English proficiency level and satisfaction with studying medicine: a mediation analysis by age among domestic and international students in Argentina

Introduction: Satisfaction with studying medicine may be influenced by English language proficiency level and student age. Research exploring the indirect relationships between these variables is limited. Objective: To analyze whether age mediates the association between English proficiency level and satisfaction with studying medicine. Materials and method: Analytical cross-sectional study using secondary data. The dataset was derived from a survey administered between October and November 2020 to 2 301 first-and fifth-year medical students in Argentina. The association between English proficiency level and satisfaction with studying medicine was evalu-ated, considering age as a mediator and adjusting for sociodemographic covariates. Hayes’ PROCESS model 4 with bootstrap resampling (5 000 samples) was used, and a directed acyclic graph was created to visually represent the proposed causal relationships. Results: The mean age of the students was 23.67 years, 79.10% were women, 72.10% reported an intermediate/ad-vanced English proficiency level, and 77.31% expressed satisfaction with studying medicine. English proficiency level was significantly associated with younger age (B=-1, p<0.001), whereas being a student of an advanced academic year (fifth year vs. first year) and having children were associated with older age (B=1, p<0.001 and B=10, p<0.001). Other variables associated with older age included marital status, sex, and studying at a private university. The model explained 45.7% of the variance in age (R2=0.457, p<0.001). In the logistic regression model, age was negatively associated with satisfaction with studying medicine (B=-0.041, p=0.002), and English proficiency level showed no direct effect (B=0.051, p=0.653). The mediation analysis showed a significant indirect effect of English proficiency level on satisfaction with studying medicine through age (B=0.052, BootSE=0.019, 95%CI: 0.018 to 0.094), confirming its mediating role. Conclusions: English proficiency level was indirectly associated with satisfaction with studying medicine, and this association was mediated by age.