Abstract

Background: The Medical Certificate of Cause of Death is not just a legal formality but the backbone of accurate public health surveillance and policy, yet error rates as high as 50–60% threaten the integrity of national health data and decisionmaking. Addressing persistent gaps in knowledge and practice among medical ndergraduates is crucial to ensure reliable mortality statistics and effective healthcare planning for the nation’s future. Objectives: To evaluate medical undergraduates’ knowledge, awareness, and practical competence regarding the purpose, legal significance, correct completion, guidelines, and common errors of the Medical Certificate of Cause of Death, and to identify gaps in these areas. Materials and Methods: This cross-sectional study was conducted among third year, final year, and Compulsory Rotatory Medical Internship (CRMI) students, at Chettinad Hospital and Research Institute using a structured, self-administered online questionnaire to assess knowledge and awareness regarding the Medical Certificate of Cause of Death. Data were analyzed with SPSS version 29, and ethical approval was obtained from the Institutional Ethics Committee. Results: While all surveyed medical undergraduates correctly identified the expansion and legal importance of the MCCD, significant knowledge gaps persisted only about 80% knew when not to issue an MCCD, and just 70–80% consistently applied the correct sequencing of causes of death, especially in complex cases. These findings highlight persistent deficiencies in both the practical and legal aspects of MCCD completion among future certifiers. Conclusion: Precise and diligent death certification forms the bedrock of reliable health data and effective public health policy. Strengthening this competency among medical professionals is essential to uphold the integrity of healthcare systems and ensure informed decision-making at every level.

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