<p>Cancer is a major cause of morbidity and mortality globally, leading to significant healthcare and socioeconomic burdens. Medical education is crucial in preparing future healthcare professionals to manage cancer care effectively. To compare the expectations of first-year medical students about oncology training with the actual knowledge and experiences of more advanced students. A cross-sectional, quantitative study was conducted with 373 medical students (152 first-year, 121 fourth-year, and 100 sixth-year) using structured questionnaires. Data was analyzed using SPSS version 25.0, with a 5% significance level. Most students considered oncology knowledge and training highly relevant, particularly in diagnostic methods, clinical examination, and palliative care (≥ 93%). However, significant differences emerged across years. Fourth-year students reported greater uncertainty about the relevance of diagnostic tools such as colonoscopy (<i>p</i> = 0.025), upper gastrointestinal endoscopy (<i>p</i> = 0.005), and mammography (<i>p</i> = 0.025), as well as hereditary syndromes (<i>p</i> = 0.016). Sixth-year students showed reduced endorsement of molecular testing, with 21.3% reporting neutrality. A striking gap was observed between the importance attributed to oncology internships by first-year students (≥ 84%) and the limited opportunities reported by advanced students, particularly in pathology, genetics, and radiotherapy (≤ 10% completion). Among those who completed internships, nearly all acknowledged their significant contribution to learning, especially in palliative care and clinical oncology. Despite strong recognition of oncology’s importance, gaps remain between students’ expectations and their actual educational experiences, particularly in genetics, molecular testing, and access to internships. Expanding structured, longitudinal, and practice-oriented oncology training is essential to prepare future physicians to meet the demands of cancer care and precision medicine.</p>