Med Ed: Do weed out courses really weed out premeds?

Charlene ZhangID*, Nathan R. Kuncel, Paul R. Sackett. The process of attrition in pre-medical studies: A large-scale analysis across 102 schools. PLoS ONE 15(12): e0243546. December 28, 2020

University of Minnesota, Minneapolis, Minnesota, United States of America

There is always talk of “weeding out” pre-medical students. These authors sought to look at how much “weeding out” actually occurs and when. They used existing data collected by the College Board, analyzed a sample of 15,442 students spanning 102 institutions who began college between 2006 and 2009 (so this might be slightly dated at this point). They looked at a cohort of students that identified as premed when they took the SAT test. They looked at premedical prerequisit courses completed as a surrogate marker for continuing on the “pre-medical track”. The data is anonymous so they were not able to gather qualitative data that “explained” why certain groups discontinued their premed requirements.

They examined whether students fulfilled the required coursework to remain eligible for medical schools at several milestones: 1) one semester of general chemistry, biology, physics, 2) two semesters of general chemistry, biology, physics, 3) one semester of organic chemistry, and 4) either the second semester of organic chemistry or one semester of biochemistry and predictors of persistence at each milestone. This type of data set could not identify whether those students ultimately applied to or attended medical school, but only, whether they completed the required prerequisites. It is unclear how they took into account students who placed out with AP credit or took required courses at another institution.

First off, although this research was published in December 2020, the data is based on retrospective data from 2006-2009 which is definitely dated today. For example, they cite data that there is higher attrition among women students which may no longer hold true today when applications to medical school are approximately 50/50. There have been many changes since 2006 including a movement towards holistic admissions, expansion of post-baccalaureate programs, and decreasing medical school course requirements so it is really unclear how to apply the data to the current day admissions environment. However, I did find the conclusions backed up what is “common knowledge” and some of the data cited in the background was interesting.

They concluded that only 16.5% of students who intended to major in pre-med graduate college with the required coursework for medical schools. Attrition rates are highest initially but drop as students take more advanced courses. Predictors of persistence include academic preparedness before college (e.g., SAT scores, high school GPA) and college performance (e.g., grades in pre-med courses). Students who perform better academically both in high school and in college courses are more likely to remain eligible for medical school.

Other data I found interesting from cited studies included the following:

  • Health professions and related programs were found to be the second most popular field of study among four-year college students in 2018 - although time flies and this was now 3 years ago.

  • Demographic characteristics such as having family members who were doctors and higher family income have been found to aid with persistence. No surprises there.

  • Males and females with high levels of college performance were equally likely to apply to medical schools, females with low performance were less likely to apply than males with similarly low performance. Ouch to this one!

  • The 2019 MSQ by the AAMC reported that of the medical school matriculants, 55.3% had decided that they wanted to study medicine prior to entering college and 34.8% did so during college. So not everyone had this epiphany in childhood.

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