Support groups for students at higher risk of failing

Most medical schools have a failure rate of around 5% at finals. While large medical schools  provide diversity in students, teachers, teaching methods and patients, some students - especially students who are lone workers who have not formed strong peer groups - can feel lost in the crowd.

This case study looks at initiatives created by Guy's, Kings and St Thomas' School of Medical Education to support students at higher risk of failing.

What extra support is provided?

To support students who fail, and to help them to be successful and more importantly competent and safe doctors in the future, students repeating the final year at Guy's, Kings and St Thomas' School of Medical Education are encouraged to join a supported learning group. In 2013 following a successful pilot, we started one for students coming into Phase 5 statistically more likely to fail: those disadvantaged by poor physical or mental health, previous academic failures or after interrupting their Phase 5 studies.

What type of support is provided?

Two learning sets have been established at King's: the Phoenix Group was set up as a learning support intervention for MBBS students who fail finals. The Karabiner Group was started for students entering final year identified as at risk of failing.

These names are to give a sense of corporate identity, foster a team spirit mentality and remove any resit/repeater/failed/struggling status from the group and from titles of sessions. For example rooms can be booked for The Phoenix Group as opposed to the resitters.

The groups aim to help students look at how they have been learning and address why previous techniques have not been successful. Students have additional support in:

  • exploring and improving learning strategies by reflecting on why their study skills might need altering
  • experiencing formative exams to desensitise them from previous stresses and to provide focused feedback from examiners, patients, simulated patients and peers
  • sessions with a performance coach working on voice projection, posture and confidence
  • teaching workshops in areas identified by the formative exams as where the cohort is weaker.

The students look at feedback from examinations, clinical encounters and in-course assessments, and process these with their mentor. Both groups are run by King's Undergraduate Medical Education in the Community (the department of general practice) as the one-to-one teaching style in general practice is seen as beneficial for students in this situation.


Effective teamwork

Students are strongly encouraged to work as a team supporting each other. They created their own extra-curricular programme of sessions in the evenings and at weekends, and they form their own social media groups and encourage the stragglers. All final year students attended weekly GP rotation seminars and the Phoenix Group had their own seminar group.

Independent research and annual evaluation both show that the groups themselves are the most important thing and this is fostered in new groups each year. All of the 2014 cohort of the Phoenix students said that the group was the best or most important aspect of the repeat year. The students very much appreciate being part of a small team known personally to a senior member of faculty, and knowing that they can contact her in any way.

Improved performance

Examination results for The Phoenix Group before and after completing the course were compared and showed improved performance. Evaluation of free text comments demonstrated student insight and confidence specifically about their role on graduation as junior doctors.

Future development

King's is now implementing student support much more rigorously. Assessment needs to look at all aspects of students' progression - not just the exams, and all students need encouragement to disclose learning difficulties, seek help and work with their peers. The school is also implementing new IT systems that make 'finding' these students easier.

I want to learn more

For further information, contact Ruth Sugden at

Who is this page for?
This case study will be beneficial for anyone involved in supporting students during their medical education.
Why might this page help you?
It contains useful ideas that may result in fewer students failing their finals.