Dominic Johnson¹
Gill Vance2 and Bryan Burford²
1 Liverpool University
2 Newcastle University

A proportion of medical students each year fail their final assessments. While processes for resitting vary between medical schools, some are required to resit their entire final year. However, little is known about their experience of this (Patel, 2011). 

The work aimed to explore the experience of failing the medical degree final examination in the context of relevant theoretical models and to derive a theory that described the experience and could be used to understand and support students who fail in the future. 

A modified grounded theory approach explored how failing medical finals affected students and graduates from one medical school in the UK (Charmez, 2006) The project drew on theories of self-esteem and professional identity to examine the phenomena. 

Eighteen interviews at three time points were completed to explore the experience of resitting and the data analysed using a thematic data analysis strategy. 

It was clear from the data that the students went through a series of stages of adverse affective response, moving from shock and frustration to anger and then sadness. 

As the students re-started the year they experienced feelings of stupidity, a sense of boredom and then significant anxiety as they approached finals for the second time knowing if they failed they would not become doctors. 

However, many participants were able to process through these and tried to see the positive in the re-sitting year. This had positive effects on identity and self-esteem and led to a better sense of preparedness to be a doctor. 

This work postulates the experience as an ‘academic adjustment disorder’ (APA 2013). 

Viewing the experience as an adjustment disorder, from which students can nevertheless emerge with benefits for their ongoing education and professional development, provides new ways of approaching the processes for supporting students who fail. 

References (maximum three) 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 

Charmaz, K. (2006) Constructing grounded theory: A practical guide through qualitative research. London: Sage Publications Ltd. 

Patel, R. S. (2011) 'The experience of medical students classified as unsatisfactory at finals: A qualitative exploration of student perceptions about failure', Medical Education, Supplement, 45, p. 36.