Cross-sectional study of resident physician knowledge and perceptions regarding MASLD in Canada

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately 25% of Canadians. As its prevalence grows, it is crucial for future primary care physicians to have a thorough understanding of MASLD to improve patient care. Methods: We conducted a nationwide cross-sectional survey among resident physicians in primary care specialties to assess their knowledge and perceptions of MASLD. "Reasonable knowledge" was defined as correctly answering over 50% of the questions. Associations were analyzed using chi(2) testing and multiple logistic regression analysis. Results: We received 413 responses, with 252 (61%) from Family Medicine residents and 161 (39%) from Internal Medicine residents. Among the respondents, 91% considered MASLD an important public health issue; however, only 11% felt they had adequate exposure to the condition and 94% endorsed a need for more teaching. Overall, 35% of the respondents displayed a reasonable knowledge of MASLD. In univariate analysis, factors associated with greater MASLD knowledge included Internal Medicine residency (p = 0.001), higher post-graduate year (p = 0.003), prior GI or hepatology rotations (p = 0.003), previous MASLD lectures (p = 0.021), and higher subjective familiarity with MASLD (p <0.001). However, only moderate (odds ratio (OR) 5.7, 95% CI 1.1-26.3, p = 0.026) and high (OR 10.1, CI 1.6-65.3, p = 0.015) subjective familiarity with MASLD, and three or more prior MASLD lectures (OR 3.4, CI:1.1-10.4, p = 0.031) remained statistically significant in multivariate analysis. Conclusions: Resident physicians recognize MASLD as an important health issue but lack adequate exposure and knowledge about the condition. Further emphasis and education are required to bridge these knowledge gaps and improve patient outcomes.