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Demographic, situational, and scholastic factors in medical school attrition.

In an investigation of withdrawals and delays among students enrolled at the University of Tennessee College of Medicine over a four-year period, we found significantly higher rates of attrition among minority than nonminority students and among female than male enrollees. There were, however, no significant sex-related differences in the nature of delays (ie, voluntary versus involuntary) or in the timing of their occurrence within the curriculum (preclinical versus clinical). Academic problems were cited for most of the students who were required to delay or withdraw, while voluntary attrition was related to family, psychologic, and career-choice problems. When compared with successful matched control students, the study group of all delays and withdrawals had significantly higher scores on the verbal and general knowledge MCAT subtests, while the subgroup of involuntary delays had significantly lower science MCAT scores than their controls. In addition, significantly more of the successful controls had attended a superior private liberal arts college, had an undergraduate science major, and came from professional families. We suggest that these findings indicate the need for substantial revision in curricula and selection processes if we are to achieve the goal of producing well rounded physicians who are an ethnically and socioeconomically representative group.