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Introduction: Nowadays, admission of students for medical specialty courses has faced some challenges. Due to the special importance of the duties and mission of physicians and the necessity of careful selection in their admission, the purpose of this study was to determine the contribution of academic performance and cognitive factors in students' admission to medical university. Methods: This was a descriptive cross-sectional study. The study population consisted of all the candidates of the specialty exams of Medical Sciences Universities in 2018, The members of these two groups were 1096 that score of them were analyzed in GPA, pre-internship score and cognitive test scores. The sample was selected by simple random sampling method. Research tools were California analytical thinking test, Watson Glazer critical thinking test, and reading comprehension test whose reliability by Cronbach's alpha coefficient came out as 0.79, 0.76, and 0.80, respectively. Data were analyzed using SPSS and R software and logistic regression, stepwise regression and independent t-test were used to answer the research questions. Result: The results showed that variables of GPA (t < 8.59, P = 0.0001), pre-internship test score (t < 7.45, P = 0.0001) and cognitive test score (t < 4.48, P = 0.0001) have a significant role in predicting candidates' performance in specialty entrance exam. Also, these variables could predict the status of admission or rejection of students in specialized courses (X2 = 630.63, P = 0.0001). The results of independent t-test showed that there was a significant difference between the performance of men and women in specialty entrance exam (t < 4.91, P = 0.0001), GPA (t < 4.67, P = 0.0001) and cognitive tests (t < -2.08, P = 0.038). Conclusion: Cognitive ability of medical university specialty candidates and their previous academic performance are the most important predictors of success in university entrance examination and admission. So it is necessary to accept students in specialized courses and universities based on essential competencies for medical students such as analytical thinking skills, logical thinking, problem solving and decision making, in addition to the entrance exams and performance of previous courses, in their assessments.