This study was to examine the difference of medical students' academic motivation, self-directed learning and self-efficacy by their each academic achievement levels in criterion-referenced assessment system. Based on this, the implications for students’ learning level support for criterion-referenced assessment operations were aimed to be offered. Number of 121 students, who are freshmen in medical school, participated. The scales of academic motivation, self-directed learning and self-efficacy were used in this study. The final records of the students were gathered. It was divided into top, medium, and low achievement level and then, it was analyzed. We conducted a MANOVA, ANOVA and t-test analysis for this study. As the result, self-efficacy in the overall score was higher in second semester compared to the first semester. Yet, there was no difference in academic motivation and self-directed learning. As sub-factors of academic motivation and self-directed learning of the second semester increased significantly compared to the first semester depending on the achievement levels. Based on the above findings, we suggested implications for learning support strategies depending on achievement levels in criterion-referenced assessment system. These findings suggest that, to enhance self-directed learning as a lifelong learning competency, It is desirable to consider academic achievements levels when designing the learner support strategies.