{"id":73282,"date":"2026-04-07T08:00:31","date_gmt":"2026-04-07T00:00:31","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/taps\/?post_type=issues&#038;p=73282"},"modified":"2026-04-07T08:25:38","modified_gmt":"2026-04-07T00:25:38","slug":"impact-of-intimate-relationships-on-medical-undergraduate-performance-and-extracurricular-activities","status":"publish","type":"issues","link":"https:\/\/medicine.nus.edu.sg\/taps\/issues\/impact-of-intimate-relationships-on-medical-undergraduate-performance-and-extracurricular-activities\/","title":{"rendered":"Impact of intimate relationships on medical undergraduate performance and extracurricular activities"},"content":{"rendered":"<p>Submitted: 21 June 2024<br \/>\r\nAccepted: 18 November 2025<br \/>\r\nPublished online: 7 April, TAPS 2026, 11(2), 32-39<br \/>\r\n<a href=\"https:\/\/doi.org\/10.29060\/TAPS.2026-11-2\/OA3446\">https:\/\/doi.org\/10.29060\/TAPS.2026-11-2\/OA3446<\/a><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-GB\">Prabodha De Silva<sup>1<\/sup>, Kavishan De Silva<sup>1<\/sup>, Supun Deshapriya<sup>1<\/sup>, Sachini Dewagiri<sup>1<\/sup>, Uthpali Dhammadinna<sup>1<\/sup>, Kasun Bandara Ekanayake<sup>2<\/sup> &amp; Amal Nishantha Vadysinghe<sup>2<\/sup><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: justify;\"><i><sup><span lang=\"EN-GB\">1<\/span><\/sup><\/i><i><span lang=\"EN-GB\">Faculty of Medicine, University of Peradeniya, Sri Lanka; <\/span><\/i><i><sup><span lang=\"EN-GB\">2<\/span><\/sup><\/i><i><span lang=\"EN-GB\">Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka<\/span><\/i><\/p>\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-GB\">Abstract <\/span><\/b><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Introduction:<\/span><\/b><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">University students may be influenced by intimate relationships (IR) and extracurricular activities (EA), which can impact academic performance (AP). This study assessed the effects of IR and EA on the AP of medical undergraduates.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Methods:<\/span><\/b><span lang=\"EN-GB\"> A cross-sectional study was conducted among 253 medical undergraduates at the <\/span><span lang=\"EN-GB\">University of Peradeniya, Sri Lanka. Data was collected using an online self-administered questionnaire. AP was evaluated using the cumulative grade point average (cGPA) from the previous semester.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Results:<\/span><\/b><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Of the 253 participants, 110 (43.5%) were involved in IR and 143 (56.5%) were single; 56.9% were female. Among participants in relationships, 44.5% had partners within the same faculty. There was no significant association between involving in an IR and AP (p=0.651), regardless of the other variables of IR. Most participants (51.8%) believed EA had no impact on AP, and analysis showed no significant association between EA and AP (p=0.394). Economic status of participants was positively associated with their AP (p=0.015). The prevalence of IPV in IR was 18.2% (7.9% of the total sample), with psychological type being the most prominent. Out of those in relationships, 18.2% reported experiencing IPV, of whom 75.0% were male and 25.0% were female, possibly due to underreporting by females. However, there was no significant association between experiencing IPV and AP (p=0.534).<\/span><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Conclusions:<\/span><\/b><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Although involvement in IR and EA did not significantly affect AP, the presence of IPV highlights the need for targeted interventions. Males were more likely to report IPV than females, emphasising the importance of support programs.<\/span><b><span lang=\"EN-GB\"><\/span><\/b><\/p>\r\n<p style=\"text-align: justify;\"><b><span lang=\"EN-GB\">Keywords<\/span><\/b><b><span lang=\"EN-GB\">:<\/span><\/b><span lang=\"EN-GB\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <i>Academic Performance, Demographic Data, Intimate Relationships, Extracurricular Activities, Medical Education, Medical Undergraduates<\/i><\/span><b><span lang=\"EN-GB\"><\/span><\/b><\/p>\r\n<p align=\"center\"><strong><span lang=\"EN-GB\">Practice Highlights<\/span><\/strong><\/p>\r\n<ul>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">There was no significant association between academic performances and intimate relationships.<\/span><\/li>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Extracurricular activities didn\u2019t show any impact on academic performances. <\/span><\/li>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">No significant association was observed between intimate partner violence and academic performance. <\/span><\/li>\r\n\t<li style=\"text-align: justify;\"><span lang=\"EN-GB\"> <\/span><span lang=\"EN-GB\">Males were more likely to experience intimate partner violence than females.<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: center;\"><strong>I. INTRODUCTION<\/strong><\/p>\r\n<p style=\"text-align: justify;\">Intimate relationships (IR) include, but are not limited to, heterosexual\/homosexual romantic relationships. IR can have a significant impact on the university life of medical students. Medical undergraduates represent a unique population because their training requires them to fulfil high academic demands. Unlike many other undergraduate groups, medical students have limited time for leisure or personal life. These challenges make them particularly vulnerable to stressors arising from balancing IR with academic commitments.<\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">Studies have shown that medical students in IR often experience higher levels of stress, anxiety, and depression than their single counterparts (Dyrbye et al., 2006). This is likely due to the demanding nature of medical school and the pressure to balance academic and personal responsibilities. Additionally, medical students in IR may have a harder time maintaining boundaries and achieving work-life balance. They may also have difficulty finding time for their relationship due to the demands of medical school and clinical rotations.