Objective To characterise some of the environmental factors that are sensitive to cultural influence, and are involved in the development of medical empathy in Spanish and Latin American physicians-in-training. Design Cross-sectional study using questionnaires. Setting Primary care and specialized medicine centres of the Healthcare System of La Rioja, Logroño, Spain. Participants Physicians-in-training Main measurements: Empathy was measured using the Jefferson Scale of Physician Empathy, version for healthcare professionals (JSE-HP). Socio-demographic, academic, and professional background information was collected. Results A total of 104 residents (67 from Spain and 32 from Latin America) answered and returned the questionnairess. The JSE-HP showed adequate psychometric properties. The empathy mean score of Spanish group was higher than that of the Latin American group (P=.01). Differences in the development of empathy were associated with: the development of professional models (P<.001), the positive encounter with other professionals (P=.001), and with a continuing medical education (P=.008). Conclusions Some factors involved in the development of empathy that are sensitive to cultural influence have been characterised. The development of future research areas is suggested.