Factors associated with academic delay in the first two years of the medical program at UNAM

Background: Academic delay affects both the quality and equity of education.Identifying its associated factors, stratified by sex, is key to designing effective interventions.Objective: To assess the association between sociodemographic, mental health and lifestyle factors and academic underachievement during the first two years of medical school, stratified by sex and pandemic period.Materials and methods: A prospective cohort study was conducted with 10,866 first-year medical students (2017-2023) from the Faculty of Medicine at Universidad Nacional Autónoma de México (UNAM), followed for two years.Multivariate logistic regression models were applied, stratified by sex and pandemic period.Results: Differences were observed across the three periods in academic, sociodemographic, lifestyle, and health-related variables.Among men, older age, attending Colegio de Ciencias y Humanidades (CCH), overweight/obesity, and experiences of violence increased the risk of academic delay, whereas high previous academic performance, parental education, effective study strategies, and family support were protec-tive factors.Among women, older age, attending CCH, violence, and the combination of depression and obesity were associ-ated with higher risk, while private high school education and higher maternal education level were protective.Conclusions: Academic underachievement is influenced by sociodemographic and health factors, with sex-based differences.These findings highlight the need for tailored interventions to improve academic performance and reduce inequalities.