This question was originally posted on Quora.com and was answered by Michael Keyes, M.D. Psychiatry, Tulane University School of Medicine (1970) It varies, of course, but for most it is the stress of getting in. Once you are in medical school in the US and Canada, you are pretty much assured of graduating because of the predictability of the course of study and mentoring. The majority of dropouts (the rate is about 3.6% across all medical schools) are due to non-academic reasons, some of them stress related but often more inter personal or circumstantial. Medical schools select their students fro a huge pool of qualified applicants and they look for qualities that will help determine if a person is suited for medical school. Core Competencies for Entering Medical Students Once in, a student is faced with an exponentially greater amount of information and skill building under stress. While this sounds awful, it is very doable for the selected group and this is proven time and again by entering classes in the 150+ medical schools in North America. This does not mean that individual student won‘t be affected significantly, but as a rule medical students deal with it. Part of this has to do with the fact that in order to be a doctor you have to be able to make decisions under (literally) life threatening stress (for the patients, though I have been threatened while performing my duties) so part of schooling is an introduction to this stress and an increasing level of independence while under stress, especially in residency. (Medical school/learning never stops and residency is the most practical intensive training. ) All that being said, getting in is still much more stressful because you have no control over what will happen after you apply even though you may have perfect GPAs and MCATs. Eleven percent fo those who do fail to get into medical school and the mean of those who do get in are in the 83rd percentile of MCAT scores and the 90th percentile of GPA. Pre-med is a grind that you have to dedicate yourself to and there is not assurance that you will succeed. (Seventeen percent of pre-med freshmen get into medical school.) It’s tougher because as a freshman you don’t have the study skills and intensity needed to be a medical student and very likely don’t have the organizational skills needed to succeed in pre-med. These have to be learned or developed through good counseling, observation, focus and smarts. Not everyone who wants to be a doctor has those qualities (See above article.). Even at the very best schools, these stressors are noticed. From a personal standpoint, the most stressful aspect of medical school was on relationships. It is hard to find time for another person (it is done all the time, however) so both of you have to have a good understanding of the stressors and the goals. It is different for each person, of course, but medical school is not designed to foster personal relationships. I, like many of my classmates, ended up marrying another doctor which reflected the limited choices I had (we have been happily married for 45 years now, but divorce rates are similar to the rest of the US, about 50%.) Hope that helps. Source
