Abstract
OBJECTIVE: To examine five-year trends in academic performance across four final-year clinical subjects and evaluate the relationship between pre-admission scores and university academic outcomes. It also assessed the variability in grading practices across four clinical departments. METHODS: A record-based cross-sectional study was conducted among 1584 medical graduate students (cohorts 2020-2024) at Mutah University, Jordan. Data included General Secondary School Examination (Tawjihi) scores, grades in four core clinical subjects (Internal Medicine, Surgery, Pediatrics, and Obstetrics-Gynecology) and cumulative Grade Point Average (GPA). Analysis used descriptive statistics, Pearson correlation coefficients, analysis of variance and regression models. RESULTS: Tawjihi scores showed a weak but statistically significant correlation with GPA (r = 0.257; p < 0.001). Subject grades correlated significantly with GPA (Pediatrics r = 0.810), Obstetrics-Gynecology r = 0.786, Internal Medicine r = 0.779, Surgery r = 0.628; all p < 0.001). Year-to-year differences were significant across all subjects (F = 6.84-42.44, all p < 0.001). Regression analysis revealed that the practical component (β = 0.602; p < 0.001) slightly outweighed written exams (β = 0.547; p < 0.001) in predicting final course grades. CONCLUSION: Grading variability across departments highlight the importance of standardization in clinical evaluation. These findings emphasize the need for unified assessment frameworks to enhance equity and reliability in medical education.