Background
Medical students and doctors face various challenges in clinical practice. Some of these challenges are
related to ethical issues. Therefore, teaching ethics respectively building moral competences has become an integral part of the medical curriculum in Germany and many other countries. To date, there is little evidence on moral competence of medical students.

Methods
Self-administered survey among medical students from one German medical school in the first (cohort 1) and fifth semester (cohort 2) in the winter term 2019/20 (T0). Both cohorts received the same questionnaire one year later in winter term 2020/21 (T1). Assessment was performed with Lind’s Moral Competence Test. We performed convenience sampling. We analyzed the data with descriptive statistics and C-Scores as a measure of moral competence (higher scores=higher competence, ≥30 points=high competence).

Results
A total of 613 students participated in the study (response rate 67.5%, n=288 with data on both time points). 69.6% of the participants were female, the mean age was 21.3 years. Mean C-Score for both cohorts for T0 (first and fifth semester) is 32.5±18.0 and for T1 (third and seventh semester) is 30.4±17.9. Overall, 6.6% (T0) and 6.7% (T1) of respondents showed some but very low moral competence. 3.3% (T0) and 3.0% (T1) showed no moral competence. Additionally, students without prior experience in the healthcare system scored 3.0 points higher.

Conclusions
Improvement of assessment of moral competence as well effective interventions are particular needed
for supporting those students which have been identified to demonstrate little moral competences.