Objective  To provide inspiration for the clinical application and development of fecal microbiota transplantation (FMT) by investigating the awareness and acceptance of this technology among clinical medical students of different grades.

  Methods  An electronic questionnaire was used to investigate the group of eight-year medical students at Peking Union Medical College, Tsinghua University from Class 2014—2021. The students were divided into clinical medicine group (Class 2014—2016), transitional group (Class 2017—2018) and basic medicine group (Class 2019—2021) according to their grades. The awareness and acceptance of FMT among different groups of medical students were explored through data analysis and comparison between different groups.

  Results  A total of 210 questionnaires were distributed and 205 valid questionnaires were recovered, with an effective recovery rate of 97.6%. There were significant differences in FMT awareness among medical students of different grades (P < 0.001). 35.6%(73/205) of the medical students did not know anything about FMT, among which the basic group had the highest proportion, compared with the clinical group and the transition group, and the difference was statistically significant(59.7% vs. 10.3%, P < 0.001; 59.7% vs. 32.0%, P=0.001). 77.1%(158/205) of medical students agreed to use FMT for disease treatment, and the proportion of clinical group(82.8%) and transition group (82.7%) was higher than that of basic group (66.7%). The main concerns of not agreeing to use FMT for the treatment of patients' diseases were "insufficient evidence of evidence-based medicine" and "fear of infection with other unknown diseases". 78.0%(160/205) agreed to use FMT for the treatment of their own diseases, and the proportions of clinical group, transition group and basic group were 77.6%, 81.3% and 75.0%, respectively. Moreover, 83.7%(169 / 202) of medical students were willing to donate their fecal microbiota for disease treatment.

  Conclusions  The overall awareness of FMT among medical students is insufficient, but with the increase of years of education, the awareness continues to improve. Meanwhile, most medical students are willing to donate their fecal microbiota and accept FMT as an exploratory attempt for the treatment of patients' and their own diseases, which will help promote the development of FMT related clinical research in China. More attention should be paid to the promotion of FMT related research among medical students, in order to offer more insights and suggestions for the development and improvement of new technologies.