Failure to fail: the institutional perspective

Med Teach. 2014 Sep;36(9):799-803. doi: 10.3109/0142159X.2014.910295. Epub 2014 May 20.


Purpose: To determine institutional barriers to placing failing students on probation, dismissing students.

Methods: An online survey study was distributed to Student Affairs Deans or the equivalent at allopathic (MD) and osteopathic (DO) medical schools, and physician assistant (PA) and nurse practitioner (NP) schools across the United States. Nineteen (40%) of the 48 schools responded: six MD, four DO, five PA and four NP. The survey contained demographic questions and questions regarding probation and dismissal. Themes were independently coded and combined via consensus based on grounded theory. The survey was distributed until saturation of qualitative responses were achieved.

Results: Respondents identified variations in the use of probation and dismissal and a wide range of barriers, with the greatest emphasis on legal concerns. Respondents felt that students were graduating who should not be allowed to graduate, and that the likelihood of a student being placed on probation or being terminated was highly variable.

Discussion: Our results suggest that institution culture at heath professions schools across the United States may represent an obstacle in placing failing learners on probation and dismissing learners who should not graduate. Additional studies are needed to prove if these concerns are founded or merely fears.

MeSH terms

  • Educational Measurement / methods*
  • Health Personnel / education*
  • Humans
  • Nurse Practitioners
  • Organizational Culture
  • Osteopathic Physicians
  • Physician Assistants
  • Physicians
  • Residence Characteristics
  • Schools, Health Occupations / organization & administration*
  • Schools, Health Occupations / standards
  • United States