Introduction. The adaptation of international medical students is a complex process that occurs under conditions of intense academic load, sociocultural transformation and professional development. Key determinants of successful adaptation are dynamically interrelated factors: physical activity (PA) level, emotional well-being (anxiety, depressive symptoms) and subjective quality of life (QoL). Objective. To study the influence of physical activity on the socio-psychological adaptation of international students in the environment of higher medical education. Materials and Methods. The study was conducted as part of psychohygienic monitoring among 516 international students of one of the leading universities of the Russian Federation. Four validated methods were used for comprehensive assessment: an adapted scale developed based on the principles of the International Physical Activity Questionnaire (IPAQ), the Hospital Anxiety and Depression Scale (HADS), the short form of the SF-36 questionnaire, and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) in the modification by N.P. Fetiskin and T.I. Mironova (based on the methodology of N.E. Vodopyanova). Results. Statistically significant nonlinear differences in physical activity, psychological health, and quality of life indicators were found between the academic years. The level of physical activity (score 0-49) differed significantly. The proportion of students with hypodynamia reached its maximum in the 5th year (57.5%). Anxiety indicators (HADS-A) demonstrated a biphasic dynamics: peaks in the 1st (53.5% with a clinically significant level) and 6th years (54.5%), and a minimum in the 5th year (38.4%). The level of depressive symptoms was highest in the 6th year (48.5% ≥ 8 points). Quality of life (SF-36) was highest in the 2nd year across all scales, reflecting a period of successful adaptation. By the 6th year, a significant decline was observed, especially in social functioning and general health perception, indicating a dissociation between objective condition and subjective well-being prior to graduation. The overall quality of life index (Q-LES-Q) reached its maximum in the 5th year; however, the "Communication with close ones" subscale showed a steady decline starting from the 3rd year, with the proportion of students reporting low levels of communication increasing from 28.7% (1st year) to 67.6% (3rd year). Strong associations were identified: students with hypodynamia significantly more often exhibited signs of anxiety and low communication levels. Low communication was strongly associated with anxiety, highlighting the role of social integration as a key protective factor. Discussion. The obtained data made it possible to identify three critical periods in the academic trajectory of international students: adaptation (1st year), socio-academic crisis (3rd-4th years), and graduation stress (6th year). Dynamics are wave-like, where periods of stabilization (2nd year) and uplift (5th year) alternate with phases of decline, refuting the idea of linear adaptation. Conclusion. The study revealed a nonlinear, wave-like dynamics in the psychological well-being of international medical students over the six-year training period with three critical phases. Strong statistical relationships were established: hypodynamia is reliably associated with anxiety and social isolation, which, in turn, is a key predictor of emotional distress. The obtained data indicate the need to consider the identified complex adaptation trajectory when organizing psychohygienic support.