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Studies conducted among university students show non-compliance with the recommendations for healthy physical activity, while the factors that hinder or facilitate its practice remain insufficiently understood. The aim of this study is to examine barriers, motivations, and the degree of compliance with physical activity among medical students, comparing University of Seville, Spain (US) and Paris-Saclay University, France (UP-S) samples.

This cross-sectional empirical study included 223 undergraduate medical students (M = 22.30 years, SD = 2.259), from US and UP-S, 68.8% were women. In the selected classroom and in their respective languages, participants completed the instruments: International Physical Activity Questionnaire (IPAQ); habitual distances travelled; Self-Report of Barriers to Physical Exercise Practice (ABPEF); Goal Content for Exercise Questionnaire (GCEQ). The non-parametric Mann-Whitney U test was used, with significance set at p < 0.05, and correlational analyses were conducted using Kendall's tau-b (Tb) statistic in SPSS version 25.0.

UP-S students reported higher barriers than US students across all ABPEF factors, with significant differences in Total score (U = 4.616,5; p = 0.001), Fatigue/Laziness (p < 0.001), and Environment/Facilities (p = 0.002). US students showed significantly higher motivation in the Social Recognition factor of the GCEQ (p = 0.018). According to the IPAQ classification of three physical activity levels, US students were classified in the high physical activity level, whereas UP-S students were classified in the low and moderate levels (p < 0.001). The University/Country variable was associated with the distance from home to leisure facilities (p = 0.008), with the Total, Fatigue/Laziness, and Environment/Facilities (p = 0.002) barrier scores, and also with the Social Recognition motivational scale (p = 0.018).

The differences identified in our results highlight the need to consider the environmental context in studies on the physical activity of professionals directly involved in public health. US and UP-S medical students perceive Lack of time, primarily due to the high academic demands, as the main barrier to physical activity. Universities and European Higher Education Area policies should make greater efforts to provide physical and curricular environments that facilitate and motivate physical activity practice, within medical degree programs, a population that is key to the prevention of non-communicable diseases, in line with "Healthy Doctor - Healthy Patient", and the 3rd Sustainable Development Goal.