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">However, some studies suggest that healthy IRs shown to have a positive impact on students in healthcare professions (Avci et al., 2022). Being in a relationship can provide emotional support, which can be beneficial for coping with the stress of medical education. Additionally, having a partner can provide a sense of social support, which can help medical students feel less isolated and lonely. Despite the potential challenges, many medical students can successfully navigate IR while in medical school. Even so, to prevent the potential harmful impact of IRs, medical schools need to provide support and resources for students in relationships, such as counselling services and relationship awareness programs.<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">A Sri Lankan study found that 52% of the participants who were university students were engaged in romantic relationships (Gunawardena et al., 2012). Therefore, it&#8217;s crucial to understand how these relationships impact their university experience. The majority of studies regarding IRs were focused on violence towards intimate partners, and there was an overall lack of relevant literature when it came to the effects of IRs as general on academic performances (AP). Previous studies have identified vulnerabilities among university students, particularly young women, who are at increased risk of experiencing unwanted sexual attention (Forke et al., 2008) and unhealthy or stressful IRs (Hayden et al., 2016). These findings highlight the importance of further research into how such relational factors may influence AP. A study from the United States involving over 6800 female undergraduates revealed that there is an indirect link between physical and psychological intimate partner violence (IPV) and academic disengagement via depression symptoms (Schrag et al., 2020). Furthermore, American studies involving over 84,000 subjects found that undergraduates experiencing IPV were more likely to have increased academic difficulties (N. Brewer et al., 2018) as well as health impairments (N. Q. Brewer &amp; Thomas, 2019).<\/span><\/p>\r\n<p style=\"text-align: justify;\">These findings suggest that IPV and its consequences may be particularly relevant for medical students, who already face high academic stress. Therefore, exploring not only the general influence of IRs but also the potential academic impact of IPV is essential in understanding the relationship between students\u2019 personal and academic lives. The University of Peradeniya, being one of the largest public universities in Sri Lanka, attracts students from diverse regions and socioeconomic backgrounds. Its academically rigorous environment provides a suitable context to study how interpersonal and extracurricular factors relate to AP. The objective of this study was to examine the association between involvement in IR, AP and extracurricular activities (EA) among the medical undergraduates of the University of Peradeniya, Sri Lanka.<\/p>\r\n<p style=\"text-align: center;\"><strong>II. METHODS<\/strong><\/p>\r\n<p style=\"text-align: justify;\">A descriptive cross-sectional study with an analytical component was conducted with the participation of 2018\/19 (3rd year), 2019\/20 (2nd year) and 2020\/21 (2nd year) batches enrolled at the Faculty of Medicine, University of Peradeniya, Sri Lanka. The senior-most batches were excluded because they were engaged in clinical rotations at external hospitals, making it logistically difficult to ensure their participation. The sample size was calculated based on a total population of 707 students from the 2018\/19, 2019\/20, and 2020\/21 batches. Using a conservative proportion (p=0.5), a 95% confidence level (z=1.96), and a 5% margin of error (e=0.05), the minimum required sample size was 249.<\/p>\r\n<p style=\"text-align: justify;\">A self-administered questionnaire was newly developed to assess the study objectives. It included sections on demographic factors (age, gender, economic status), IR status, partner characteristics, AP, and EA. Items related to IPV assessed physical, psychological, and combined abuse using Yes\/No questions. The questionnaire was pilot tested to ensure clarity and reliability. Economic status was self-reported by participants and categorised as less than 50,000 LKR (1 USD = 323 LKR at the time of data collection in August 2023), between 50,000\u2013100,000 LKR and above 100,000 LKR. IR included romantic relationships, heterosexual or homosexual, in the duration of the last semester&#8217;s work. IPV types were specified as physical, mental or both. EA were defined as participation in university clubs, sports, arts or other organised student activities.<\/p>\r\n<p style=\"text-align: justify;\">Data collected using the questionnaire, via Google Forms, was entered into a Microsoft Excel spreadsheet and analysed using IBM SPSS Statistics 26. Normality of the data collected was assessed, and non-parametric tests (Chi-square tests) were used accordingly. Microsoft Excel was used to calculate a cumulative Grade Point Average (cGPA) value for examination results up to the last semester, based on the university\u2019s 0.000 to 4.000 grading scale. Before administering the questionnaire, written informed consent was obtained from each participant. The ethical approval for the study was obtained from the Ethics Review Committee (2023\/EC\/SP\/38) of the Faculty of Medicine, University of Peradeniya, Sri Lanka.<\/p>\r\n<p style=\"text-align: center;\"><strong>III. RESULTS<\/strong><\/p>\r\n<p style=\"text-align: justify;\">Data was collected from 253 medical undergraduates enrolled in 2018\/19, 2019\/20 and 2020\/21 batches of the Faculty of Medicine, University of Peradeniya, Sri Lanka.