Psychosocial factors associated with academic performance in medical students: a systematic review

INTRODUCTION: Academic performance in medical students is influenced by a wide range of psychosocial variables, including emotional distress, motivation, emotional intelligence, and social support. Understanding how these factors relate to academic outcomes is essential for designing effective educational and mental health interventions. OBJECTIVE: To systematically evaluate the association between psychosocial factors and academic performance among medical students and to identify which determinants show the most consistent evidence across studies. METHODS: A systematic review was conducted following PRISMA 2020 guidelines. Searches were performed in PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science for studies published between 2014 and 2024. Observational studies examining psychosocial factors in relation to academic performance were included. Quality assessment was conducted using the Newcastle-Ottawa Scale. RESULTS AND CONCLUSIONS: Forty-five studies met the inclusion criteria, most of which were cross-sectional. Academic performance was evaluated through GPA/CGPA, examinations, and licensing or OSCE scores. Psychosocial variables assessed included stress, anxiety, depression, motivation, emotional intelligence, resilience, burnout, and social support. Across studies, stress, anxiety, and depressive symptoms showed predominantly negative associations with academic performance (reported in 67-80% of articles addressing these constructs), while intrinsic motivation, resilience, emotional intelligence, and perceived social support demonstrated mostly positive associations (60-85% of relevant studies). Some studies reported null findings, reflecting heterogeneity in measures, populations, and outcomes, or a true null effect. Evidence supports consistent associations between psychosocial factors and academic performance among medical students. Stress and negative emotional states are generally linked to poorer outcomes, whereas motivation, social support, emotional intelligence, and resilience tend to predict better performance. The predominance of cross-sectional designs and varied measurement tools precludes causal inference. Strengthening psychosocial resources may help improve both academic success and well-being among medical students.