Background In low- and middle-income countries (LMICs), the family unit is the cornerstone of geriatric care. However, medical education often focuses on a biomedical, hospital-centric model. This study investigated medical students' perspectives on the role of family participation in elderly care and assessed the perceived adequacy of their clinical training in the Sudanese context.Methods A cross-sectional descriptive study was conducted at the Faculty of Medicine, Dongola University, Sudan, from July 2024 to April 2025. A validated, structured questionnaire was administered to 159 randomly sampled medical students. Data were analyzed using SPSS (v.26), employing the Kruskal-Wallis and Pearson tests to evaluate associations between academic seniority and perceptions.Results While 65.4% of participants had personal experience in elder care, only 33.3% had received formal geriatric training. Despite this, 81.1% felt personally prepared for geriatric practice—a "confidence gap" likely driven by cultural proximity. Students identified family as the primary caregiver (66.7%) and a vital source of emotional support (71.1%). Recognition of the family’s role as primary caregivers and advocates significantly increased with academic seniority ($p = 0.001$). Furthermore, 84.9% of students advocated for formal caregiver support systems, and 71.1% identified a critical need for physician-led caregiver training.Conclusion Medical students at Dongola University highly value family involvement in geriatric care, and this appreciation matures with clinical exposure. However, a significant gap exists between cultural intuition and formal clinical training. Medical curricula must transition toward a biopsychosocial model that equips future physicians to educate and support family caregivers as essential clinical partners.