<\/p>\r\n<p><em>A. Socio-Demographic Profile<\/em><\/p>\r\n<p style=\"text-align: justify;\">The age of the sample ranged from 19 to 26 years, with a mean age of 23.2 years. The sample included 144 females (56.9%) while males accounted for 43.1% (n=109) respondents. Among the 3 batches considered, the 2018\/19 batch had the highest number of responses, which amounted to 33.9% (n=86). Respondents from the 2020\/21 batch amounted to 33.2% (n=84) while the 2019\/20 batch had 32.8% (n=83) respondents. When considering the economic background of the family, 58 subjects (22.9%) represented the group earning less than 50,000 LKR per month, followed by 90 subjects (35.6%) earning 50,000-100,000 LKR per month and 105 subjects (41.5%) earning more than 100,000 LKR per month.<\/p>\r\n<p style=\"text-align: justify;\">Out of 253 respondents, 110 respondents (43.5%) claimed that they were involved in IR during the last semester. Out of the females in the sample, 58 subjects (40.3%) were involved in an IR during the last semester. Among the 110 subjects who were involved in IR, 67 respondents (60.1%) had their partners in the same university, and 49 of them (44.5%) in the same medical faculty as the subjects. Only 43 (39.0%) claimed to have partners outside the university, including in other universities (34, 30.9%), another residential area (8, 7.2%) and in the health training sector (1, 0.9%).<\/p>\r\n<p style=\"text-align: justify;\"><em>B. Academic Performance<\/em><\/p>\r\n<p style=\"text-align: justify;\">When the Shapiro-Wilk test was applied to the total sample of 253, the distribution of cGPA significantly deviated from a normal distribution (p&lt;0.001). Therefore, the median (3.200) of the cGPA of respondents was used as a cut-point for assessing AP, differentiating between high-performing and low-performing, instead of the mean (3.065). More than half of the samples (58.1%) had a cGPA of 3.000 or more, while only 7.9% had a cGPA of less than 1.500.<\/p>\r\n<p style=\"text-align: justify;\">Of the 110 respondents involved in IR, 57 (51.8%) scored lower than a cGPA of 3.200, while 73 (51.0%) of the respondents who were not involved in any IRs scored at or above a cGPA of 3.200 (Table 1). However, this finding was not statistically significant (p=0.651, OR=1.12, 95% CI: 0.68\u20131.84). The mean cGPA for respondents involved\/not involved in IRs was calculated, and respondents who were in an IR had a mean cGPA of 3.05, in contrast to a mean cGPA of 3.08 of the respondents with no involvement in IRs.<\/p>\r\n<div align=\"center\">\r\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"567\" style=\"width: 85.0899%; height: 41px;\" height=\"311\">\r\n<tbody>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"132\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-US\">Relationship Status<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"170\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Low performing<\/span><\/b><\/p>\r\n<p align=\"center\"><b><span lang=\"EN-US\">(cGPA&lt;3.200)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"189\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">High performing<\/span><\/b><\/p>\r\n<p align=\"center\"><b><span lang=\"EN-US\">(cGPA&gt;=3.200)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"75\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 11px;\">\r\n<td width=\"132\" style=\"height: 11px;\">\r\n<p style=\"text-align: center;\"><span lang=\"EN-US\">Involved in IR<\/span><\/p>\r\n<\/td>\r\n<td width=\"170\" style=\"height: 11px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">57 (51.8%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"189\" style=\"height: 11px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">53 (48.2%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"75\" style=\"height: 11px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">110<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"132\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><span lang=\"EN-US\">Not involved in IR<\/span><\/p>\r\n<\/td>\r\n<td width=\"170\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">70 (49.0%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"189\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">73 (51.0%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"75\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">143<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"132\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"170\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">127 (50.2%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"189\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">126 (49.8%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"75\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">253<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p align=\"center\"><span lang=\"EN-US\">Table 1. Impact of IR on AP<\/span><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">Considering the 144 female respondents, 31 performed low in academics whilst being in a relationship, and 40 female students who weren\u2019t involved in IRs performed relatively low in academics. Among high performing females, the majority (63.0%) were not involved in IRs during the last semester. In contrast, high-performing males were more evenly distributed, with 49.1% not in IRs and 50.9% involved in IRs (Table 2). However, the association of AP with gender and IR was not statistically significant (p=0.275; OR=1.45, 95% CI: 0.74\u20132.84). Economic status was also analysed in relation to AP, and a statistically significant positive association was observed (p=0.015), indicating that students from higher economic backgrounds were more likely to achieve higher cGPA scores.