Purpose: This study evaluated the experiences, challenges, and academic performance of Bridging Course (BC) graduates compared to direct entrants at Ernest Cook University (ECU), Uganda. In 2025, data from the Uganda National Examinations Board revealed that only 65.5% of secondary school candidates met the minimum university admission requirement, leaving one-third without direct access to higher education. To address this gap, the National Council for Higher Education (NCHE) introduced BCs under the Higher Education Certificate (HEC) framework to prepare learners for diploma and degree programs. Methods: A cross-sectional quantitative design was employed, involving 243 BC and 523 direct-entry students enrolled in professional programs, including Medical Imaging, Ultrasound, Radiography, and Biomedical Engineering. Academic performance was compared using Cumulative Grade Point Average (CGPA) data, and student experiences were assessed through an online Likert-based questionnaire. Findings: Results showed that BC graduates achieved a slightly higher mean CGPA (3.39 ± 0.58) than direct entrants (3.23 ± 0.90), though the difference was not statistically significant (p = 0.22). Most BC graduates (62%) reported improved attitudes toward science subjects, while overall program satisfaction averaged 3.9/5, particularly for lecture delivery (4.25) and instructor effectiveness (4.16). Key challenges included subject difficulty, limited practical exposure, and technological or financial constraints. Feasible Policy Implication: The study supports scaling up and institutionalising BCs under the NCHE framework to expand access to higher education. Policies should prioritise lecturer capacity-building, practical curriculum enhancement, and investment in learning resources to improve program quality and sustainability.