This study suggests that participation mediates the relationships between motivation and learning strategies, and medical school performance. However, participation and self-efficacy beliefs also made unique contributions towards performance. Encouraging participation and strengthening self-efficacy may help to enhance medical student performance.

Strong ethnic disparities exist in medical school performance even after adjusting for age, gender, pu-GPA and socio-demographic variables. More subjective grading cannot be ruled out as a cause of lower grades in clinical training, but other possible explanations should be studied further to mitigate the disparities.

The lower dropout rate of selected students is related to both self-selection of participants before the start of the selection procedure and the academic part of the selection procedure. The higher clerkship GPA of selected students is almost exclusively related to the non-academic selection criteria.