Association Between Medico-Legal Training and Competency in Ethical Reasoning and Risk Assessment Among Final Year Medical Students in Southwest Nigeria

Background: Despite rising medical litigation and evolving patient rights, medico-legal training remains peripheral in sub-Saharan Africa. This leaves final-year medical students in Nigeria potentially unprepared for ethical and legal aspects of practice, with limited evidence on its association with ethical reasoning and risk assessment. Objective: To assess the association between medico-legal training and competency in ethical reasoning and risk assessment among final-year medical students in Southwest Nigeria. Methodology: A multicentre cross-sectional study among 157 final-year medical students in Southwest Nigeria. Data were collected via a structured, expert validated questionnaire assessing medico-legal training exposure, ethical reasoning, risk assessment, and perceptions. Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression (p<0.05). Results: Mean age was 24.03 ± 2.11 years; 65.6% were female. Overall, 73.9% received medico-legal training, mainly lectures (58.3%) and case-based discussions (26.0%). Mean scores were: ethical reasoning 21.06 ± 3.40, risk assessment 27.29 ± 4.86, and perception 27.74 ± 5.35. Ethical reasoning strongly correlated with risk assessment (r=0.761, p<0.001), with moderate correlations to perception (r=0.415-0.576, p<0.001). Regression analysis showed a small positive but non-significant association between medico-legal reinforcement and risk assessment (β=0.116). Conclusion: Although medico-legal training exposure is common, weak associations with competency outcomes suggest that current training approaches may benefit from greater emphasis on structured, practical, case-based methods. Nigerian medical schools should strengthen medico-legal curricula to better prepare future clinicians. Keywords: Medico-Legal Training; Ethical Reasoning; Risk Assessment; Clinical Decision-Making; Medical Education; Southwest Nigeria.