Original Article

The Effect of Marital Status on Academic Performance of Medical

Students: A Cross-sectional Study
Tahira Raza, M. Wagar Sharif, Noor-e-Fatima, Shafaq Shezad

ABSTRACT
Objective: To measure association of demographics of medical students with attitude towards affect of marriage on education.
Study Design: Cross-sectional study
Place of Study: CMH Lahore Medical College, Lahore.
Methodology: Students from all years of the MBBS, house officers and post graduate trainees were included in this study. Data was collected
through two semi structured questionnaire designed, validated and reliability was assessed by reliability analysis using chronbach alpha which
was 0.80. Information from married and unmarried subjects was collected separately. Data was entered and analyzed by using statistical package
for social sciences (SPSS version 22.0). Descriptive statistics for qualitative data was calculated in form of frequencies and percentages whereas
descriptive statistics for quantitative data were calculated in the form of mean and standard deviation. Chi-square test of significance was used
to see association, ifany between marriage and academic performance. P-value < 0.05 was considered statistically significant.
Results: Total response rate was 92.5%. Mean age of unmarried respondents was 23.50 + 1.86. Mean age at marriage of females was 22.52+2.47
and for males it was 22.78+1.95.The gender distribution of the unmarried respondents was 31.6% male and 68.4 % female while among married
respondents there were 37.5% male and 62.5% female. Significant association was found between marriage and better academic performance (p
=0.001). More female married respondents were of the view that they wish they had not married before graduation, significant value of (p= 0.04)
was obtained. Sixty seven point seven(67.7%) unmarried respondents thought that their married colleagues were happy; 84.9% said that they
feel more relaxed as compared to their married colleagues. Eighty four point nine (84.9%) said they would marry after graduation. Eighty one
point seven (81.7%) unmarried respondents were of the view that marriage clashes with the study.
Conclusion: Marriage has beneficial effects on academic performance and life's perception overall. Opinion varies among gender about being
married before graduation or after which is understandable owing to difference in responsibilities and level of understanding between the
spouses.

Key words: Medical Education, Marriage, Academic Performance, Marital Status.

INTRODUCTION Medical education requires hard work, endurance,

arriage is a socially and ritually recognized
legal contract which establishes the basis of
obligations between two individuals. Being a
very important decision, it has great influences on our
lives. According to Islamic laws, we follow the sunnah
and continue our generation by getting married and
attaining education so we can live purposefully.
Marriage changes one's view towards every aspect of
life. Responsibilities of married men increase too many
folds because they ought to run a family in a prodigious
manner and continue their job or study with full
potential. Likewise a house wife has to provide
guardianship to their children and manage household at
the same time. Apart from that, working women have to
cope with the ongoing professional obligations.
Similarly, an engaged couple has to take out time for
keeping up the relation they have committed to.
Therefore it's a clear fact that marriage or engagement
influences our lives to a great extent.
Correspondence: Dr. Tahira Raza
Assistant Professor
Department of Community Medicine
CMH Lahore Medical college and Institute of Dentistry
Lahore
Email: tahiraraza@hotmail.com
persistence and well orientation to keep up the good
scores in each professional exam. This paper highlights
the effects of marriage or engagement on academic
performance of medical students. No particular attention
has been given to this topic till now but a lot of work has
been done on various predictors of academic
performance. A happy marriage with healthy
trustworthy relationship affects the life positively while
an unhappy marriage increases the stress on both
individuals. According to Chris Woolstone a study
published in Physiology and Behavior, beneficence of a
happy marriage to men is greater and depression of an
unhappy marriage affects women more. ‘ Being bounded
in an unhappy relationship will have more deleterious
effects on health thus reducing the life span of individual
while a happy relationship increases the time span as
well as eradicates the chances of diseases. Study of Irfan
Mushtaq et al showed that communication, learning
facilities, proper guidance and family stress had great
influence on the academic performances. Family stress
being our point to ponder had 2% variation of
performances in negative direction.” Cognitive
functioning and learning of medical student declines a
lot under stress, competition being the basic reason of
stress. Likewise, a study concluded that marriage
affected some students negatively and did not affect
some at all. Observations were done among Saudi
female medical students by Kamal-Eldin et al showed

