CONTEXT: Academic backwardness exists almost in every institute.In institutes providing professional education, the problem is on higher scale with more seriousness and complications.For the academic backwardness, multiple reasons like financial, family, personal stressors are contemplated.This study is an attempt to recognize the problem areas in these students which will help us to take some preventive measures.AIMS: To find the probable causes of repeated failure in the university examination at an individual, family and institutional level.OBJECTIVES: To find prevalence of psychological morbidity.To identify stressors.To identify the reasons for irregularity.SETTINGS AND DESIGN: Retrospective cohort type of study, done in a Rural Medical college.METHODS AND MATERIAL: Academically backward students identified according to MUHS criteria.Data collection done from previous college records, open ended semi structured proforma with a personal individual interview with GHQ.STATISTICAL ANALYSIS USED: Qualitative research methodology was used.RESULTS: Poor study pattern, poor concentration and time management issues were observed in 45.45%.Poor English comprehension, personal illness, family problems, poor coping in negative stressful emotional life events, boredom in repeating the same subject studies were also noted.Prevalence of depression and anxiety was observed in 40.91%.Substance use was observed in 18.18%.59.1% were found to have more general health problems on GHQ.At family level parental divorce, interpersonal stressors with parents and at institutional level, poor attendance in revision classes and practical's were noted.CONCLUSIONS: Psychological problems were more prevalent as compared to previously reported studies, which may be attributed to the fact that the study group consisted only of academically backward students.