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Extensive research has identified numerous factors contributing to doctoral student dropout. However, the relative importance of these factors remains unclear. This study addresses this gap by analyzing seven years of survey data from over 5,600 doctoral students at Research Intensive University. Using a novel approach inspired by medical severity assessments, we examined the relationship between reported reasons for dropout contemplation and the intensity of such thoughts. Our findings reveal that advisor-related issues and toxic departmental environments are most strongly associated with frequent and intense thoughts of quitting, while personal reasons and exogenous factors have less impact. These insights offer valuable guidance for institutions seeking to improve doctoral retention, highlighting the need for targeted interventions in advisor-student relationships and departmental climate.