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Tahira Raza, M. Wagar Sharif, Noor-e-Fatima, Shafaq Shezad

influence of marriage on lives but people having strong
determination achieve their goals at any cost.’ Analysts
James P.Yess (et) al concluded that marriage affected
negatively the graduating QPA in some students while it
did not influence some students, who scored equally as
when single. ° Devoting less time to studies because of
immense responsibilities, made married people to
graduate late.’ Marriage with love and care by husband
gave a positive influence to some married students yet
they were not satisfied with their academics while some
unmarried students had a firm opinion to get married
after higher education. Culture also effects the education
of a married woman as Asians are totally occupied in an
opinion that women are made for households and are a
property of males.’
Literature review explains an obvious effect of marriage
on lives, influenced with self-confidence and
determination. The paucity of knowledge toward
marriage and education warranted this study which has to
be designed with two aims. 1) To measure association of
demographics of student with attitude towards affect of
marriage on education. 2) To measure the attitude of
unmarried medical students towards their married
colleagues.
METHODOLOGY
This cross-sectional study was conducted at CMH
Lahore Medical College (LMC) and Institute of
Dentistry, Lahore (Pakistan) after approval by the
Research Ethics Committee of CMH medical college.
Students from all years of the MBBS, house officers and
Table 1: Demographic characteristic of married respondents and distribution year wise
post graduate trainees were included in this study, which
took place from June, 2015 to August, 2015. Total
numbers of subjects were 200 out of which 100 were
married and 100 unmarried. Sample was collected by
using WHO sample size calculator by taking confidence
interval 95%, margin of error 5% and power of study
80%. Purposive sampling technique was used for
colleges and subjects. Data was collected through two
separate semi structured questionnaires. These were
designed to collect information from married and
unmarried subjects at various medical colleges namely
CMH Lahore medical college, Allama Iqbal medical
college, King Edward medical university, Fatima Jinnah
medical college and Wah medical college. Eighty 80% of
respondents were from CMH Lahore medical college. A
total of 200 self-administered questionnaires were
distributed to potential respondents to ensure an adequate
percentage response rate. Before handing over the
questionnaire verbal consent was obtained from all
participants. They were informed about the aims of this
study and assured that their information will not be
reported individually. Questionnaire was adapted with
changes from a previous study conducted by Kamal-
Eldin at Saudi university. Demographics were asked in
the first section which followed various questions from
married respondents which covered improvement in
studies after marriage and beneficial effects of marriage.
Similarly, attitude of unmarried students was identified
through questions which included level of interaction
with the married colleagues and their own perception
about affects of marriage on academic performance.

Year of study Gender (%) mean age (years) number

2nd Male, female 21.00 3 3.3

3rd Male, female 22.00 7 7.6

4th Male, female 21.00 1 12

5th Male, female 23.00 19 20.7

House Male, female 23.00 11 12

job Male, female 23.50 22 23.9

post Male, female 23.67 19 20.7

graduate Male, female 25.75

Did'nt mention Male, female 26.00

Table 2: Comparison of marital status and academic performance based on Previous- results.

Study performance better Total P

or worse Value
Better Worse
Marital Yes 64 25 89 0.001
Status no 37 53 90
Total 101 78 179

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 The Effect of Marital Status on Academic Performance of Medical Students: A Cross-sectional Study

Table 3: Relationship between gender and their wish that they had not married earlier

| wish | haven’t married — Total

since my graduation Value

yes No
Male 11 10 21 0.005
Female 33 5 38

Total 44 15 59

is marriage a push factor or pull factor ?

