Positive attitude and self-evaluation are necessary for medical students and doctors. To explore how best to integrate physiology teaching in our Thai medical curriculum, we investigated relationships between student's academic performance, their attitude, self-evaluated knowledge, and proportion of physiology taught in an organ-system integrated block. We organized 13 physiology laboratory classes, during which students self-rated attitude and knowledge. Academic performance was measured by formative and summative assessments. One hundred thirty-six participants were categorized into most proactive (Most PA), more proactive (More PA), less proactive (Less PA), and least proactive (Least PA) attitude groups by self-preparation questionnaire. Eighty participants were categorized into high (HighE), moderate (ModerateE), and low (LowE) self-evaluation rating groups. Mean formatives score in the Most PA group was significantly higher than in the other PA groups ( = 0.003, = 0.001, and < 0.001, respectively). Mean summative score in the Most PA group was significantly higher than the Less PA and the Least PA groups ( = 0.017 and = 0.015 respectively). There was no significant difference in mean assessment scores among HighE, ModerateE, and LowE groups. Proportion of teaching time dedicated to physiology positively correlated with student attitude ( = 0.84, = 0.001) and negatively correlated with self-evaluation rating ( = -0.73, = 0.007). Thai medical students may benefit from a proactive attitude to studying physiology, contrasting with traditional didactic expectations of Thai education. Proportion of teaching time dedicated to physiology does not influence academic performance; therefore, future adjustments to curriculum integration may incorporate classes that facilitate self-directed learning. Future study should explore other influences on learning and assessment performance.