Determinants of academic performance among medical students in Egypt: a multi-center cross-sectional study

Academic performance is a critical determinant of career opportunities for medical students. This study aimed to identify the socio-demographic, institutional, and social factors associated with academic achievement among medical students across Egypt's diverse university systems.

A multi-center cross-sectional study utilizing an online survey was conducted from January to May 2025, involving 751 medical students from 38 public, private, and Al-Azhar universities across Egypt. Academic performance was measured using self-reported cumulative percentage. Multivariable linear regression was used to analyze the relationships between academic performance and various predictive factors.

The mean cumulative percentage for the cohort was 85 (SD = 8.96). In the final multivariable model, lower academic performance was significantly associated with being male (unstandardized coefficient (B) = -1.77, 95% CI = -3.03, -0.52), attending an Al-Azhar university compared to a public one (B = -5.75, 95% CI = -8.23, -3.26), and living in student housing vs. with family (B = -3.31, 95% CI = -4.68, -1.94). Conversely, higher academic performance was significantly associated with receiving parental support (B = 2.06, 95% CI = 0.03, 4.08) and being from a medical school in the Lower Egypt region compared to Urban Governorates (B = 1.94, 95% CI = 0.49, 3.38).

Academic performance among Egyptian medical students is significantly influenced by a combination of institutional, demographic, and social support factors, which appear more impactful than traditional socioeconomic markers in this cohort. These findings highlight potential systemic inequities and emphasize the need for targeted educational interventions and policy review to ensure a fair and supportive learning environment for all students.