Phenomenon: Medical school curricula challenge even the most adept learner, potentially leading to feelings of burnout. When faced with uncertainties in a new curriculum, confidence in achieving academic goals may be threatened. We previously found associations between academic performance and pride, hope, anxiety, and shame in medical students. Are these emotions still associated in the context of an evolving curriculum? Approach: All 1st- and 2nd-year medical students were invited to participate in a survey study (n = 264). Year 1 students were in the first semester of the new curriculum. The Hope, Pride, Shame, and Anxiety subscales of the Achievement Emotions Questionnaire and the Maslach Burnout Inventory (MBI) General Survey for Students were administered in fall 2017. Academic performance (semester overall percentage) was matched to participants completing all 4 questionnaires. Descriptive and inferential statistics were used to analyze the results. Findings: Response rates for those who completed every survey administered was 18.5%. Combined data from the classes revealed relationships between academic performance with MBI subscale-professional efficacy (r = .577), hope (r = .497), pride (r = .411), anxiety (r = −.307), and shame (r = −.402). Upon analyzing data from each class, professional efficacy (M1: r = .535; M2: r = .674) and pride (M1: r = .591; M2: r = .450) were correlated to academic performance. In a stepwise regression model, professional efficacy was the only predictor of academic performance (B = .560, t = 3.82, R2 = .31). Insights: When faced with challenges from medical school, positive emotions strengthen self-efficacy, allowing students to identify strategies to accomplish academic goals. Although it is important to acknowledge the emotions that students experience, our finding that professional efficacy was the most significant predictor of academic performance suggests the need for strategies to enhance self-efficacy. Use of flipped classrooms or problem-based learning offers opportunities for cognitive appraisal to foster their self-efficacy
