Predictive Factors of Graduation Delay in a Medical Program: a Retrospective Cohort Study in Brazil, 2010-2016

Abstract

Introduction: Medical training is a long and expensive process. Admission processes are highly competitive all over the world but being accepted is no guarantee of academic success. Medical school is demanding and stressful, and some students are not able to cope with this new scenario successfully. It is estimated that 10-15% of medical students experience difficulties in adapting to the course, which can lead to academic failure. The identification of predictive factors of failure supports the creation of mechanisms and strategies to avoid course dropout or graduation delay. To identify predictive factors of academic failure in a Brazilian medical program. Methods: A retrospective observational study was carried out with all medical students admitted to a private Brazilian medical school in 2010 and 2011. The main outcome was academic success. Academic failure was defined as graduation delay or course dropout (Group 1), and academic success was defined as graduating within 6 years (Group 2). Sociodemographic and academic data were collected, including grades obtained at the admission process and the first-semester courses. Freshman students and students with passing grades in the first semester (passed students) were analyzed separately. Descriptive and comparative analyses, logistic regression and ROC curve analysis were performed. The level of significance was 0.05. Results: A total of 312 students were admitted during the study period, but 10 were excluded due to lack of information. Of the 302 students included in the study, 105 were included in Group 1 and 197 were included in Group 2. Thirty-two students failed the first semester. The 270 students with passing grades in the first semester were divided into Group 1 (n=73) and Group 2 (n=197). Among the freshman students, lower admission grades were associated with a higher chance of failure (padjusted=0.012). Of the 270 students with passing grades, low academic performance (courses’ mean grades) was associated with graduation delay (padjusted<0.001). Conclusions: Low grades at the admission process (freshman students) and low academic performance in the first semester (students with passing grades) were predictive factors of academic failure.

Fluctuation of academic performance of medical students selected by affirmative action policies (PIMESP)

“…Although the students' doings showed no problems, as there were no failures during the study period, contrary to the findings of Rocha & Júnior (2020) that low academic performance at the beginning of the course is a predictor of academic failure 32 , the item "final results" showed a significant difference at the beginning of the course, as it happened with the grades, with BC students showing better final performance than PIMESP students, proportionally, with more direct pass statuses. In this item, the behavior observed with the grade averages was once again repeated, with differences no longer being significant at the end of the second year and reappearing at the end of the third year.…”

Flutuação do desempenho acadêmico de alunos de medicina selecionados por políticas afirmativas (PIMESP)

“…Pena et al 31 , que analisaram alunos de Medicina da Universidade Federal de Ouro Preto (Ufop), ingressantes no ano de 2013, afirmam que "o desempenho acadêmico após o ingresso na universidade é equivalente entre cotistas e estudantes da ampla concorrência". Embora a movimentação do alunado não tenha apresentado problemas, visto que não houve reprovações no período estudado, contrariando achados de Rocha et al 32 de que baixo desempenho acadêmico no início do curso é um fator preditivo de insucesso acadêmico, o item "situação final" apresentou diferença significativa no início do curso, assim como aconteceu com as notas, com os alunos AC apresentando desempenho final melhor que os alunos Pimesp, proporcionalmente, com mais aprovações diretas. Nesse item, o comportamento observado com as médias das notas voltou a se repetir, com as diferenças deixando de ser significativas ao final do segundo ano e voltando a aparecer ao final do terceiro ano.…”