Purpose: This study was aimed to identify application motives and to explore the impact of motives on school adjustment in medical school students. Methods: Fifty-one third-year medical students were individually interviewed by two independent interviewers to evaluate application motives and school adjustment. Fisher s exact test and two-way analysis of variance were used to examine group differences in school adjustment and academic performance according to application motives and personal characteristics. Results: On the basis of Marcia s identity status model, four types of application motives were identified including “objective orientation”, “achievement orientation”, “heteronomy” and “objective diffusion.” Students who were classified into either objective orientation or achievement orientation did not have any adjustment problem. However, half the students classified into either heteronomy or objective diffusion had academic or social problems. The students in the first two classifications achieved higher grades in basic science courses than those of the later two. Conclusions: These results suggest that application motives tend to impact school adjustment and academic performance. Motive-based admission policies and student guidance should be considered as alternative measure for improving school adjustment and academic performance in medical school students.