The practice of self-medication (SM) nowadays is widespread in societies and has been increasing over time due to the availability and easy access to medicines and increased knowledge of medical science [1]. World Health Organization (WHO) defines SM as “the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms” [2].

SM has largely been associated with the use of over-the-counter (OTC) medicines, which can be bought in pharmacies without a prescription. Responsible SM can be considered as a part of self-care, which is defined as “the ability of individuals, families, and social groups to promote health, prevent disease, maintain health, and manage illness and disability with or without the assistance of a health care provider” [3]. Responsible SM has an important role to play in health policy as it reduces unnecessary consultations, thereby reducing the burden on health care systems, particularly in terms of medical follow-up costs and physicians’ workload [4][5].

According to a systematic review and meta-analysis that assessed the incidence of SM worldwide from 2000 to 2018, the most common reason for SM was the mild nature of the condition and the patient’s preference for SM rather than consulting a doctor [1]. Pharmacies were the most common source of medicines for SM reported in the systematic review [1]. SM can have harmful consequences for society and health care systems, resulting in huge costs for countries. It is recognised that the risks associated with SM are mainly due to inappropriate use of medicines [5]. This may result in potential delay in treatment of a serious condition, masking of symptoms of a serious condition, drug interactions, adverse reaction, and antimicrobial resistance [6]. In fact, SM is the most common reason for the development of antibiotic resistance in human pathogens [7].

Young people, in particular students, are among the most vulnerable to SM, because of their higher educational level [8]. According to a systematic review, the prevalence of SM among university students was 70.1%, being higher among medical students (97.2%) than non-medical students (44.7%) [8]. Medical students typically possess extensive knowledge about drugs, as they frequently use them during their training in health centres and have easy access to medications, which may increase the likelihood of SM among this population. In fact, the practice of SM among medical students has been widely studied around the world. Many studies reported high prevalences of SM; 89.6% in Iran [9], 79.7% in Ethiopia [10], 81.3% in Serbia [11], 76.6% in Nepal [12], and 61.1% in Zambia [13].

In Morocco, no study has been carried out to assess the practice of SM among medical students. Thus, the objectives of our study were to estimate the prevalence of SM practice, to describe its characteristics among Moroccan medical students, and to identify factors associated with this practice.

To our knowledge, this study is the first study conducted in Morocco about the practice of SM among medical students. SM practice was highly prevalent among medical students of the FMPC, with 83.59% of them reporting SM in the last sixth months. A variety of results have been reported in the literature for a period of SM practice ranging from one to 12 months. Similar to our study, an Iranian study reported a prevalence of 89.6% in the past six months among medical sciences students [9]. In a Nepalese study, an approach covering the last two months found a prevalence of 76.6% [12]. In contrast, a study in Saudi Arabia reported a prevalence in the previous month of 49.3% among medical students [14]. This wide variation across countries could be explained by differences in advertising, and in legislations, and the ability to obtain certain drugs without a prescription, the quality of health care services as well as the duration of SM practice assumed in each study.

Paracetamol was the most commonly used drug for SM in our study. Similarly, analgesic-antipyretic was the most used drug reported in various studies [12][15]-[17]. Paracetamol was also the most commonly used medication by medical students during the COVID 19 pandemic [18]. In fact, Paracetamol is one of the most commonly prescribed and recommended over-the-counter molecules, but it is also used for SM, as it has a wide range of indications. Its danger is often unjustly minimized, yet its use in high doses carries significant risks, in particular hepatotoxicity [19]. In our study, antibiotics were the second most commonly used drugs for SM (50.5%). Similarly, in studies conducted among university students in Ethiopia and Nigeria, and a study conducted among medical students in Zambia, antibiotics were found to be the second most used type of medication after analgesics [13][16][17]. In contrast, a southeastern Iranian study of pharmacy and medical students found that antibiotics (74.4%) were the most commonly used drugs followed by analgesics (59.0%) [20]. In many low- and middle-income countries, it is common for patients to buy antibiotics from drugstores without a prescription [21]. This could explain the high prevalence of antimicrobial resistance (AMR) in these countries, knowing that SM with antibiotics is the major reason of AMR [7]. Medical students need to be fully aware of this problem, as they will be the future prescribers of antibiotics. According to a Saudi Arabian study, most medical students showed negative behaviors regarding the practice and attitudes toward SM with antibiotics, although they had fairly good knowledge about the efficacy, possible adverse drug reactions, and side effects of antibiotics compared to non-medical students [22].

