Dropping out of medical school in the UK: explaining the changes over ten years

Context In the context of changing admissions criteria and an expanding medical school intake in the UK, we analysed the determinants of the medical school dropout probability. Objectives We aimed to analyse the determinants of the probability that a student will drop out of medical school during Year 1 and to compare the results of this analysis over time. Methods We carried out logistic regression analysis for the 6 intake cohorts of 1990–92 and 1998–2000. Results Between 1990–92 and 1998–2000, there were substantial increases in both the size of the entry cohort and the proportion of students dropping out of medical school. A logit model for the 1990–92 and 1998–2000 cohorts reveals that the probability of dropping out depended on both the medical school attended and the personal characteristics of the student, including academic preparedness. Almost none of the increase in the dropout rate between the 2 cohort groups 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 medical school, and a growing mismatch between student and school characteristics. Testing between these competing hypotheses is left for future work.