Association between Undergraduate Medical Education Factors and Self-Reported Quality of Patient Care among Junior Doctors in Tertiary Care Hospitals

Abstract

Background: Undergraduate medical education (UME) shapes the knowledge, skills, professional behaviours, and preparedness of doctors entering clinical practice. However, evidence linking specific UME factors with the quality of patient care reported by junior doctors in Pakistan remains limited.

Objective: To assess the association between key UME factors and self-reported quality of patient care among junior doctors working in tertiary care hospitals.

Methods: This cross-sectional analytical study included 425 house officers, postgraduate trainees, and medical officers who had graduated within the preceding five years and were recruited consecutively from tertiary care hospitals between January and June 2026. A structured questionnaire assessed ten UME domains and five patient-care quality domains using five-point Likert scales. Associations were examined using Spearman correlation, group differences using Welch's t-test and one-way ANOVA, and independent predictors using multiple linear and binary logistic regression adjusted for age, gender, designation, college type, and curriculum type.

Results: Perceived preparedness was moderate across all UME domains (mean scores 3.45-3.53), whereas the mean self-reported patient-care quality score was 4.13 ± 0.52; 63.1% of respondents were classified in the good-care category. All ten UME domains were positively correlated with total care quality (Spearman ρ = 0.597-0.666; all p < 0.001). The linear regression model explained 83.7% of the variance in care quality (adjusted R² = 0.83). Interprofessional learning, ethics and professionalism, teaching methods, and clinical exposure showed the largest standardized coefficients. Unadjusted care-quality scores did not differ significantly by gender, designation, college type, or curriculum type.

Conclusion: UME factors were consistently associated with self-reported patient-care quality. Interprofessional learning, ethics and professionalism, teaching methods, and clinical exposure emerged as prominent predictors. Strengthening these areas may improve graduates' preparedness and support safer, more patient-centred care.