Assessment of leadership competence among medical students in Saudi Arabia using the MeLeCoS scale: a cross-sectional study

Introduction Leadership competence is increasingly recognized as an essential attribute for physicians, enabling effective teamwork, healthcare system management, and improvement of patient outcomes. Medical schools worldwide are increasingly integrating leadership training into their curricula; however, limited evidence exists regarding leadership competence among medical students in Saudi Arabia. This study aimed to assess self-perceived leadership competencies among medical students at King Faisal University and to explore demographic and academic factors associated with leadership competence. Methods A cross-sectional study was conducted among medical students at the College of Medicine, King Faisal University, Alahsa, Saudi Arabia. Participants were selected using a proportionate stratified sampling technique to achieve representation across different academic years. Data were collected through a structured questionnaire consisting of demographic characteristics and the 37-item Medical Leadership Competency Scale (MeLeCoS), which assesses six domains of leadership competence: self-management, responsible behavior, teamwork, managing services, innovation in undergraduate education, and systemic perspectives. Descriptive statistics were used to summarize participant characteristics. Independent sample t-tests, one-way analysis of variance (ANOVA), Pearson's correlation, and multiple linear regression analyses were performed to identify factors associated with leadership competence. Results A total of 191 medical students participated in the study (overall response rate 59.5%). The mean age of participants was 21.76 ± 1.53 years and the mean GPA was 4.32 ± 0.63. Female students constituted 59.7% of the sample. The overall mean leadership competence score was 3.72 ± 0.58, indicating a moderate to high level of perceived leadership competence. Among the MeLeCoS domains, responsible behavior and teamwork demonstrated the highest competence levels, whereas innovation in undergraduate education showed the lowest score. Female students had significantly higher leadership competence scores compared with male students ( p = 0.001). Academic performance (GPA) was positively correlated with leadership competence (r = 0.217, p = 0.006). In multiple regression analysis, gender ( β = 0.256, p = 0.002) and GPA ( β = 0.201, p = 0.010) were identified as significant predictors of leadership competence. Medical students at King Faisal University reported moderate to high levels of self-perceived leadership competence, particularly in responsible behavior and teamwork. Gender and academic performance were significant predictors of self-perceived leadership competence. Discussion These findings highlight the importance of incorporating structured leadership development programs within undergraduate medical education to enhance leadership capacity among future physicians.