Ramadan Fasting, Cognitive Strain, and Academic Scheduling in English-Medium Medical Education: Evidence from Saudi Arabia

The practice of fasting during Ramadan through extended daily abstention from eating and drinking water can negatively impact both a university student's learning and overall cognitive performance. In order to gain insight into these issues, this study adopted a quantitative cross-sectional survey methodology to evaluate the perceptions of 94 male undergraduate medical students at a public university in Saudi Arabia—who were studying through the medium of English—regarding their cognitive performance while fasting during Ramadan. The students' feelings and opinions were captured via a structured questionnaire. The questionnaire items included, but were not limited to, the following areas- whether or not the students had eaten prior to dawn (suhur); the students' perception of dehydration-related mental fatigue; hours of sleep per night; the students' perception of clarity of mind after breaking the fast (iftar) and the students' opinion towards modification of the academic schedule during Ramadan.The results indicate that many of the students experienced some degree of cognitive strain each day as a result of their fasting periods. They also reported a variety of negative experiences while fasting; these included decreased concentration, significant amounts of dehydration-related mental fatigue, and lack of sleep. Despite most of the students reporting that they ate suhur each day, they continued to report difficulty focusing, suggesting this early sustenance offers little protection for students in an academic setting. Conversely, a large number of the students reported increased cognitive clarity after having broken their fast (iftar), suggesting the possibility of time-dependent recovery. Additionally, an extremely high percent of the students expressed agreement that their academic schedules should be modified during Ramadan.Overall, the findings suggest that the cognitive strain resulting from fasting may result from a combination of metabolic depletion, dehydration, sleep deprivation, disruption to students' natural circadian rhythms, and the rigid academic schedules faced by these students. As such, the present study emphasises the necessity for context-sensitive, institution wide policies to support student learning while observing Ramadan in universities across Saudi Arabia and other Muslim countries.