Factors Shaping Learning Enthusiasm of the Medical Students: A Comparative Study of Eight-Year and Five-Year Programs

Background: Understanding the drivers of medical students’ learning enthusiasm is crucial amid concerns about the physician workforce. This study compares China’s five-year and eight-year medical programs, focusing on curriculum design and the effectiveness of assignments. Objective: To compare learning enthusiasm between the two programs and analyze how assignment design and curriculum influence active learning and critical thinking. Methods: A cross-sectional study surveyed 504 medical students (98 eight-year, 406 five-year) using the Self-Assessment Scale for Active Learning and Critical Thinking (SSACT). Results: Significant differences emerged between five-year and eight-year students in geographical origin (χ 2 = 22.11, P < 0.001, Cramer’s V = 0.209) and program preference (χ 2 = 67.26, P < 0.001, Cramer’s V = 0.366). Eight-year students were more often from provincial capitals (39.80% vs 17.98%) and had chosen their program as a first preference (88.78% vs 68.23%), with stronger clinical career commitment (57.14% vs 36.45%). Lecture engagement was higher in the eight-year cohort. The assignment evaluation showed that both groups invested more than 5 hours per week. Review writing showed differences between the two groups (χ 2 = 22.49, P < 0.001, Cramer’s V = 0.212), but eight-year students found it more meaningful (49.49% vs 28.07%). Using the reliable SSACT (Cronbach’s α = 0.892), eight-year students scored higher in active learning (managing study, P = 0.037; summarizing discussions, P = 0.025) and critical thinking (formulating questions, P = 0.034; generating solutions, P = 0.014; connecting knowledge, P = 0.018; developing hypotheses, P = 0.004). Conclusion: Assignment overload and limited self-study time in the current model may undermine critical thinking and active learning. Reforms should balance task quality with volume to better support educational goals. Keywords: learning enthusiasm, medical and clinical students education, curriculum design, problem-based learning, critical thinking, SSACT evaluated learning enthusiasm