Aims. Educational performance of medical students are affected by many factors and recognizing the educational drop-out risk factors is necessary. This study carried out in order to assess academic performance of medical alumni of Kashan University of medical sciences and its related factors.

  Methods. In a cross sectional study, 586 medical alumni of KUMS from 1986 to 2003 were selected by headcounting. A questionnaire including demographic characteristics and educational performance of alumni (grades averages of basic sciences, pathophysiology, externship and internship courses and final average of medical faculty) was used. The means of grades averages of each of educational periods in faculty were assessed separately and were spotted as cut-off points in statistical analysis. In each of educational periods, average grades less than mean were assigned as unacceptable performance (case group). Data was analyzed using odds ratio and percent difference.

  Results. Grades average for basic sciences, pathophysiology, externship and internship courses and final average of medical faculty was 15.13±1.47, 14.60±1.53, 15.42±1.25, 17.31±0.95, and 15.74±1.10, respectively. Prevalence of unacceptable performance in basic sciences, pathophysiology, externship and internship courses was 41, 42.7, 43 and 37.7%, respectively. Based on final average of faculty, 278 persons (47.4%) had unacceptable performance. Conquerration, marital status, sex and delay in university entrance were introduced as the major influencing factors.

  Conclusion. Unacceptable performance in university seems to be common. It is recommended to revise the strategies for accepting students to the university and to support vulnerable students.