The hidden influence: Medical students' knowledge and attitude of conflict of interest-A cross-sectional study in Jeddah, Saudi Arabia.

Introduction: Conflicts of interest (COI) pose ethical challenges in medical education and clinical practice, potentially influencing decision-making. While COI policies and education vary globally, inconsistent training leaves medical students vulnerable to industry influence. In Saudi Arabia, COI education remains underexplored. This study assesses medical students' knowledge, attitudes, and exposure to COI, aiming to identify gaps and inform educational improvements.

Methodology: A cross-sectional study was conducted among 392 medical students from multiple universities in Jeddah, Saudi Arabia. A validated questionnaire was administered to assess COI knowledge, attitudes, and exposure to industry interactions. Data were analyzed using IBM SPSS 29.0, with statistical significance set at p < 0.05.

Results: A total of 392 participants were included. Overall, 71.4% of students were able to define COI, while 28.6% lacked awareness. Clinical students had significantly higher knowledge scores than preclinical students (p = 0.001). Grade Point Average (GPA) was significantly associated with attitudes toward COI, with students who had excellent GPAs scoring the highest (p < 0.001). No significant differences were observed in knowledge or attitude scores based on gender, research experience, and university affiliation. Over half of the students (52.6%) felt inadequately educated about COI, and 48.5% had never attended a COI lecture. Clinical students (65.2%) reported more interactions with pharmaceutical representatives than preclinical students (34.8%).

Conclusion: While medical students generally recognize COI, gaps in knowledge and formal education persist. Clinical exposure appears to enhance knowledge, yet inconsistent education leaves students vulnerable to industry influence. Strengthening COI education within medical curricula is essential to promote ethical decision-making and uphold professional integrity.