Introduction: Children in the same family are different from each other in their academic achievement and birth order plays an important role in defining a child’s character and personality. Grade Point Average (GPA) refers to the grading processes used to measure educational achievement. Aim: To investigate the association between birth order (sibling rank) and academic performance in connection with other variables such as sibling size, gender, age, parent’s education, parent’s job and family monthly income. Materials and Methods: The study design was a cross-sectional survey where data were collected by a self-administered questionnaire to gather information about students’ Cumulative Grade Point Average CGPA, birth order, age, socioeconomic status of the parents, family size and gender. Various methods were used for assessment such as written and oral exams, Objective Structured Clinical Examination (OSCE), Objective Structured Practical Examination (OSPE) and oral case presentation. A total of 308 questionnaires were distributed to the participants (174 male and 134 female) out of which 269 (148 male and 121 female) were returned. Excel sheet was used before reverting to statistical software SPSS version 20.0 for analysis. The F-test (ANOVA) compared the mean CGPA by the birth order. General linear model was used as a multivariable analysis to accommodate for other baseline characteristics. Chi-square test assessed the relationship between the birth order and CGPA categories. p-value