607

Percent
Percent

remain the same improve detriorate T

push factor pull factor

Both married and unmarried respondents were of the view that marriage is
push factor.

Figure 1: Perception of married students about change in grades after marriage Figure 2: Marriage as a push/pull factor

Marriage changed the perception about life

Byes
no

Figure 3: Marriage changed the perception about life

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Journal of CMH Lahore Medical College, Pakistan 2017; Vol1(01):18-23
Tahira Raza, M. Wagar Sharif, Noor-e-Fatima, Shafaq Shezad
DATA ANALYSIS
Data was analyzed in SPSS version 22 software.
Frequency and percentage of response of married and
unmarried subjects were documented. Chi-square test
was used to determine the probability values for nominal
data. Marital status was variable to assess academic
performance; P-value was considered significant at (p
<0.05).
RESULTS
Total response rate was 92.5% (185 out of 200
respondents returned the questionnaire). Mean age of
unmarried respondents was 23.50(1.86) and married
respondents was 24.83 (3.08). Mean age at time of
marriage of married respondents was 22.39 (2.27). Mean
age of marriage of females was 22.52 and for males it was
22.78. The gender distribution of the unmarried
respondents was 31.6% male and 68.4 % female while
among married respondents there were 37.5% male and
62.5% female. The distribution according to year of
study among unmarried respondents was 1” year
3(3.2%), 2" year 7(7.5%), 3" year 9(9.7%), 4" year 15
(16.1%), 5" year 24(25.8), house officers 3(3.2%), PG
trainees were 7(7.5%) and 25 (26.9%) respondents did
not mention year of study in their response form. Among
married respondents maximum distribution was
22(23.9%) post graduate trainees (Table I).
Significant value of (p = 0.001) was obtained when chi-
square was applied against marital status and study
performance which means according to married
respondents, study performance became better after
marriage but according to unmarried respondents, study
performance of married individuals worsened after
marriage (Table II). Thirty nine point eight(39.8%)
unmarried respondents were of the view that academic
performance of their married colleagues got better but
majority (53%) thought that it became worse.
There was no significant correlation between gender and
worsening of performance. More female married
respondents were of the view that they wish they had not
married before graduation in fact significant value of( p=
0.04) was obtained (Table III),Whereas more married
male respondents said that they wish they had married
earlier before graduation, at the level of 0.05 correlation
was found significant. Number of kids were direct cause
of post-partum affects on studies significant value of (p=
0.001) was attained. Sixty nine point six(69.6%) married
respondents were in of the view that their academic
performance got better after marriage and 27.2% said
that it got worse after marriage Thirty eight(38 %)
married individuals said that their grades improved after
marriage , 36% said it remained the same while 21% said
grades declined after marriage (Fig I).
Sixty seven point seven (67.7%) unmarried respondents
thought that their married colleagues were happy and
32.3 % thought that they were not happy. Eighty four
point nine (84.9%) unmarried respondents said that they
feel more relaxed as compared to their married
colleagues. Seventy four point two (74.2%) said that they
Journal of CMH Lahore Medical College, Pakistan 2017; Vol1(01):18-23
usually mingle well with their married colleagues.
Only 14 % unmarried respondents said that they would
prefer to marry before graduation and 83.9 % said they
would marry after graduation. Eighty one point seven
percent (81.7%) unmarried respondents were of the view
that marriage clashes with the study. Sixty eight point
eight (68.8%) unmarried respondents said that marriage
is push factor while 30.1 % said it is pull factor. Similarly
68.5% married respondents said that their spouse is
pushing factor for them while 29.3% thought that it is pull
factor.
Seventy two (72%) said that it is their parent's wish to be
married after graduation. Eighty two point eight 82.8%
respondents said that family life is main factor which
causes delay in study of females, 82.6% married
individuals perceive that their family is supportive. Fifty
four point three (54.3%) said it is not the family
responsibilities which are keeping them away from
studies while for 43.5% it's the reason they are away
from studies.
Amazingly, 62% married respondents would advice their
unmarried colleagues not to marry and 46.7% and 43.5%
married respondents told that they have spouse who is
working in medical field and relative respectively .Sixty
five point two (65.2%) married individuals said that they
will apply for post graduate degree while 29.3% said they
are going to postpone it until children grow older.
Only 52.2% thought that the marriage was beneficial
regarding studies.
Seventy nine point three (79.3%) married/engaged
respondents said that being in relationship changed their
perception about life and 82.2% were motivated to get
good job and score high in professional or post graduate
exams .Fifty percent (50%) said they feel burnt out and
48.5% said they don't hangout anymore with the old
friends like they used to do before marriage.
DISCUSSION
This study was conducted to assess the association of
marital status with attitude towards effect on education. It
also highlights the perception of respondents regarding
marriage's effect on academic performance.
According to our results, academic performance of the
married individuals got better after marriage which can
be associated with sound mental (House et al 1988)* and
physical health that provide an imperative bulwark
against stress (Kessler and Essex 1982, Berkman 1988.”
According to Bellas 1992 and Daniel 1995, spouse
provides influential support that enhances the other
partner's productivity or augments his/her career.'
Whereas, unmarried respondents were of the view that
academic performance of their married colleagues had
worsened after marriage, which may be because of their
wrong perception about relationship, that marriage
affects academics unconstructively. The likelihood of
being failed in professional examination was more or less
common in both the groups and similarly both considered
marriage to be a push factor rather than a pull factor.
However, the social life of almost half of the married
students got disturbed and they felt emotionally drained
after marriage.
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The Effect of Marital Status on Academic Performance of Medical Students: A Cross-sectional Study

