Factors associated with empathy among medical students: a cross-sectional study

ABSTRACT Objective To examine factors associated with empathy among medical students, focusing on sociodemographic, academic, and personal characteristics. Methods A cross-sectional study was conducted with 580 medical students from all academic years. Empathy was assessed using the Interpersonal Reactivity Index. Independent variables included sociodemographic data (age, gender, socioeconomic status, and religion), academic characteristics (year of study, career intention, and extracurricular activities), and personal factors (mental health, self-perceived empathy, and satisfaction with life domains). Descriptive analyses and multivariate linear regression models were conducted. Results The mean empathy score was 99.6 (SD=11.9), indicating relatively high empathy levels. Among the four subscales, Personal Distress showed the greatest variability. Multivariate regression revealed that higher empathy scores were independently associated with females (β=+6.1, p<0.001), religion or spirituality (β=+3.1 to +3.8, p<0.05), preference for clinical specialties (β=+4.2 to +9.3, p<0.001), and anxiety symptoms (β=+4.0, p<0.001). Interaction analyses indicated that anxiety had a stronger positive effect on empathy among male students and those with religiosity or spirituality. Variables such as institution, year of study, age at admission, financial factors, depressive symptoms, substance use, and satisfaction with life domains were not significantly associated. Conclusion Empathy among medical students is influenced by sociodemographic, academic, and personal factors. Female gender, religion/spirituality, clinical specialty interest, and anxiety symptoms were positively associated with empathy. These findings support integrating structured empathy training into medical curricula, considering psychological support, reflective practice, and cultural–spiritual dimensions to preserve and enhance empathy throughout medical education.