The impact of admission criteria and English proficiency on medical students' academic performance in the pre-clinical phase

The correlation of medical schools preadmission criteria and subsequent student academic performance of undergraduate medical students have been investigated in several studies. This performance can also be affected by the use of English language as a medium of instruction for the non-native speaker students. In Saudi Arabia, medical students face learning difficulties due to the adoption of English language as a medium of education, although schooling is mostly in Arabic. Language barrier is considered one of the important challenges in our region. To assess medical students' performance during the pre-clinical phase based on their scores in preadmission tests and premedical English. Also, to evaluate if these factors can identify students that may be at risk of poor academic performance. Methods: This cross-sectional study was conducted at the Faculty of Medicine, King Fahad medical City (KFMC/KSAU-HS). Students' scores of preadmission tests (High school average, National Aptitude and Achievement test), final premedical English, and preclinical grade point average (GPA) were collected. Students included in the study were (n=110)) second year, and (n=87) third year medical school. Those with a medical school GPA <3 were considered poor performers. T-test, Pearson correlation, and linear regression test were used for analyses. Results: An intermediate correlation was observed between High school scores and GPA for both cohorts (p<0.05). Similar but a stronger correlation was obtained with premedical English scores. National Achievement test showed significant correlation with GPA of the 2nd year cohort only. For Aptitude test, there was no significant correlation with GPA for both cohorts (p>0.05). A prominent influence of premedical English scores on GPA was indicated by the regression analyses. Poor performers' GPA was significantly correlated with English for both cohorts. Although two of three preadmission tests showed a correlation with academic performance of Saudi medical students, they failed to have a predicative impact. However, premedical English language scores presented as a significant predictor of academic performance. Therefore, we suggest that there is a need to introduce other valid and reliable tools for admission to medical schools such as English proficiency test and well structured mini-interviews.