Gul Muhammad Shaikh, Rabia Khan, Rehan Khan, Rahila Yasmeen


Background: Academic failure adds extra pressure to emotional intelligence of students and this may lead to psychological disturbance. The objective of this study was to explore perception of students and teachers regarding academic failure of undergraduate medical students in Lahore, Pakistan.

Materials & Methods: This qualitative exploratory study was conducted at Department of Medical Education, University College of Medicine and Dentistry, University of Lahore, Pakistan from January 2018 to October 2018. Sample included nine MBBS students who took their last examination in year 2017 and five teachers, all from University College of Medicine and Dentistry, University of Lahore. Sampling was purposive. These nine students included five who graduated without failure and four who experienced two/more failures. Medical students were interviewed via two focus groups, whereas face to face semi-structured, audio-recorded interviews were done for teachers. Interview questionnaires were designed on basis of attribution theory. The fundamental question of study was “What are the reasons behind undergraduate medical students’ failure in annual examination?” with five more questions. The interviews were transcribed in English and sent back to participants for member checking. The interviews were organized in ATLAS.ti software for thematic analysis based on Weiner’s Attribution Theory. Open coding was done after familiarization of data, leading to formation of categories, sub-themes and themes related to our conceptual framework.

Results: 160 open codes were condensed to 35 axial codes leading to two themes. Main reasons for students’ failure in examinations perceived by both students and teachers were lack of ability, lack of effort and lack of motivation. Additionally, the students attributed bad luck to academic failure. Other factors included were teachers’ related factors, curriculum related factors and negative students’ attitude.

Conclusion: Medical institutions must take into account reasons for academic failure among medical students and address those issues to improve their performance.


Academic Failure; Medical Students; Medical Education; Focus Groups; Curriculum; Faculty; Motivation; Attitude; Pakistan.

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