<\/span><\/p>\r\n<div align=\"center\">\r\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\" style=\"width: 84.7714%; height: 140px;\" height=\"345\">\r\n<tbody>\r\n<tr style=\"height: 100px;\">\r\n<td width=\"145\" rowspan=\"2\" style=\"height: 110px;\">\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-US\">Relationship Status<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"185\" colspan=\"2\" style=\"height: 100px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Low performing<\/span><\/b><\/p>\r\n<p align=\"center\"><b><span lang=\"EN-US\">(cGPA&lt;3.200)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"189\" colspan=\"2\" style=\"height: 100px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">High performing<\/span><\/b><\/p>\r\n<p align=\"center\"><b><span lang=\"EN-US\">(cGPA&gt;=3.200)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"76\" rowspan=\"2\" style=\"height: 110px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"92\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Male<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Female<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Male<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Female<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"145\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><span lang=\"EN-US\">Involved in IR<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">24 (44.4%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">31 (43.7%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">28 (50.9%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">27 (37.0%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"76\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">110<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"145\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><span lang=\"EN-US\">Not involved in IR<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">30 (55.6%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">40 (56.3%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">27 (49.1%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">46 (63.0%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"76\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">143<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"145\" style=\"height: 10px;\">\r\n<p style=\"text-align: center;\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">54<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">71<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">55<\/span><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">73<\/span><\/p>\r\n<\/td>\r\n<td width=\"76\" style=\"height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">253<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p align=\"center\"><span lang=\"EN-US\">Table 2. AP according to gender and relationship status<\/span><\/p>\r\n<div>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">Out of the 110 participants who were involved in an IR, the majority (63, 57.3%) of respondents believed it to have a positive impact on their AP, while 8 (7.3%) believed that it had negatively affected their AP and 39 subjects (35.5%) believed that there is no significant impact. Among the 110 respondents with an intimate partner, 54 (49.1%) stated that they do not miss any academic work in their coursework, and 49 (44.5%) respondents stated that they have missed academic work due to their relationship. There was no significant association between missing academic work and AP (p=0.226; OR=1.67, 95% CI: 0.76\u20133.64) (Table 3).<\/span><\/p>\r\n<div align=\"center\">\r\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"612\" style=\"width: 83.6454%; height: 135px;\" height=\"568\">\r\n<tbody>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"312\" colspan=\"2\" rowspan=\"2\" style=\"height: 75px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">\u00a0<\/span><\/p>\r\n<\/td>\r\n<td width=\"208\" colspan=\"2\" style=\"height: 65px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Academic Performance<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"92\" rowspan=\"2\" style=\"height: 75px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 93px;\">\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Low performing<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">High performing<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"198\" rowspan=\"5\" style=\"height: 50px; text-align: center;\">\r\n<p style=\"text-align: center;\"><span lang=\"EN-US\">Have you ever missed a lecture\/clinical appointment\/practical\/tutorial due to the relationship?<\/span><\/p>\r\n<\/td>\r\n<td width=\"113\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">No<\/span><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">30<\/span><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">24<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">54 (49.1%)<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"113\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Yes, about 1-4<\/span><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">15<\/span><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">22<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" rowspan=\"3\" style=\"height: 30px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">49 (44.5%)<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"113\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Yes, about 5-9<\/span><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">5<\/span><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">5<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"113\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Yes, more than 10<\/span><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">1<\/span><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">1<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"113\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Don&#8217;t know<\/span><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">6<\/span><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">1<\/span><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><span lang=\"EN-US\">7 (6.3%)<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 65px;\">\r\n<td