Strengthening medical education through health policy and management training: a cross-sectional study among Portuguese medical students

Background and objectives: Modern health systems require physicians to not only provide high-quality clinical care but also understand, navigate, and lead complex healthcare organizations. However, undergraduate medical education in Portugal remains predominantly focused on clinical skills, with minimal exposure to health policy and management (HPM). This study aimed to assess Portuguese medical students' exposure to, attitudes toward, and preferences for HPM education. Methods: We conducted a cross-sectional survey of 483 medical students across 10 Portuguese medical schools. The questionnaire assessed prior exposure to HPM education, self-perceived knowledge of the national health system, curricular preferences, and civic participation. Results: = 141; 95% CI 25.1-33.2) reported any previous HPM training, and those with exposure were more likely to demonstrate higher institutional literacy and greater confidence in understanding health system governance. Overall, 94.8% supported the inclusion of HPM in the medical curriculum, and 64.4% supported making it compulsory, with stronger support among civically engaged students. Conclusion: Portuguese medical students had limited formal exposure to HPM but expressed strong demand for structured training in this area. These findings highlight a misalignment between current curricula and students' perceived needs and support the introduction of a mandatory HPM course in Portuguese medical schools to better prepare future physicians for leadership and governance roles within the health system.