Cognitive measures explain only part of why some medical students perform well while others struggle. Conscientiousness is a promising non-cognitive factor, but evidence in medical education remains scattered, particularly regarding whether its association with performance varies across assessment types and stages of training. This systematic review followed PRISMA 2020 guidance and examined the association between conscientiousness and academic performance in undergraduate medical students. PubMed, ScienceDirect, and PsycINFO were searched on 5 October 2025. Twelve studies involving 3847 medical students met the eligibility criteria. Because the included studies reported heterogeneous outcomes and statistical metrics, findings were synthesized narratively. Across the included studies, conscientiousness showed a generally positive association with academic performance, with reported estimates typically ranging from 0.18 to 0.48. Associations appeared somewhat stronger in clinical assessments than in preclinical written examinations and were minimal in procedural skills, although formal subgroup meta-analysis was not performed. Longitudinal studies also suggested that the predictive relevance of conscientiousness may become more apparent across later stages of training. Conscientiousness is a modest and generally consistent correlate of academic performance in medical students. Its relevance appears greater in learning environments that require sustained self-regulation and autonomous effort. These findings do not support the use of conscientiousness for high-stakes admissions decisions. Instead, they support using these findings to guide targeted educational support and curriculum design that strengthen students’ planning, follow-through, and adaptive self-regulation.

Introduction: Breast cancer is the most common malignancy in women of reproductive age, and treatment advances have heightened the importance of fertility preservation (FP) for young patients. Despite heterogeneity across subtypes—hormone receptor-positive (HR+), HER2-positive, triple-negative (TNBC), and BRCA1/2-associated—existing guidelines lack subtype-specific FP guidance. Methods: This systematic review compared FP strategies across subtypes, identified subtype-specific challenges, and proposed pathways toward precision oncofertility care. PubMed, Scopus, and Web of Science were searched following PRISMA guidelines for English-language studies from 2004 to 2024. Results: After screening 1837 records, 19 studies met eligibility criteria (2 RCTs, 17 cohort studies); 11 of 17 non-randomized studies were at low overall risk of bias, and 6 at moderate risk due to confounding. Discussion: COS using letrozole- or tamoxifen-modified protocols was feasible, yielding 8–14 mature oocytes per cycle with reduced estradiol exposure suitable for HR+ disease. Evidence was strongest for HR+ patients; TNBC and HER2+ data were more limited, with some studies noting reduced ovarian reserve. GnRH agonists during chemotherapy reduced ovarian failure rates and improved post-treatment recovery, most consistently in hormone receptor-negative disease. BRCA1/2 carriers showed broadly comparable FP outcomes to non-carriers, though BRCA1-positive patients had modestly reduced oocyte yields in some studies with inconsistent results. Conclusions: Among studies with medium-term follow-up (3–5.5 years), no significant increase in recurrence or mortality attributable to FP was identified; long-term data beyond 5 years remain sparse. Substantial heterogeneity precluded meta-analysis; all synthesis is narrative. Standardized outco reporting and larger prospective subtype-stratified studies are required to establish precision oncofertility recommendations.