Abstract
Background. In the context of the modernization of higher medical education, the formation of an individual educational trajectory for each learner is of particular importance, as it enables the adaptation of the educational process to the personal needs, interests, and professional goals of students. Elective disciplines (EDs) serve as a tool for implementing such trajectories. However, their impact on the academic performance of medical students and their preparation for the licensing exam remains insufficiently studied. Aim: to determine the relationship between participation in elective disciplines at the Department of Pathophysiology and the academic performance of medical faculty students in the core course “Pathophysiology,” as well as their performance on the relevant section of the licensing exam “Krok 1.” Materials and methods. The study involved 404 students of the Faculty of Medicine No. 1 at Bogomolets National Medical University who, during the 2024/2025 academic year, took both the final exam in Pathophysiology and the Pathophysiology subtest of the integrated licensing exam “Krok 1.” The sample was divided into two groups: the “ED+” group (n=136), who had completed the electives “Introduction to Clinical Pathophysiology” and/or “Cytophysiology with Elements of Pathophysiology,” and the “ED-” group (n=268), who had not enrolled in any electives. Additional comparisons were made based on gender, form of study (state-funded vs. contract), source of prior education (secondary school vs. junior specialist diploma), and re-enrolment status. For statistical analysis, final scores in the Pathophysiology course (on a 200-point scale) and percentage scores on the Pathophysiology subtest of “Krok 1” were used. Results. Students who took EDs demonstrated higher scores in Pathophysiology (median = 158.5) compared to those who did not (median = 150; p<0.05). The positive effect was significant among male students, where the absence of EDs corresponded with the lowest results (Me=142; p<0.05). Higher academic achievement was observed among state-funded students, regardless of ED participation. Junior specialists who completed EDs performed at the same level as students who had entered after completing full secondary education (p>0.05), while junior specialists without EDs had significantly lower results (by 32.5 points; p<0.05). Among ED+ students, the median score on the “Krok 1” Pathophysiology subtest was 86.4%, while in the ED– group it was 81.8% (p<0.001). The proportion of unsuccessful test-takers (<64%) was 7.4% in the ED+ group versus 16% in the ED– group (p<0.05), with a 2.14-fold increased risk of failure in the absence of EDs. Conclusion. Studying elective disciplines at the Department of Pathophysiology contributes to improved academic performance in the core subject and reduces the risk of unsatisfactory outcomes on the licensing examination. EDs are particularly effective for students in at-risk groups (contract students and junior specialists), highlighting their value as a compensatory educational tool