The main conclusion is that all three medical schools cannot rely on clerkship experiences alone to provide adequate basic skills training. A problem-based learning environment and training in a skills laboratory appear to result in students performing more skills during clerkships. Assessment of clinical skills, obligatory clerkships in specialties and general practice, and continuous monitoring of the quality of clerkships may also be strong determinants of the present findings.

Clinical clerkships do not automatically provide an ideal learning environment for medical students.

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SUM M ARY Effectivity of basic clinical skills am ong students in their ® nal year at tw o typically European m edical schools was evaluated. The two schools rely heavily on clerkships to train basic clinical skills. Three groups of ® nal-year students from tw o m edical schools were studied in a 12-station, 13-minute OS CE. This OSC E was based on existing skill lists and w as constructed in close consultation w ith faculty of both schools. Observers were senior faculty and experienced general practitioners. Students w ere rated unsatisfactory in any station when a m ean score of # 50% was given. Results show poor overall perform ance, indicating defective skills training, for skills of both the com pulsory and the non-com pulsory clerkships. Therefore curricula need revision and in the m eantime basic clinical skills should receive ample attention in postgraduate education. Notes on contributorsRO Y REMMEN, MD is a general practitioner and researcher in the