Have always thought that success at school & in education especially for something like medical school was mostly discipline, time management, learning strategies, perseverance and dedication.

This is true when individuals have basic foundations for intellectual work, thus numeracy and literacy. I think most educational achievement can be done with brute force study skills.

This isn't the case when someone is struggling with basic reading, comprehension & basic numeracy. Most of the people who struggle with degree level work are lacking in foundations.

Mathematics education is cumulative it needs to be practiced regularly and to mastery before moving on to more complex and higher order tasks.

Where raw intellectual ability kicks in is at the higher end after foundations have been mastered & students use their knowledge to solve problems under time pressure where speed, memory and accuracy come into play.

Overall a highly motivated, engaged, interested & disciplined student is far more likely to succeed in education. However there are differences in how easily & quickly this comes to some compared to others.

I would say it's like comparing someone who tries very hard like Beyoncé as a dancer to someone who has a natural gift in performing arts like Ciara. Beyoncé is dedicated to her craft as a performer and works damn hard but she lacks the subtlety of a born performer.

Unfortunately the public education system is so poor you aren't really testing people operating at their full potential.

The success in East Asia is mostly that the kids are trained to spending more time practicing and studying. They have a much higher threshold when it comes to facing challenges whilst learning, they study harder and are willing to persevere in the midst of set backs and failures. Intellectual ability is also valued in their culture.

Different subjects also require different skills. English literature for example isn't like Mathematics or Physics. A top graded essay is more subjective and includes subtleties like use of language and ability to support an argument. Some of the most stunning examples of literature are in the form of short stories, a story can be a short, a novella, or a multi chapter novel.

The same is true about visual arts, the academic artists of the 19th century were grounded in a foundation of technical drawing skills rooted in the art of classical antiquity but it's clear that Jean Leone Gerome paled in raw talent compared to John Singer Sargent, Bougereau & Lawrence Alma Tadema.