As air travel rebounds in the post-COVID-19 period, in-flight medical emergencies (IMEs) are anticipated to become more frequent. Despite this, there is limited research assessing the readiness of health profession students to respond to such situations. This study aimed to evaluate medical students’ knowledge, confidence, and willingness to assist in an IME within their internship program. A cross-sectional design was employed using an online, self-administered questionnaire distributed to medical students at two Saudi Arabian medical colleges. The survey consisted of three sections: sociodemographic information, knowledge of aviation medicine (10 questions), confidence (7 questions), and willingness (4 questions) to respond to IMEs. Associations between knowledge levels and independent variables were assessed using odds ratios (OR) and 95% confidence intervals (95% CI). Confidence and willingness responses were measured using a 5-point Likert scale. The results revealed that 61.4% of participants demonstrated insufficient knowledge for managing an IME. Attendance in life support courses did not significantly affect knowledge levels (60.4% vs. 66.7%, P > 0.99). The only factor associated with higher knowledge was flying at least twice a year [OR = 1.89 (95% CI = 1.14–3.17), P = 0.02]. Regarding willingness, 93.3% of students scored low, 6.3% moderate, and 0.8% high. Confidence scores were similarly low for 86.3%, moderate for 12.2%, and high for 1.5% of participants. Attendance in life support courses did not influence confidence or willingness scores. Despite the majority of students having previously completed life support training, most lacked adequate knowledge, confidence, and willingness to respond to IMEs. These findings highlight the critical need for targeted education on in-flight medical emergencies and their specific challenges before students enter their mandatory 7th-year internship.