width=\"312\" colspan=\"2\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"109\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">57<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"99\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">53<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"92\" style=\"height: 10px; text-align: center;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">110<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p align=\"center\"><span lang=\"EN-US\">Table 3. Number of academic work sessions missed due to IR<\/span><\/p>\r\n<p style=\"text-align: justify;\"><em>C. Extracurricular Activities<\/em><\/p>\r\n<p style=\"text-align: justify;\">Among the participants who were involved in IR, 58 (52.7%) had engaged in EA before the relationship started, and 65 (59.1%) were currently engaged in EA during the duration of the relationship. In the sample, 8 subjects (7.3%) stated that they have stopped EA due to the current IR. The subjects have claimed that 44 (40.0%) have a positive impact, 9 (8.2%) have a negative impact and no impact on 57 (51.8%) from IR on EA.<\/p>\r\n<p style=\"text-align: justify;\">Among the 65 respondents involved in both IR and EA, 25.5% were academically performing better while being engaged in EA, whereas 33.6% were performing lower academically while being engaged in EA (Table 4). There was no significant impact between participating in EA and AP (p=0.394; OR=0.61, 95% CI: 0.28\u20131.30).<\/p>\r\n<\/div>\r\n<\/div>\r\n<div align=\"center\">\r\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"529\" style=\"width: 80.8185%; height: 50px;\" height=\"338\">\r\n<tbody>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"142\" rowspan=\"2\" style=\"width: 26.8797%; height: 20px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Participated in extracurricular activities<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"292\" colspan=\"2\" style=\"width: 54.8872%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Academic Performance<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"95\" rowspan=\"2\" style=\"width: 25.5639%; height: 20px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"151\" style=\"width: 28.3835%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Low performing<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"141\" style=\"width: 26.5038%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">High performing<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"142\" style=\"width: 26.8797%; text-align: center; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">No<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"151\" style=\"width: 28.3835%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">20 (18.2%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"141\" style=\"width: 26.5038%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">25 (22.7%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"width: 25.5639%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">45 (40.9%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"142\" style=\"width: 26.8797%; text-align: center; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Yes<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"151\" style=\"width: 28.3835%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">37 (33.6%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"141\" style=\"width: 26.5038%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">28 (25.5%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"width: 25.5639%; height: 10px;\">\r\n<p align=\"center\"><span lang=\"EN-US\">65 (59.1%)<\/span><span lang=\"EN-US\"><\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 10px;\">\r\n<td width=\"142\" style=\"width: 26.8797%; text-align: center; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"151\" style=\"width: 28.3835%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">57 (51.8%)<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"141\" style=\"width: 26.5038%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">53 (48.2%)<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"95\" style=\"width: 25.5639%; height: 10px;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">110<\/span><\/b><b><span lang=\"EN-US\"><\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p align=\"center\"><span lang=\"EN-US\">Table 4. Impact of EA on AP<\/span><\/p>\r\n<div>\r\n<p style=\"text-align: left;\"><i><span lang=\"EN-US\">D. Intimate Partner Violence<\/span><\/i><\/p>\r\n<p style=\"text-align: justify;\"><span lang=\"EN-US\">Out of the 110 respondents who were involved in relationships, 20 subjects (18.2%) had experienced some form of IPV, which included 15 males (75.0% of IPV victims) and 5 females (25.0% of IPV victims)<\/span><span lang=\"EN-US\"> (Table 5). This was 7.9% of the original sample of 253 students. Among the 20 victims of IPV, mental IPV was the most prevalent single type, with 15 respondents (75.0%) being victims. Only 2 respondents (10.0%) stated that they had experienced physical IPV, while 3 respondents (15.0%) had experienced both physical and mental IPV. Out of the 20 respondents who experienced IPV, 8 (40.0%) were high performers. There was no statistically significant association between IPV and AP (p=0.534, OR=0.54, 95% CI: 0.17\u20131.77). These findings, particularly the higher proportion of male IPV victims, should be interpreted with caution and reported sensitively, as they challenge common gender-related assumptions about IPV.<\/span><\/p>\r\n<div align=\"center\">\r\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" style=\"width: 78.3513%; height: 50px;\" height=\"406\">\r\n<tbody>\r\n<tr style=\"height: 79px;\">\r\n<td width=\"208\" rowspan=\"2\" style=\"height: 20px; text-align: center; width: 41.9924%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Have you ever experienced IPV within your relationship?