Perceived competency of final-year medical students in managing acute medical emergencies: A cross-sectional questionnaire study

Abstract

Background. Medical interns often respond to acute medical emergencies, yet little is known about their practical and perceived preparedness. Local and international literature has shown that junior doctors often lack hands-on experience and confidence, which may impact patient safety and doctor wellbeing. Objectives. To determine final-year medical students’ exposure to acute medical emergencies in an undergraduate programme in South Africa (SA), as well as their self-perceived competency in identifying and managing these emergencies. Methods. An online questionnaire was shared with all 345 final-year students at the end of 2024. Participants rated ten medical emergencies from the University of the Witwatersrand MB BCh curriculum for exposure (score 0 - 3; maximum (max) 30) and perceived competency in identifying and managing them (score 1 - 4; max 40). Descriptive statistics, non-parametric tests, logistic regression and correlation were used to explore associations. Results. A total of 78 responses were received. Participants had a median age of 25 years, and 66% were female. Overall, 28.2% of participants recorded high exposure scores (≥20). High identification scores (≥30) were reported by 53.8% of participants, while only 21.8% recorded high management scores (≥30). Exposure scores were positively correlated with both identification and management scores (Spearman’s rank-order correlation (ρ)=0.53 and 0.54, respectively; p<0.001). Statistical significance was set at p<0.005. Conclusion. Junior doctors’ self-perceived competency remains low despite moderate theoretical training and practical exposure. Extended emergency medicine rotations, simulation-based training, workplace assessments and student roles in active care should be included in the curriculum. To inform curriculum reform, future studies should evaluate other universities' curricula, use longitudinal designs and measure objective competency.