SUMMARYIn undergraduate medical education, a shift away from in‐patient teaching towards greater use of the ambulatory care setting is occurring. This paper looks at what effect this change in emphasis might have on students' clinical competence. A log‐book approach was used to study final‐year orthopaedic students' opportunities to interact with patients in the wards and out‐patient clinics at the University of Dundee Medical School. Students perceived that similar opportunities to interact with patients to develop and improve their clinical skills were provided by both settings. The study showed that much greater use could be made of both settings for clinical skills teaching. While students were not enthusiastic about the log‐book approach, it stimulated their thinking. It is concluded that student opportunities to develop clinical skills will not be adversely affected by the trend towards ambulatory care teaching. There should be more clinical teaching in the out‐pati