Majority of married respondents believed that being in a
relationship changed their life in an affirmative and
optimistic way and now they were more concerned about
their bright future which was in accordance with study
published ."'Nearly half of the married students said that
their family responsibilities are not an encumbrance
towards their studies, which may be because
supportive family. As concluded in a review published,
the responsibilities of married individuals proved to be
motivational point for them.’ Answer to a question about
early marriage, a large number of female married
respondents were of the view that they wish that they
hadn't married earlier, which may be correlated to high
prevalence of depression,” and postpartum anxiety in
females.” Similarly, greater number of female married
respondents said they will not advice their unmarried
colleagues to get married as this may be associated with
interference of married life with career.
About relation of motherhood and career, most of the
married respondents intended to apply for post graduate
degree and denied children being negative effect on
further studies. This is in line with a study that was
conducted to explore the relationship between marriage,
motherhood and research performance in science.
According to this study, the number of papers published
by married women with children was no less than
married women without children.’ Conclusively, nearly
half of the married students believed that getting married
before graduating ultimately proved to be beneficial for
their academic performance.
A great number of unmarried respondents said that
marriage clashes with study therefore they would like to
marry after graduation. These results were in
concordance with a study conducted in Nigeria .It is
natural effect that unmarried individuals would feel
greater tranquility than married ones, which is
accordance with our study. However, a large number of
unmarried individuals thought married couples are
happy and amicable.
development goals. It is recommended that there should
be detailed analytical studies focusing on factors which
contribute towards better or worse performance .Further
analytical studies with large sample size should be
conducted to see the effects of marriage on academic
performance of medical under graduates/ graduates.
of their
LIMITATIONS
The study has a few limitations, since the sample size was
small and the study was confined to the students of few
medical colleges. It is further suggested to conduct
studies on similar topics and include a larger population
as sample, so we can generalize the results about effects
of marriage on academic performance more accurately.
Furthermore the results obtained cannot be extrapolated
to other population group levels that differ
demographically from the subjects in our study.
REFERENCES
1. Woolston, Ch (Jan 20, 2016) Marriage and Stress [blog post].
Retrieved from
http://consumer.Healthday.com/encycolopedia/emotionalhealt
h-17/love-sex-and-relationship-health-news-452/marriage-
and-stress-645970.html
2. Mushtaq SN. Factors affecting students’ academic
performance. Global Journal of Management and Business
Research. 2012 Nov 6; 12(9).
3. Abdulghani HM, Al Kanhal AA, Mahmoud ES,
Ponnamperuma GG, Alfaris EA. Stress and its effects on
medical students: cross-sectional study at a college of medicine
in Saudi Arabia. J Health Pop Nutr. 2011; 29:516-22.
4. Abou-Elhamd, Ahmed KE, Abdullah Al-Wadaani H,
AlMulhim S, and Abdul Rehman. "FEMALE MEDICAL
UNDERGRADUATE; DOES MARRIAGE AFFECT THE
ACADEMIC PERFORMANCE IN A SAUDI
UNIVERSITY" Professional Medical Journal 2014(21):
no.3

