Open Access Open Badges Research article

Predictors of first-year GPA of medical students: a longitudinal study of 1285 matriculates in China

Ying-Xue Zhou1, Zhi-Tao Zhao2, Li Li1, Cheng-Song Wan1, Cheng-Hua Peng2, Jun Yang1 and Chun-Quan Ou1*

Author Affiliations

1 School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China

2 Office of Academic Affairs, Southern Medical University, Guangzhou 510515, China

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BMC Medical Education 2014, 14:87  doi:10.1186/1472-6920-14-87

Published: 23 April 2014



Although medical education has developed rapidly in the last decade, and the National College Entrance Examination (NCEE) is used as the "gold standard" for admission to medical college in mainland China, there is a lack of literature regarding the influence of NCEE score and other factors on the academic performance of medical students. This study aimed to examine potential predictors of first-year grade point average (GPA) for medical students.


This study included 1,285 students who matriculated at a first-tier medical university in mainland China in 2011. The precollege motivational attitudes for each matriculate were investigated via questionnaire. A hierarchical linear model was fitted to regress first-year GPA on a 100-point scale on NCEE score and other student-level and major-level characteristics.


NCEE score was a significant predictor of both within-major and between-major variation of first-year GPA for medical students. Majors with higher mean NCEE scores had higher mean GPAs, and higher GPAs were observed among those individuals with higher NCEE scores after controlling for major-level characteristics. First-year GPA differed by certain individual socio-demographic variables. Female students had a 2.44-higher GPA on average than did male students. NCEE repeaters had a 1.55-lower GPA than non-repeaters. First-year GPA was associated negatively with parental income but positively with academic self-concept.


NCEE score is an important predictor of the first-year GPA of medical students, but it is not the sole determinant. Individual socio-demographic characteristics and major-level characteristics should be taken into account to understand better and improve the first-year GPA of medical students.

National College Entrance Examination; First-year GPA; Medical students; China; Hierarchical linear model