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Kien Xuan Nguyen,1,&ast; Tien Viet Tran,2 Thuan Duc Nghiem,3 Tuan Ngoc Tran,1 Thang Ba Ta,4 Ba Van Nguyen,5 Tuan Dinh Le,6,&ast; Son Tien Nguyen,6 Kien Trung Nguyen,7 Hoa Trung Dinh,8 Dinh Cong Pho,9 Toan Nguyen Duy,10,&ast; Pham Quoc Toan11 1Department of Military Medical Command and Organization, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 2Department of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 3Department of Otolaryngology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 4Respiratory Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 5Department of Oncology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 6Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 7Center of Hematology and Blood Transfusion, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 8Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 9Department of Military Science, Vietnam Military Medical University, Hanoi, 10000, Vietnam; 10Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 11Department of Nephrology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam&ast;These authors contributed equally to this workCorrespondence: Pham Quoc Toan, Department of Nephrology, Military Hospital 103, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Email toannephro@gmail.comIntroduction: Metacognition plays an essential role in competency-based medical education. Metacognitive skills consist of knowledge and regulation metacognition. This study was conducted to investigate the metacognition of undergraduate students and its correlation with students’ academic performance.Methods: The metacognitive skills inventory comprised 52 binary-scale items administered to 202 Vietnam Military Medical University medical students. The entire semester and clinical results were used to measure their academic performance.Results: Medical students’ total metacognitive awareness score was high (median 0.8). The median metacognitive knowledge score was significantly lower than the metacognitive regulation score (0.7 vs 0.8, respectively). The participants with a total metacognition score ≥ 0.8 had significantly higher academic results (full semester exam results of 7.4 and clinical exam of 7.5). The group of participants in the military, having sports habits and usually searching academic documents in English, had a higher proportion of total metacognitive awareness score ≥ 0.8 than the group without these above characteristics (with the percentages of 53.3%, 59%, and 64.3%, respectively; p < 0.05). The number of books read by participants with a total metacognitive awareness score ≥ 0.8 was significantly higher than those with a total metacognitive awareness score < 0.8 (3.5 compared to 2.4 books).Conclusion: Metacognitive awareness of Vietnam Military Medical University medical students was likely to be high. A high score of metacognitive awareness could predict high academic performance. Being a military student, playing sports, reading books, and searching English documents were predictors of better metacognitive awareness.Keywords: metacognition, medical student, metacognitive awareness, academic performance