Knowledge and readiness toward precision medicine and pharmacogenomics in diabetes care among medical students: a cross-sectional study

Pharmacogenomics is an emerging component of precision medicine that may enable safer and more individualized treatment. Its application in diabetes is particularly relevant because patients can differ in their response to commonly used antidiabetic medications. This study aimed to assess knowledge, attitudes, readiness, and ethical concerns regarding precision medicine and pharmacogenomics in diabetes care among medical students in Palestine. A multicenter cross-sectional study was conducted among undergraduate medical students from Palestinian universities between June and August 2026. Data were collected using a self-administered online questionnaire assessing sociodemographic characteristics, knowledge, attitudes, readiness, ethical concerns, and educational needs. Knowledge was assessed using 18 true/false questions, while attitudes, readiness, and ethical concerns were assessed using five-point Likert-scale items. Data were analyzed using descriptive statistics, chi-square tests, Kruskal-Wallis tests, and multivariable logistic regression. Among 352 participants, 62.2% ( n = 219) demonstrated adequate knowledge, while 29.3% ( n = 103) had favourable attitudes and 18.8% ( n = 66) met the criterion for readiness. Greater experience with diabetes pathogenesis and treatment was independently associated with adequate knowledge (OR 1.78, 95% CI 1.36–2.34; p < 0.001) and favourable attitudes (OR 1.32, 95% CI 1.06–1.65; p = 0.013). Readiness was independently associated with greater biostatistics experience (OR 1.55, 95% CI 1.17–2.06; p = 0.002) and previous genetics study (OR 5.17, 95% CI 1.21–22.15; p = 0.027). Knowledge was significantly associated with attitudes and readiness, with a stronger association observed between attitudes and readiness (Cramér’s V = 0.39, p < 0.001). Only 23.0% of students believed that pharmacogenomics was adequately covered in their curriculum, while 89.2% supported its inclusion and 90.9% wanted additional training. Medical students demonstrated relatively good conceptual knowledge but limited readiness to apply pharmacogenomics in clinical practice. These findings highlight a gap between theoretical understanding and clinical preparedness and support the integration of structured, clinically oriented, and experiential pharmacogenomics education into medical curricula in Palestine.