Introduction: In the context of the modern educational process, accompanied by a high intensity of intellectual work, one of the most important tasks of school medicine specialists is to support, maintain and improve cognitive skills of schoolchildren as the main predictors of academic success. Objective: The study aimed to give a physiological and hygienic characteristic of cognitive functions determining academic success of schoolchildren aged 15–17 years under conditions of various schooling intensity. Materials and methods: We conducted a time study to assess schooling intensity of 250 pupils of a multidisciplinary lyceum (Group 1) and 274 pupils of a comprehensive school (Group 2) and evaluated their academic performance. Computer testing was used to study the functional state of the central nervous system, mental performance and cognitive skills of the schoolchildren. Results: We established higher grade point averages in key disciplines among Group 1 students with high schooling intensity (class 3.1) compared to those in Group 2 with optimal intensity of the educational process (class 1). We found that high academic performance in Group 1 was attributed to the optimal functional state of the central nervous system characterized by stabilization of nervous processes and a better ability of the nervous system to form the adaptive functional system of the body in response to various stimuli; to the dominance of the left cerebral hemisphere in 61.2 % of the students, which determined mature skills of verbal, abstract, logical and analytical thinking in 51.9–93.5% of the students; high speed of mental activity and concentration of voluntary attention promoting cognitive activity and maintaining normal mental performance of the schoolchildren. Conclusions: Our findings contribute to a better understanding of the processes of adaptation of schoolchildren to various factors of school environment and learning to be used within the development of school medicine when organizing educational activities of students at schools with an intensive learning regime in order to promote academic performance and achieve high efficiency of the educational process within physiological capabilities of children and adolescents. At the same time, from physiological and hygienic points of view, assessment of cognitive skills in children and teenagers by means of medical and psychological testing in educational establishments implementing profile training of various difficulty levels can become an effective diagnostic tool in predicting academic performance of students and help resolve issues of prevention of maladjustment and stress at school.

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