When are students most at risk of encountering academic difficulty? A study of the 1992 matriculants to US medical schools

The authors carried out the study reported here to assess which variables a re most predictive of the risk of medical students' experiencing academic d ifficulties and to assess when these students are most susceptible to encou ntering those difficulties. The entering class of 1992 was chosen as the st udy population because it was the first matriculating class in which the ma jority of students (88%) applied to medical school with Scores from the rev ised Medical College Admission Test (MCAT), first implemented in 1991. The primary event of interest in this study was the first occurrence of one of the following events because of academic difficulty: withdrawal, leave of a bsence, dismissal, or delay of graduation date. The variables examined were MCAT scores, undergraduate science GPA, undergraduate institutional select ivity, undergraduate major, racial-ethnic background, sex, and age upon ent ering medical school. Survival analysis was used to assess which variables were most predictive of the risk of academic difficulty and when students w ith different characteristics were most at risk. The results of the survival analysis indicated that (1) while the risk and timing of academic difficulty varied across the groups studied, a majority of the students who experienced academic difficulty eventually graduated fr om medical school; and (2) students with non science undergraduate majors d id not have a greater risk of academic difficulty. The results confirm prev ious findings that increased risk of academic difficulty is associated with low MCAT scores, low science GPA, low undergraduate institutional selectiv ity, being a woman, being a member of a racial-ethnic underrepresented mino rity, or being older. The study findings can be generalized to help in early identification of-st udents who are more likely to be at risk of experiencing academic difficult y Knowing when these students are more likely to be at risk can help medica l schools develop targeted remedial and enrichment programs. Further studie s are needed to investigate school-related factors associated with risk.