Med School: The Reaping

pe0068725They supposedly do this thing at the beginning of medical school:

Look to your left, look to your right. Only one of you will graduate in the allotted time.

I don’t remember them doing it for our class, three years ago. I used to think it was because they were committed to getting us all to the end of med school in one piece.

Nowadays, I think I may just have bunked that lecture. Or fallen asleep during it.

Of my original clinical group, only two of us remain. One person may not even be in my year anymore, soon.

I have seen brilliant medical students not only fail, but get excluded from their course. These are students whose notes I have used to study for exams. These are people who taught me to draw blood or put up an IV or resuscitate a patient.

I understand that medicine is a tough field. I understand that doctors hold the lives (and livelihoods) of their patients in their hands. But I have to wonder if we are assessing whether one is a “good doctor” correctly – if people like me get to stay, and people like them have to leave.

This is South Africa. We cannot afford rotten doctors. But nor can we afford to produce so terribly few doctors.

I am seeing some of the best doctors being removed from this profession before they are even part of it. And there is nothing I can do about it.


  1. It sounds like South Africa has a very different system from Canada. When I started medical school, we were told that historically 97% of the people who start medical school will graduate. That held true for my class, as all but one student (who went on maternity leave) graduated on time.

    What is the mechanism by which students get removed from medical school in South Africa?

    1. Methods for inclusion/exclusion aren’t standardized in SA, every school has her own methods.

      Ours is a complicated formula, something to do with the amount of credits you have accumulated, divided by the number of years you have studied.

      What it comes down to, is that if you fail more than one year (and to fail a year you need only fail a single module) you get excluded.

      Which seems fair, especially considering that my school prides itself on producing excellent doctors – but there are a myriad of things that complicate South African students’ university careers. When a student who graduated top of his class in high school struggles to perform at university, I believe we need to sit down and figure out what it is that’s preventing him from reaching his potential.

      1. Wow. I know a number of students in my class who’ve failed a block (1/3 of a year; presumably somewhat similar to a module in South Africa) and still been able to continue with medical school. While it’s obviously important to have high standards for doctors, I don’t think struggling with one specific area of medicine should automatically prevent someone from completing their training as long as they’re able to make up the failed material. No wonder the South African doctors who emigrate to Canada are so good.

  2. MedicalRose says:

    We definitely got that talk, about two days into the first semester of second year though. And I’d simply thought, “We’re rock stars. We’re a dedicated bunch. We’ll make it.” And then two of my close friends didn’t make it to third year. And in the Dis-hall you can literally feel the vacuum that their presence used to fill.

    I agree that no-one is asking the question of WHY top students from all over the country are failing out of med school. Which is strange, as you’d think after that ‘Creme de la Creme’ pep talk we all got in first year The Administration would be wracking their heads in confusion.

    1. Do you know that nobody said the “creme de la creme” thing at the big first-year welcoming this year? Wonder if they figure its bad karma.
      Anyway, I’d like to analyse the situation a bit more. Once my Derms test is over and the first years start class, that is.

      1. MedicalRose says:

        Really? I guess it does sort of jinx you right from the start, though. Anywho, we eagerly await the analysis. I’m eager to see something other than the conspiracy theories flying around campus…

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