An analysis of the records of 41 students at risk for dismissal while studying at the George Washington University School of Medicine and Health Sciences was undertaken to identify characteristics that correlated with future success or failure. Four distinct groups were identified and their outcomes followed. The group with academic problems lacked the academic capabilities to compete successfully; 57 percent graduated. Those in the group with intrapersonal problems were hindered by personal conflicts and excessive anxiety; 71 percent graduated. The group with interpersonal problems consisted of students who did not relate effectively to professors, clinicians, physicians, or patients; 8 percent graduated. The fourth group encompassed those students who suffered both from excessive anxiety and limited academic ability; 71 percent graduated. Accepting psychotherapeutic help when recommended was related to graduation and was greatest in the group with intrapersonal problems. Seven of the eight students who threatened litigation after dismissal were from the group with interpersonal problems.