SUMMARYThe study assessed the effectiveness of a programme aimed at increasing medical students' skills in counselling patients presenting for HIV testing/AIDS information. Senior medical students were randomly assigned to receive a short course in pre‐ and post‐test counselling, or to a control group which received the usual curriculum. The students' performance in counselling simulated patients was videotaped at baseline and after 3 months. A subsample was also assessed at 12 months. Students receiving the programme showed significantly greater improvement in pre‐ and post‐test counselling skills over 3 months than did the controls. For the subsample continuing to 12 months, a significant effect over time was found; however, there was no significant difference between the groups. This may have been influenced by the small sample sizes used for the 12‐month assessment. General interactional skills improved for the overall sample over 3 and 12 months, but again there were no significant differences between groups. Those exposed to the programme did not show significantly greater changes in either knowledge or attitude scores over either time frame, compared with controls. When taught in addition to the usual undergraduate curriculum at Newcastle University, this short interactional skills course significantly enhanced students' ability to provide pre‐ or post‐test counselling