Participation in a medical academic Olympiad is associated with high intrinsic motivation and positive perceptions of academic outcomes.

Academic and scientific Olympiads have been used as educational tools since the late nineteenth century, fostering students' interest, creativity, and critical thinking. However, their application in medical education remains limited. In this context, Brazilian medical students created the Medical Olympiad (OMED), a nationwide, student-led initiative designed to promote active and collaborative learning, foster clinical reasoning, and enhance academic engagement. Despite the long-standing use of Olympiads in basic education, their educational impact in medical school has been minimally investigated. This cross-sectional study evaluated the educational impact of OMED by examining its influence on participants' intrinsic motivation and their perceptions of its academic benefits. A structured questionnaire was administered to students after the first phase of the fourth edition of OMED (held in 2024) and completed by 677 participants. Participation was predominantly driven by intrinsic and other self-determined forms of motivation. Postevent assessments indicated that OMED has strong potential to promote the internalization of motivation and to enhance students' overall motivation to study. Participants also reported that the Olympiad supported knowledge acquisition and consolidation, self-assessment of strengths and weaknesses, and the development of clinical reasoning, suggesting that OMED effectively achieved its educational objectives.NEW & NOTEWORTHY This study provides the first empirical evaluation of a student-led medical Olympiad within undergraduate medical education. By analyzing responses from 677 participants, it demonstrates that such initiatives can foster intrinsic motivation and enhance academic outcomes. Although academic Olympiads are well established in basic education, their use and educational impact in medical training have been largely unexplored. These findings highlight the substantial educational potential of student-driven, competition-based learning environments in medical education.