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BackgroundDespite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal.MethodsThis study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009–2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated.ResultsThe results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them.ConclusionsThis study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

The effectiveness of a pharmacist-initiated drug regimen review (DRR) in reducing the incidence of drug-related problems (DRPs), such as drug interactions, additive adverse effects and duplicate therapy, in the elderly was investigated. The medication profiles of 85 patients aged over 65 years, in an elderly care facility in South Africa, were evaluated for potential DRPs. It was found that 77 per cent of the patients were receiving one or more drugs at a dose exceeding the recommended geriatric dose. Some 68 per cent were receiving six or more drugs. Potential drug interactions and duplicate therapy were identified in 64 per cent and 34 per cent, respectively. A total of 85 pharmacist-initiated recommendations was presented to seven medical practitioners over a period of 16 weeks. Of these, 66 (77.7 per cent) met with the approval of the prescribers. Statistical interpretation of results showed that the incidence of all DRPs declined significantly post-recommendation. The cost benefit of the study was clearly illustrated by a 41 per cent reduction in the jncidence of polypharmacy (PCO.01).TWO key issues initiated the investigative research approach outlined in this paper. First, people are living longer. Projections by gerontologists indicate that the world population of persons 60 years and over will increase from 376m in 1980 to 590m in 2000 and to 967m by the year 2020. ' Secondly, drug-related problems (DRPs) are more common in the elderly than in younger patients.' This may be attributed to elderly people taking more drugs on a chronic basis compared with younger individuals. Multiple pathology and altered drug handling are also more prevalent in the elderly and further predispose them to DRPs such as drug interactions, additive side effects and duplicate therapy.DRPs may contribute to up to one third of hospital and one half of nursing home admissions If elderly patients.' The far reaching socioeconomic implications of these figures emphasise the need for quality assurance of medication therapy in such patients.Identifying the drugs that are most likely to give rise to drug-related problems is the key, since 75 3er cent of adverse drug reactions in the elderly ire avoidable.3 Psychotropics, non-steroidal antinflammatories, oral hypoglycaemics, H*-recepor antagonists, cardiovascular drugs and antilarkinsonian drugs are examples of high risk hugs, all being commonly implicated for their atrogenic complications in the elderly.4*5The role of the pharmacist in reviewing medicaion regimens is legally acknowledged in the Jnited States. Since 1974, under the Medicare md Medicaid entitlement programmes, pharmaists have been required to review the medication megimens of residents in long term care facilities In a monthly basis and to report the findings to he medical administrator.6 Since 1990, Medickid-beneficiary states in the US have been reluired to establish drug review programmes, provided by pharmacists, to ensure that prescriptions are appropriate, medically necessary and not likely to result in adverse me...

Some students struggle through medical school and do not have the confidence to seek help. This pilot study sought to explore the challenges and needs of medical students experiencing academic difficulty. Semi-structured interviews and online surveys were used to collect data from an academic advisor and thirteen medical students who had experienced academic difficulty. Unexpected academic failure and the loss of self-efficacy contributed to students hiding their academic difficulty and avoiding available support systems. Despite the sampling limitations, the findings of this pilot study have value in giving direction to future research. Programs that will change the current attitudes to academic difficulty, normalising access to support and encouraging early intervention, are needed to build the capacity for excellence among these students.