Medical students in Tamil Nadu value forensic medicine but few plan careers in it

Medical undergraduates in Northeast Tamil Nadu largely appreciate the role of forensic medicine in clinical practice, but only a small minority want to pursue it as a specialty, according to an analytical cross-sectional questionnaire study published in BMC Medical Education. Among 397 consenting responses analysed from 409 submissions, 97.2 percent were Final Year Part I MBBS students, making the cohort strongly weighted towards students who had already been exposed to the discipline during their course.

The degree curriculum was the most commonly reported knowledge source, cited by 80.1 percent of respondents. Awareness was highest for three areas: autopsies, medico-legal litigation, and sexual assault cases. Attitudes towards the discipline were strongly positive, with 91.7 percent agreeing that forensic medicine defines the role of forensic physicians and 90.2 percent agreeing that practitioners should know liability laws. Autopsy attendance was considered educationally important by 90.2 percent of students.

Fear of litigation driving defensive medical decisions was reported by 71.8 percent of respondents, a figure the authors highlight alongside the high perceived relevance of the subject. Defensive medicine, as defined in the study, refers to clinical decisions taken primarily to reduce perceived medico-legal risk rather than to benefit the patient directly. Perceived course importance and perceived sufficiency of teaching were moderately correlated, with a Spearman correlation coefficient of 0.569 (p < 0.001), suggesting that students who saw the subject as important were also somewhat more likely to regard their training in it as adequate, though a moderate correlation of this kind does not establish which perception drives the other.

Specialty orientation was the weakest link. Definite willingness to pursue forensic medicine as a residency was limited to 18.4 percent of respondents. Among those definite responders, multivariable logistic regression identified three factors associated with willingness to choose the specialty: familiarity with defensive medicine (adjusted odds ratio 1.42), reported influence of the course on residency choice (adjusted odds ratio 6.48), and reported influence of liability knowledge (adjusted odds ratio 4.61). These are self-reported associations from a single questionnaire administered at one point in time, so they indicate which attitudes track with specialty interest rather than proving that any factor causes students to choose forensic medicine.

The authors frame the findings as evidence of educational needs and perceptions rather than objective measures of competency. Because the study is a self-reported cross-sectional survey of students in participating colleges in one region, dominated by a single year of study, the results cannot be generalised to all Indian undergraduates, and no causal conclusions can be drawn from the correlations reported. The background section notes that Indian undergraduate evidence on forensic medicine perceptions, medico-legal concern, autopsy learning, and specialty choice has remained limited, which the study partly addresses for this region.

The overall picture that emerges is of a student body that recognises the clinical and medico-legal importance of forensic medicine and toxicology, links the discipline to documentation, death investigation, injury interpretation, and accountability, yet shows modest interest in it as a career. With more than nine in ten students endorsing the discipline’s defining role and the educational value of autopsies, but fewer than one in five definitely willing to enter the specialty, the survey points to a gap between perceived relevance and specialty orientation among final-year-dominant undergraduates in Northeast Tamil Nadu.

Subject of Research: Forensic medicine awareness, medico-legal risk perception and specialty choice among medical undergraduates in Northeast Tamil Nadu

Article Title: Insight of forensic medicine awareness, medico-legal risk perception and specialty orientation among final-year-dominant medical undergraduates in Northeast Tamil Nadu: an analytical cross-sectional study

Article References: Mohan, S., & Arun Prakash, D. K. S. (2026). Insight of forensic medicine awareness, medico-legal risk perception and specialty orientation among final-year-dominant medical undergraduates in Northeast Tamil Nadu: an analytical cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10236-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10236-4

Keywords: forensic medicine, medical education, cross-sectional study, defensive medicine, medico-legal risk, autopsy, undergraduate students, Tamil Nadu, specialty choice, survey, Insight, forensic