CONCLUSION 5. Yess, James P. "The influence of marriage on community

Significant number of respondents said that marriage is a
push factor towards achieving good scores and that they
are more motivated and focused. Married male 6.
respondents were in a view, that they should have
married before because family life after marriage had
changed their perception, which helped them to perform
well .While female respondents said that they will seek
for post graduation when their children will grow older. 7.
Marriage is an important, cultural, traditional and
religious event in our society. Opinion varies among
gender about being married before or after graduation,
8.
which is understandable owing to the difference in
responsibilities and level of understanding between
partners.
9.
RECOMMENDATIONS
Trained professionals are the back bone of any country.
Timely completion of studies and academic performance
contributes certainly towards economic development 10.
and political wellbeing, which is an aspect of sustainable
college student achievement in specific programs of study."
Research in Higher Education 1981(14) no. 2: 103-118.
Gordon, C. D., S. K. Williams, G. A. Hudson, and J. Stewart.
"Factors associated with academic performance of physical
therapy students." The West Indian medical journal 2010(59)
no. 2: 203-208.
Potokri, Collins O. "The academic performance of married
women students in Nigerian higher education." PhD diss.,
University of Pretoria, 2011.
Uecker, J. E. (2012). Marriage and mental health among young
adults. Journal of Health and Social Behavior, 53, 67-83.
doi:10.1177/0022146511419206
Coombs, R. H. (1991). Marital Status and Personal Well-Being:
A literature Review. Family Relations, 40, 97-102.
doi: 10.2307/585665
Ribar, D. (2004). What do social scientists know about the
benefits of marriage?: A review of quantitative methodologies.

22
Journal of CMH Lahore Medical College, Pakistan 2017; Vol1(01):18-23
Tahira Raza, M. Wagar Sharif, Noor-e-Fatima, Shafaq Shezad

IZA Discussion Papers Series.
11. Gove, W. R., Hughes, M., & Style, C. B. (1983). Does marriage
have positive effects on the psychological well-being of the
individual? Journal of Health and Social Behavior, 24,
122-131. doi:10.2307/2136639
12. Thomas, J., Raynor, M., & Al-marzooqi, A. (2012). Marital
status and gender as predictors of undergraduate academic
performance : a United Arab Emirates context. Learning and
Teaching in Higher Education, (2010);9: 1-9.
14. Health Care Settings. Arch Gen Psychiatry 1998; 55: 405-413.
Stuart, S., Couser, G., Schilder, K., O'Hara, M. W., & Gorman,
L. Postpartum anxiety and depression: onset and comorbidity in
a community sample. The Journal of Nervous and Mental
Disease1998;186: 420-424.
15. Cole, J. R., & Zuckerman, H. Marriage, motherhood and
research performance in science. Scientific American 1987;
256:8119-125. doi:10.1038/scientificamerican0287-119

13. Gater, R., Tansella, M., Korten, A., Tiemens, B. G., Mavreas, V.
G., & Olatawura, M. O. Sex Differences in the Prevalence and
Detection of Depressive and Anxiety Disorders in General

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