Objectives
Empathy is crucial in patient-centered care, enabling shared decision-making, better satisfaction, and clinical outcomes. We examined the association between empathy and personality in a sample of medical students from Brazil. 

Methods
The sample comprised medical students from the first to sixth year at a private university in Sao Paulo. Empathy was evaluated cross-sectionally using the Interpersonal Reactivity Index. The NEO Five-Factor Inventory was used to assess personality domains. A multivariate linear regression analysis modeled the association between personality and empathy.  

Results
The final sample consisted of 227 subjects. The mean age was 24.2 (SD 4.3) years, and the sample was predominately female (75%). Higher levels of Neuroticism (β = 2.11, 95% CI 0.84–3.38, P = 0.001) and Agreeableness (β = 2.50, 95% CI 1.46–3.53, P < 0.001) were associated with higher empathy scores. Extraversion (β = 0.00, 95% CI -1.26–1.26, P = 0.998); Openness to Experience (β = 0.85, 95% CI -0.28–1.98, P = 0.138), and Conscientiousness (β = -0.80, 95% CI -1.95–0.35, P = 0.173) did not show significant associations with empathy scores. Female gender, year in the program, and sociodemographic characteristics did not show significant associations with empathy. 

Conclusion
Both Neuroticism and Agreeableness were found to be associated with higher empathy. We review available interventions to enhance empathy and identified potential medical education curricular changes that could foster empathy development.