Demographic and academic characteristics of first-year medical students with low academic performance across face-to-face, online, and HyFlex Learning: A seven-year single-center study.

Maria Milagros U Magat, MD, MEM; Jennifer M Nailes, MD, MSPH; Vinna Marie T Quinones, MD

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Demographic and academic characteristics of first-year medical students with low academic performance across face-to-face, online, and HyFlex Learning: A seven-year single-center study.

Author: Maria Milagros U. Magat, MD, MEM ¹ ; Jennifer M. Nailes, MD, MSPH ² ; Vinna Marie T. Quinones, MD ³
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1. Department of Biochemistry, College of Medicine, University of the East Ramon Magsaysay Memorial Medical Center Inc.
2. Department of Preventive and Community Medicine, College of Medicine, University of the East Ramon Magsaysay Memorial Medical Center Inc.
3. Department of Medical Humanities, College of Medicine, University of the East Ramon Magsaysay Memorial Medical Center Inc.
Publication Type:Journal Article
Keywords: National Medical Admission Test (NMAT); Grade point average (GWA); Online learning; HyFlex learning
MeSH: Students, Medical; Academic performance; Education, Distance;
From: Health Sciences Journal 2026;15(1):45-51
CountryPhilippines
Language:English
Abstract: Introduction:Medical student attrition and poor academic performance have implications for both medical schools and the future healthcare workforce. This study aimed to determine the demographic and academic characteristics of first-year medical students with low academic performance across different instructional modalities—traditional face-to-face, online, and HyFlex learning.
Methods:This non-concurrent cohort study included first-year medical students enrolled from School Years (SY) 2018–2019 to 2024–2025. Student characteristics analyzed included sex, pre-medicine degree, pre-medicine general weighted average (GWA), National Medical Admission Test (NMAT) score, and academic performance in annual first-year subjects. Low academic performance was defined as failure in at least one annual subject. Students were grouped according to instructional modality: face-to-face (SY 2018–2020), online (SY 2020–2022), and HyFlex (SY 2022–2025). Demographic and academic characteristics were compared between students with and without low academic performance.
Results:A total of 2,936 first-year medical students were included. The proportion of students with low academic performance was 19% during the face-to-face period, 17% during the online period, and 27% during the HyFlex period. Across all instructional modalities, students with low academic performance had significantly poorer pre-medicine GWA than students who passed all annual subjects (p<0.05). During the online and HyFlex periods, students with low academic performance also had significantly lower NMAT scores than students who passed all annual subjects (p<0.05), whereas no significant difference in NMAT scores was observed during the face-to-face period.
Conclusion:Pre-medicine GWA was consistently associated with academic performance across face-to-face, online, and HyFlex instructional modalities. Lower NMAT scores were associated with low academic performance during online and HyFlex learning. Early identification of students with poorer pre-medicine academic performance and lower NMAT scores may facilitate timely academic support.
Full text:2026072117152819761HSJ vol.15 no.1 - 45-51.pdf