Exploring cognitive ability and non-cognitive intelligence associated with preclinical academic performance: a study of Thai medical students

Understanding factors associated with academic performance in medical students is important for optimizing admission processes and improving medical curricula. This study aimed to examine the associations between cognitive and non-cognitive factors and academic achievement during the preclinical years of medical education. A total of 194 medical students admitted in the academic years 2022 and 2023 at the Faculty of Medicine, Prince of Songkla University, Thailand, were included. Cognitive factors included pre-medical grade point average (GPA), Thai University Central Admission System (TCAS) scores, and cumulative GPA (cGPA) during the preclinical years. Non-cognitive factors, including empathy, emotional intelligence, and social awareness, were assessed by psychiatrists during admission interviews. Academic achievement was defined as passing the Thai National Licensing Examination (NLE). Associations between student characteristics, admission scores, and NLE outcomes were analyzed using the Chi-square test, Fisher’s exact test, Student’s t-test, or Mann-Whitney U test, as appropriate; a p-value of < 0.05 was considered statistically significant. Of the 194 students included in the analysis, 51.5% were male. The median pre-medical GPA was 3.87 (interquartile range [IQR]: 3.72–3.95), while the median preclinical cGPA was 3.31 (IQR: 3.00-3.55). Overall, 89.2% of students passed the Thai NLE. Students who passed the examination had significantly higher preclinical cGPAs than those who failed (p < 0.001). In multivariable analysis, a higher preclinical cGPA was independently associated with increased odds of passing the NLE (adjusted odds ratio [OR] = 1.98; 95% confidence interval [CI]: 1.58–2.70). No significant associations were observed between NLE outcomes and other cognitive factors, including pre-medical GPA and TCAS subject scores, nor with non-cognitive factors such as empathy (p = 0.948), emotional intelligence (p = 0.557), and social awareness (p = 0.887). Preclinical academic performance, as measured by cGPA, was strongly associated with success on the Thai NLE. These findings highlight the importance of preclinical education in preparing students for licensure examinations. Admission performance and non-cognitive traits were not significantly associated with NLE outcomes, which may reflect limitations in the assessment tools employed in this study.