<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"189\" colspan=\"2\" style=\"height: 10px; width: 38.3354%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Frequency<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"96\" rowspan=\"2\" style=\"height: 20px; width: 19.546%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 79px;\">\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Male<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Female<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 79px;\">\r\n<td width=\"208\" style=\"height: 10px; text-align: center; width: 41.9924%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">Yes<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">15 (13.6%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">5 (4.5%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"96\" style=\"height: 10px; width: 19.546%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">20 (18.2%)<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 79px;\">\r\n<td width=\"208\" style=\"height: 10px; text-align: center; width: 41.9924%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">No<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">37 (33.6%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">53 (48.2%)<\/span><\/p>\r\n<\/td>\r\n<td width=\"96\" style=\"height: 10px; width: 19.546%;\">\r\n<p align=\"center\"><span lang=\"EN-US\">90 (81.8%)<\/span><\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 79px;\">\r\n<td width=\"208\" style=\"height: 10px; text-align: center; width: 41.9924%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">Total<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">52 (47.3%)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"94\" style=\"height: 10px; width: 19.1677%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">58 (52.7%)<\/span><\/b><\/p>\r\n<\/td>\r\n<td width=\"96\" style=\"height: 10px; width: 19.546%;\">\r\n<p align=\"center\"><b><span lang=\"EN-US\">110<\/span><\/b><\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p align=\"center\"><span lang=\"EN-US\">Table 5. Incidence of IPV in IR<\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<\/div>\r\n<\/div>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">A summary of the main analyses is shown in Appendix 1.<\/span><\/p>\r\n<p style=\"text-align: center;\"><strong>IV. DISCUSSION<\/strong><\/p>\r\n<p style=\"text-align: justify;\">The current study compares AP and EA of Sri Lankan medical undergraduates involved in IR. Compared with previous studies in South Asia, the mean age and gender distribution of this cohort were generally consistent, with a majority of female students, aligning with regional trends (Nawaz, Hussain, Sarwar, Afzal, &amp; Gilani, 2018; Rashid, Hassan, Bhat, &amp; Bhat, 2021; Wijekoon et al., 2017). Socioeconomic distribution was also comparable, with over 40% of participants coming from families with urban-level income (Department of Census and Statistics, 2022).<\/p>\r\n<p style=\"text-align: justify;\">Only 43.5% of respondents reported being in a relationship during the previous semester, slightly lower than reported in some university studies internationally (McLaughlin, 2015). Regarding EA, no significant association with AP was found, consistent with findings from a Nigerian study (Umar et al., 2010). EA encompasses a broad spectrum of activities, and its impact may vary: sports may enhance time management and stress reduction, whereas social engagements may aid networking but reduce study time. In the present study, most participants believed that EA did not influence their AP, suggesting that either their engagement in a level that does not affect AP or that medical students can maintain AP regardless of EA involvement in EA. While no significant association was found between involvement in IR and AP, relationships can provide emotional support and stress relief, which may benefit AP and EA (Avci et al., 2022).<\/p>\r\n<p style=\"text-align: justify;\">Mental IPV was the most prevalent type among those reporting any IPV (75.0% of IPV victims; 7.9% of the total sample), which is lower than figures reported in studies from the USA and Iraq (Al-Atrushi et al., 2013; Wood et al., 2020). Interestingly, the majority of IPV victims in this study were male, which contrasts with common assumptions and previous research where females are often reported as the primary victims. This finding should be interpreted with caution, as cultural and social factors may contribute to underreporting among females due to stigma, fear, or social desirability bias. Conversely, male victims may feel more comfortable reporting IPV in anonymous surveys. No significant association was found between IPV and AP, possibly because medical undergraduates are relatively homogenous regarding age, academic motivation, and coping strategies (K\u00f6tter et al., 2017). Cultural and methodological differences likely account for discrepancies in IPV prevalence across studies.<\/p>\r\n<p style=\"text-align: justify;\">When comparing the findings of this study with previous studies, contextual and methodological differences may have accounted for observed discrepancies. As an example, the prevalence of IPV in this sample was lower than that of studies in the USA and Iraq (Al-Atrushi et al., 2013; Wood et al., 2020) which may reflect differences in cultural norms regarding reporting and social acceptability. Furthermore, the cited studies often included larger or more heterogeneous student populations, including non-medical undergraduates, limiting the variability in academic outcomes and relationship experiences.<\/p>\r\n<p style=\"text-align: justify;\">A Scottish study found that their female participants performed better academically than males (Lumsden et al., 2005). The same finding was reported in single studies from Sri Lanka, Germany, Turkey, Scotland and Saudi Arabia (Dayio\u011flu &amp; T\u00fcr\u00fct-A\u015fik, 2007; De Silva et al., 2004; De Silva et al., 2006; Haidinger et al., 2005). There was no significant association between one\u2019s gender and their AP within this study. This may be due to selection bias inherent in medical school admissions, as students are already filtered through competitive examinations and represent a relatively homogenous group of high achievers. Additionally, coping strategies and time management skills may be well-developed in both male and female medical students, further reducing gender-related variation in performance.