Abstract: Introduction: Almost 20 years since the beginning of affirmative action implementation, there is still much discussion about the real effectiveness of these measures, especially regarding academic performance, comparing “quota holders” to “non-quota holders”, with doubts arising about whether the former can keep up with the latter. Objective: To establish a profile and compare the academic performance and other aspects related to the academic life of “quota holder” students (Inclusion Program with Merit in Public Higher Education in São Paulo - PIMESP) with the other students in their respective classes selected via broad competition (BC). Method: Retrospective cohort of 1st to 3rd-year medical students, divided in BC or PIMESP. The following were assessed: arithmetic mean of the final grades of the curricular subjects; final approval status (FAS) in the subjects; frequency; books borrowed from the library (BBLi) and participation in monitoring/academic center. Continuous variables were compared by Student’s t-test or Mann-Whitney test and categorical by chi-square or Fisher’s exact test. Values p < 0.05 were considered significant. Results: Of the 237 students included in the sample, all had completed the 1st year (2015, 2016 and 2017 entrants), 158 students (2015 and 2016 entrants) the 1st and 2nd years, and 78 (32.9%) had completed the 3rd year (2015 entrants) at the time of the survey. In the analysis of all those who had completed the 1st year, where 16% were PIMESP, there was a difference in mean final grades and FAS, higher for BC students and no difference for attendance, BBLi, participation in monitoring and academic center. In the analysis of those who had completed the 2nd year, where 15.8% were PIMESP, there was no difference between any of the studied variables. The analysis of those who had completed the 3rd year, where 15.4% were PIMESP, once again showed difference between the averages of final grades and FAS, higher for BC students, but with a less marked difference, and there were no significant differences for the other variables. Conclusion: We observed a fluctuation of academic performance among PIMESP students, towards inferior outcomes, when compared to BC students, throughout the first three years of medical school, but not for other variables. No increase in the dropout rate was observed, contrary to what is found in the literature.
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