. Older
students have a much higher dropout rate than
do younger ones. Women have a some-
what higher attrition rate than men have. It
should be noted, however, that studies have
shown that the academic dropout rate was the
same for both sexes but the dropout rate
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