<\/p>\r\n<p style=\"text-align: justify;\"><em>A. Limitations<\/em><\/p>\r\n<p style=\"text-align: justify;\">This study evaluated heterosexual and homosexual romantic relationships but not the other types of interpersonal relationships, which may have different impacts on AP and EA. Although only current relationships during the previous semester were considered, the lasting effects of past relationships were not considered, which may have a long-term psychological impact on AP. This study excluded the two senior-most batches enrolled in the Faculty of Medicine, University of Peradeniya. Therefore, this study could not compare whether the gravity of the effect of IR had any difference between the most senior batches who could have more stable or long-term IRs and different levels of AP. This study also could not evaluate the level of involvement in EA in an objective manner using a proper grading system for various competitive levels. This limits the ability to detect associations between the level of commitment in EA and AP. Lack of validated techniques for the evaluation of the impact of IR on EA was one of the limitations faced in the study, which could have underestimated such impacts. The questionnaire used in this study was not formally validated, which may affect the reliability and generalisability of the responses. This study did not assess the participants\u2019 English language proficiency, which could influence AP, since many undergraduates receive their pre-university education in their native language, and the transition to English can be a considerable challenge.<\/p>\r\n<p style=\"text-align: justify;\">Additionally, the small subsample for IPV (n=20) may have underpowered the detection of associations between IPV and AP. Future studies could address these limitations by including all batches of students to capture variations in IR and AP, employing validated questionnaires to assess IPV, IR dynamics, and EA involvement.<\/p>\r\n<p style=\"text-align: center;\"><strong>V. CONCLUSION<\/strong><\/p>\r\n<p style=\"text-align: justify;\">This study highlights the importance of supporting the psychosocial well-being of medical undergraduates, particularly in relation to IR and IPV. Implementing counselling services, peer-support networks, and stress management programs can help students navigate IR-related challenges while maintaining AP. The findings also highlight the need for awareness and prevention strategies addressing IPV among young adults. Expanding similar research to other faculties and universities could support evidence-based interventions, contributing to a better understanding of how interpersonal relationships affect student well-being and academic success worldwide.<\/p>\r\n<p style=\"text-align: center;\"><strong>Notes on Contributors<\/strong><\/p>\r\n<p style=\"text-align: justify;\">Prabodha De Silva contributed to the conception and design of the work; the acquisition, analysis, and interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Kavishan De Silva contributed to the conception and design of the work; the acquisition, analysis, and interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Supun Deshapriya contributed to the conception and design of the work; the acquisition, analysis, interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Sachini Dewagiri contributed to the conception and design of the work; the acquisition, analysis, interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Uthpali Dhammadinna contributed to the conception and design of the work; the acquisition, analysis, interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Kasun Bandara Ekanayake contributed to the conception and design of the work; the acquisition, analysis, interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: justify;\">Amal Nishantha Vadysinghe contributed to the conception and design of the work; the acquisition, analysis, interpretation of data for the work; drafting the work and revising it critically for important intellectual content and approved the final manuscript submission.<\/p>\r\n<p style=\"text-align: center;\"><strong>Ethical Approval<\/strong><\/p>\r\n<p style=\"text-align: justify;\">All procedures performed in the study were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Before data collection, written informed consent was obtained from each participant. Ethical approval (2023\/EC\/SP\/38) for this project was granted by the Ethics Review Committee, Faculty of Medicine, University of Peradeniya, Sri Lanka.<\/p>\r\n<p style=\"text-align: center;\"><strong>Data Availability<\/strong><\/p>\r\n<p style=\"text-align: justify;\">The data that supports the findings of this study are available from the corresponding author, ANV, upon reasonable request.<\/p>\r\n<p style=\"text-align: center;\"><strong>Funding<\/strong><\/p>\r\n<p style=\"text-align: justify;\">This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.<\/p>\r\n<p style=\"text-align: center;\"><strong>Declaration of Interest<\/strong><\/p>\r\n<p style=\"text-align: justify;\">The authors declare that they have no competing interests.<\/p>\r\n<p style=\"text-align: center;\"><strong>References<\/strong><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Al-Atrushi, H. H., Al-Tawil, N. G., Shabila, N. 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Prediction of success in the first-year exam in the study of medicine \u2013 A prospective survey. <i>Wiener Klinische Wochenschrift, 117<\/i>, 827-832. