Secondary education in Fiji ends with the Form 7 examination. Predictive validity for academic success of Form 7 scores which form the basis for admission into the Bachelor of Medicine Bachelor of Surgery programme of the Fiji School of Medicine was examined via a cohort of 129 students. Success rates for year 1 in 2008, 2009, and 2010 were 90.7 per cent, 86.5 per cent, and 83.5 per cent, respectively. Year 1 scores were positively correlated with Form 7 scores with correlation coefficients (r) of 0.7535 in 2008 (P less than 0.0001), 0.4866 in 2009 (P = 0.0023), and 0.4986 in 2010 (P = 0.0003). Similar correlations occurred between Form 7 scores and years 2 and 3 results in 2008, but no correlation was found with year 2 results in 2009. These findings show that Form 7 scores strongly predicted academic success in the School, providing support for its continued use. However, supplementary assessments may be required. (Contains 2 tables and 1 figure.)