Medical student attrition in Poland: a four-year retrospective administrative study of formal discontinuation at a large medical university

Abstract Background. Failure to complete medical studies matters for students, universities, and health workforce planning, yet the comparability of published rates is limited by differing definitions and observation periods. The aim of this study was to describe the frequency and distribution of formal removals from the student register in a medical degree programme across consecutive academic years and stages of study, the characteristics of the affected cases, the grounds for these decisions recorded in the Dean's Office documentation, and the recorded use of social support and selected university resources. Methods. A single-centre, retrospective, descriptive study of anonymised administrative data from the 2020/2021–2023/2024 academic years was conducted. Of 470 source records, 165 cases of non-commencement of studies and 13 transfers to other medical universities were excluded. The analysis included 292 cases of formal removal from the register, involving 291 students. Percentages were calculated against annual student denominators for each year of study; the combined denominator comprised 15,059 annual observations, not unique individuals. Results. The overall rate of formal removal was 1.9% of annual observations, ranging from 1.3% to 2.4% across academic years. The highest rate was recorded in Year 1 (235/2,760; 8.5%); Year 1 cases accounted for 80.5% of all removals. The most common administratively recorded ground was failure to pass required courses (73.6%), while in 24.0% of cases no ground for removal was recorded. Women accounted for 60.6% of cases, and Polish citizens for 91.4%. Conclusions. Formal removals from the register were concentrated in Year 1, where the rules in force did not provide for the usual possibility of repeating the year or for conditional progression after failing an examination or course. The findings support early, multidimensional support and the standardisation of how the grounds and circumstances of discontinuation are recorded. Full-cohort studies tracking students from admission to completion are needed to estimate the cumulative probability of non-completion.