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1007\/s00508-005-0477-x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1007\/s00508-005-0477-x<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Hayden, K., Graham, M., &amp; Lamaro, G. (2016). A cross-sectional study examining the extent of unwanted sexual attention and unhealthy intimate relationships among female university students. <i>Health Promotion Journal of Australia, 27<\/i>(2), 134-139. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1071\/HE15113\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1071\/HE15113<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">K\u00f6tter, T., Wagner, J., Br\u00fcheim, L., &amp; Voltmer, E. (2017). Perceived medical school stress of undergraduate medical students predicts academic performance: An observational study. <i>BMC Medical Education, 17<\/i>, 256. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1186\/s12909-017-1091-0\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1186\/s12909-017-1091-0<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Lumsden, M. A., Bore, M., Millar, K., Jack, R., &amp; Powis, D. (2005). Assessment of personal qualities in relation to admission to medical school. <i>Medical Education, 39<\/i>(3), 258-265. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1111\/j.1365-2929.2005.02087.x\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1111\/j.1365-2929.2005.02087.x<\/span><\/a><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\"><\/span><span lang=\"EN-GB\">McLaughlin, N. (2015). An analysis of the effect of relationship status on self-esteem and academic performance. <i>Scholars: Journal of Undergraduate Research, 25<\/i>. \u00a0<\/span><span lang=\"EN-US\"><a href=\"https:\/\/www.mckendree.edu\/academics\/scholars\/mclaughlin-issue-25.pdf\"><span lang=\"EN-GB\">https:\/\/www.mckendree.edu\/academics\/scholars\/mclaughlin-issue-25.pdf<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Nawaz, K., Hussain, M., Sarwar, H., Afzal, M., &amp; Gilani, S. A. (2018). Determine the factors influencing absenteeism among nursing students. <i>Journal of Health, Medicine and Nursing, 50<\/i>(7), 64-72. <\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Rashid, S., Hassan, A. U., Bhat, I. H., &amp; Bhat, G. M. (2021). Analyzing the attitude of medical students toward class absenteeism. <i>National Journal of Clinical Anatomy, 10<\/i>(4), 226-231. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.4103\/NJCA.NJCA_52_20\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.4103\/NJCA.NJCA_52_20<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Schrag, R. V., Wood, L., &amp; Busch-Armendariz, N. (2020). Pathways from intimate partner violence to academic disengagement among women university students. <i>Violence and Victims, 35<\/i>(2), 227-245. <\/span><span lang=\"EN-US\"><a href=\"http:\/\/dx.doi.org\/10.1891\/%20VV-D-18-00173\"><span lang=\"EN-GB\">http:\/\/dx.doi.org\/10.1891\/%20VV-D-18-00173<\/span><\/a><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Umar, S. S., Shaib, I. O., Aituisi, D. N., Yakubu, N. A., &amp; Bada, O. (2010). The effect of social factors on students\u2019 academic performance in Nigerian tertiary institutions. <i>Library Philosophy and Practice, 2010<\/i>, 1-19. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/digitalcommons.unl.edu\/cgi\/viewcontent.cgi?article=1342&amp;context=libphilprac\"><span lang=\"EN-GB\">https:\/\/digitalcommons.unl.edu\/cgi\/viewcontent.cgi?article=1342&amp;context=libphilprac<\/span><\/a><\/span><span lang=\"EN-US\"> <\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Wijekoon, C. N., Amaratunge, H., de Silva, Y., Senanayake, S., Jayawardane, P., &amp; Senarath, U. (2017). Emotional intelligence and academic performance of medical undergraduates: A cross-sectional study in a selected university in Sri Lanka. <i>BMC Medical Education, 17<\/i>(1), 1-11. \u00a0<\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1186\/s12909-017-1018-9\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1186\/s12909-017-1018-9<\/span><\/a><\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\"><span lang=\"EN-GB\">Wood, L., Voth Schrag, R., &amp; Busch-Armendariz, N. (2020). Mental health and academic impacts of intimate partner violence among IHE-attending women. <i>Journal of American College Health, 68<\/i>(3), 286-293. <\/span><span lang=\"EN-US\"><a href=\"https:\/\/doi.org\/10.1080\/07448481.2018.1546710\"><span lang=\"EN-GB\">https:\/\/doi.org\/10.1080\/07448481.2018.1546710<\/span><\/a><\/span><span lang=\"EN-US\"> <\/span><span lang=\"EN-GB\"><\/span><\/p>\r\n<p style=\"text-align: left;\">*Amal Nishantha Vadysinghe <br \/>\r\nDepartment of Forensic Medicine, <br \/>\r\nFaculty of Medicine, University of Peradeniya, <br \/>\r\nPeradeniya, Sri Lanka <br \/>\r\n+94779117011<br \/>\r\nEmail: amal_vadysinghe@yahoo.com<\/p>\r\n<\/div>\r\n<\/div>\r\n<\/div>","protected":false},"featured_media":0,"parent":0,"menu_order":5,"template":"","issues_category":[12],"archive_category":[],"issue_type":[24],"volume_category":[],"class_list":["post-73282","issues","type-issues","status-publish","hentry","issues_category-original-articles","issue_type-current-issue"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Impact of intimate relationships on medical undergraduate performance and extracurricular activities - The Asia Pacific Scholar<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/taps\/issues\/impact-of-intimate-relationships-on-medical-undergraduate-performance-and-extracurricular-activities\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Impact of intimate relationships on medical undergraduate performance and extracurricular activities - The Asia Pacific Scholar\" \/>\n<meta property=\"og:description\" content=\"Submitted: 21 June 2024 Accepted: 18 November 2025 Published online: 7 April, TAPS 2026, 11(2), 32-39 https:\/\/doi.org\/10.29060\/TAPS.2026-11-2\/OA3446 Prabodha De Silva1, Kavishan De Silva1, Supun Deshapriya1, Sachini Dewagiri1, Uthpali Dhammadinna1, Kasun Bandara Ekanayake2 &amp; 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