Pain, fever and headache were the main symptoms for which our participants turned to SM. Similar results were reported in the literature [12][15][23][24]. As these symptoms are common, students believe that they can be easily cured, whereas they could be symptoms of other diseases. In our study, SM for pre-menstrual syndrome was reported by 56.8% of female medical students. Similar results were reported by a Nepalese study with only 7.3% of the participants who sought medical consultation, reporting that SM and traditional therapies were common modalities used for treatment of premenstrual symptoms [25].

The drugstore (81.4%) was the main source of medication for SM practice among our participants. Similar results have been reported in different studies [12][14][15][26][27]. The dispensing of many medicines, including antibiotics, without a prescription is common in Moroccan pharmacies, as in many developing countries [21]. It is therefore necessary to raise awareness of the seriousness of this practice for public health. Pharmacists should take the initiative to advise patients to seek medical advice when appropriate, and the government needs to implement new policies to address this issue. In our study, the main sources of information about drugs used for SM practice were previous prescriptions (72.0%), academic knowledge (66.5%), and pharmacies (58.4%). Similarly, the primary information sources in the southeastern Iranian study were previous prescriptions (47.4%) and their own academic knowledge (39.3%) [20].

The main reasons for SM reported by our participants were previous experience with the medicine (88.7%), sufficient medical knowledge of the disease (72.5%), for urgent use (68.8%), easy access to treatment (66.0%), and mild pathology (65.7%). In contrast, the most common reasons reported in the southeastern Iranian study were the mild nature of the disease and confidence in one’s own academic knowledge [20]. On the other hand, long queues at the hospital (75.0%) and lack of time (65.0%) were the main reasons reported in a Zambian study [13]. The majority of our participants (86.4%) believed that the safety of SM practice depends on the medication used. These results show that students are fairly aware that although SM can sometimes be practiced without risk, it often involves dangers that vary depending on the type of medication taken without medical supervision.

Being sixth/seventh year student was the only factor found to be significantly associated with SM practice in our study. Similar results were reported in the literature [11][13][28]. This could be explained by several contextual factors related to medical training in Morocco. Final-year students typically undertake full-time clinical rotations, unlike junior students whose placements are often limited to half-day rotations. This enhances their familiarity with medications and may reinforce a perceived sense of therapeutic competence. Moreover, during hospital rotations—particularly during emergency on-call shifts—final-year students have easier access to medications, including samples provided by pharmaceutical representatives, which may increase the likelihood of SM. These findings highlight the need for targeted interventions among senior medical students, focusing on rational drug use, professional responsibility, and the potential risks associated with unsupervised self-prescribing, even in medically trained individuals.

This study has some limitations. Recall bias may have occurred, as participants reported self-medication practices over the previous six months, which may have led to inaccurate reporting. In addition, recovery and side effects were self-reported and not clinically verified, introducing potential misclassification and reporting bias. Finally, the use of convenience sampling limits generalizability, as the estimated prevalence and observed associations may not be representative of the wider population due to possible selection bias. These limitations should be considered when interpreting the results.

Self-medication practice was highly prevalent among Moroccan medical students, especially among senior students. Medical students must be better educated about the risks of self-medication, with a particular focus on the prudent use of antibiotics, in the context of antibiotic resistance crisis. It is also crucial to improve student access to health services by offering low-cost or free medical consultations within the university. Furthermore, it is vital to strengthen governmental regulations on the sale of over-the-counter medicines in pharmacies, especially antibiotics.