Abstract
Background and objective Attrition in medical school remains a persistent concern, despite the use of pre-admission metrics such as undergraduate science GPA (SGPA) and Medical College Admission Test (MCAT) scores, which do not consistently predict student success in high-demand, accelerated curricula. We evaluated whether engagement in three non-mandatory academic support interventions - individual tutoring, weekly tutor drop-in sessions, and lecture attendance - was associated with improved outcomes among first-semester osteopathic medical students. Methods In this retrospective cohort study, we reviewed de-identified records for 52 matriculants (Fall 2024). Students were classified as Dismissed, Repeat, Remediate, or Passed at term end. Participation in each intervention (yes/no) and baseline metrics (MCAT, SGPA, and graduate school GPA [GSGPA]) were extracted. A chi-square test of independence examined the association between intervention use and academic outcome (α = 0.05); effect size was reported as Cramer's V. Results There was a statistically significant association between the tutor drop-in sessions and academic outcome (χ²(3) = 12.13, p = 0.007; Cramer's V = 0.48). Notably, 71% of dismissed students did not attend tutor drop-in sessions, compared to 90% of remediating and 82% of passing students who did attend. Mean SGPA was lowest among dismissed students (2.98) and highest among those who passed (3.37), while MCAT scores were relatively uniform across groups (range: 496.6 to 499.0). GSGPA, though inconsistently available, did not demonstrate a clear correlation with academic outcomes. Visual trend analyses supported the conclusion that participation in the tutor drop-in sessions was more strongly associated with successful remediation and course passage than prior academic metrics alone. Conclusions The findings underscore a robust association between student engagement in academic support interventions and positive academic outcomes. Although traditional admissions metrics provided limited differentiation among outcome groups, the presence or absence of proactive academic support engagement emerged as a meaningful predictor of student success. These results suggest that optional support models may not adequately serve students at risk for academic failure, and that institutions may benefit from implementing structured, mandatory intervention frameworks to ensure equitable access and promote academic resilience, particularly for those demonstrating early signs of academic difficulty. Prospective studies should examine optimal timing, frequency, and scalability of compulsory academic-support frameworks.