Undergraduate Medical Student Attrition at Maseno University School of Medicine

Abstract Background Worldwide, admission into medical schools is highly competitive, and the training is very demanding. Despite having lower attrition rates than other university programmes, medical school attrition varies from as low as 3.8% to as high as 80%. Student attrition has several causes and also affects the students and other parties. Objectives The objectives of this study were to determine the attrition rates for six cohorts of students who graduated from the medical school (2018-2023) and to study the perceptions of ongoing students on the causes and effects of attrition in the medical school. Methodology The study employed a cross-sectional mixed-methods design conducted from January to March 2024. Quantitative data included student admission dates, repeats, discontinuations, progression challenges, and graduation dates and were analysed using the R programme. The results were presented as incidence and attrition rates, displayed graphically using Kaplan-Meier curves, with statistical differences assessed via the Log-Rank test. Qualitative data was collected through focused group discussions with fourth to sixth-year students. These sessions were recorded, transcribed, and analysed using Microsoft Excel. Results The mean study duration in the Bachelor of Medicine and Surgery (MBChB) programme was 70.8 months (min 3, max 112), with an attrition of 25%. Attrition increase was statistically significant between subsequent graduating cohorts (Chi sq= 24.8, 5 degrees of freedom, p= 0.0004), and direct entry students had statistically higher attrition than self-sponsored students (Chi sq= 66.1 on 1 degree of freedom, p= 0.0016). The students perceived academic difficulty, economic reasons and lack of social support as the top three causes of attrition. All indicated that the most significant effect of attrition was on the mental health of the affected student. Conclusion Student attrition at MSU is similar to other African medical schools, with a significant increase observed in our successive cohorts. Economic factors, programme difficulty, and lack of social support were cited as leading causes, aligning with global studies. Unique challenges at Maseno University School of Medicine include student accommodation during clinical years.