Risk factors associated with academic difficulty in an Australian regionally located medical school

BACKGROUND

Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal.

METHODS

This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated.

RESULTS

The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them.

CONCLUSIONS

This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

The influences of background on beginning medical students' perceptions of rural medical practice

BACKGROUND

Access to health care is an ongoing problem for underserved populations in rural and remote regions of Australia and North America. Despite medical schools educating more medical doctors, this maldistribution continues. While students entering medical programs with a rural focus purport to have an interest in rural medicine, their understanding of possible future rural practice is unclear. This study explored the differences in perception of rural practice between beginning medical students from rural and urban backgrounds to gain an indication of the usefulness of our selection process to meet the rural workforce mandate.

METHODS

Beginning medical students completed a writing exercise about the life and work of a rural medical doctor as a test of their academic writing skills. After completing the task and receiving feedback, students were invited to submit their work for analysis. Template analysis using themes from a study of rural medical registrars was used to analyse 103 scripts.

RESULTS

Students demonstrated foundational insight into some of the realities of rural life and practice. However, differences were noted in perspectives between rural background students and urban background students. Rural background students used everyday language to describe the practicalities of rural life, medical practice and the implications for families and communities. Urban background students generally used complex language and more negative descriptors.

CONCLUSIONS

Beginning medical students from urban and rural backgrounds differ in their perceptions and expression of rural practice. These outcomes are important for medical schools that use interviews in their selection process. Rural background applicants' suitability may be overlooked because of the interviewer's expectations of language, while urban background applicants may score higher related to complex language and use of key phrases. Interviewer training should address this likely bias thereby increasing the potential to recruit rural background students.