Background. The majority of 1st-year students are ill-equipped for university life. This heightens stress levels, which are accentuated by a lack of resilience and impact negatively on academic performance and personal wellbeing. Objectives. To explore, within the paradigm of positive psychology, the relationship between the self, family and support constructs of fortitude, and academic performance of 1st-year medical students. Method. First-year medical students completed a fortitude questionnaire and their academic performances in two academic modules were collated. Mann-Whitney and Kruskal-Wallis tests were employed for statistical analysis of the variables. Pearson correlation coefficients were calculated to assess the relationship between academic performance and fortitude subscales, as well as the fortitude composite score. Results. The student population was multicultural, multilingual and had different educational and residential backgrounds. The fortitude instrument was found to be reliable and correlated significantly with student academic performance. Male students had significantly higher fortitude scores than female students. Students who had attended state/government schools had significantly lower fortitude than those who had attended private and ex-Model C schools. Students with prior degrees had higher fortitude than matriculants. Conclusion. The significant, albeit moderate, positive correlation between fortitude and academic performance highlights the need for further exploration of wellbeing and holistic development of medical students. Support programmes are recommended to bridge the gap related to gender and educational background. Low and fair levels of fortitude indicate a need for corrective measures. These could include consulting relevant support networks such as student counsellors, mentors and academic development personnel.