Background: Empathy is a crucial component of professionalism in medicine, having a solid relationship with improved patient outcomes. The current study aims to examine the factor structure of the Toronto Empathy Questionnaire (TEQ) with a sample of Saudi medical students and to assess the differences in empathy scores by gender, year of study, and future career preference. Methods: A cross-sectional study was performed using anonymous self-administered online questionnaires. The study tool targeted a random sample of medical students in public and private Saudi medical schools in five regions (North, South, East, West, and Central) of Saudi Arabia. Results: 941 Saudi medical students enrolled in the study. 52.3% were male students, and 30.6% of the students were from the central region of Saudi Arabia. The most desired specialties were general surgery (19.2%), internal medicine (12.5%), and family medicine 8.2%. The average TEQ score was 42.31%, with 67.1% scoring low to average empathy levels. About one-third (32.9%) scored high empathy levels; females scored a higher average on the empathy score compared to males (43.48 vs. 41.24) P-value <0.001. The never-married studentsalso scored higher empathy than married students 42.53 vs. 38.78) P-value <0.00. The region with the highest empathy scores was the central province, 44.72%. Conclusion: Different factors could influence empathy scores, such as gender, marital status, GPA, and study year. Female students had a higher empathy score compared to male students. Senior medical students scored lower on the scale than younger students, and could be associated with a higher level of burnout. Further empathy-based discussions should be inserted into the Saudi medical curricula. Keywords: professionalism, Toronto empathy scale, medical students, Saudi Arabia.
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