Sannia Perwaiz Iqbal ¹ Ursala Adil ^2,3* Abdul A. Chhotani ⁴ Mashal Ahmed ¹ Ramsha Ali ⁵ Hafsah Sohail ⁴

• ¹ Bahria University, Islamabad, Islamabad, Pakistan
• ² doctor, Karachi, Pakistan
• ³ School of Bahria Business, Bahria University, Islamabad, Islamabad, Pakistan
• ⁴ Aga Khan University, Karachi, Sindh, Pakistan
• ⁵ Civil Hospital Karachi, Karachi, Sindh, Pakistan

Background: Palliative care is a critical component of healthcare, especially for patients with life-limiting illnesses. However, the knowledge and attitudes of future healthcare providers, particularly medical students, towards palliative care remain underexplored in low-and middle-income countries like Pakistan. Objective: This study aims to assess the knowledge and attitudes of final-year medical students in Karachi, Pakistan, towards palliative care and explore the association of demographic factors with these perceptions. Methods: A cross-sectional, questionnaire-based study was conducted from July 2022 to July 2023, involving 400 final-year medical students from five universities in Karachi. The participants were selected using a non-probability convenience sampling method. Data were collected through an online questionnaire assessing knowledge and attitudes towards palliative care. The association between demographic factors and students' knowledge and attitudes was analyzed using SPSS version 26.The study population consisted of 70.8% female and 29.3% male students, with 79.3% aged 20-25 years. A majority (53.7%) of participants demonstrated good knowledge of palliative care, while 46.3% had poor knowledge. Attitudinal analysis revealed that 74.7% had a moderate attitude towards palliative care, 24.3% had a favorable attitude, and 1.0% had an unfavorable attitude. Significant associations were found between university type, upbringing, and national origin with both knowledge and attitudes. Students from government universities and those with urban upbringing were more likely to have good knowledge and favorable attitudes. Additionally, gender was significantly associated with attitudes, with females showing more favorable attitudes towards palliative care (p<0.001).The study highlights the need for targeted educational interventions to improve knowledge and attitudes towards palliative care among medical students in Pakistan. The findings suggest that demographic factors play a crucial role in shaping students' perceptions, underscoring the importance of curriculum reforms that address these disparities to prepare future healthcare providers for delivering effective palliative care.