Summary.Significant trends in teaching biostatistics to medical students include: (1) recognition of the dependence of advancement in the medical sciences upon the quantitative sciences; (2) integration of biostatistics and other disciplines such as epidemiology and community medicine; (3) increased emphasis on clinical relevance through the introduction of such topics as medical decision‐making, evaluation of diagnostic test, genetic counselling and evaluating health‐science literature; (4) growing emphasis on analytic skills and computer literacy as precipitated by the presence of computerbased patient and medical information systems, expert systems, imaging and signal analysis systems; (5) the emergence of new applications of statistics in health and medicine; and (6) changes in the learning environment, for example emphasis on small‐group discussions and problem‐solving sessions. The evolution and future directions of biometrical training in medicine as precipitated by these trends, and the response of course directors at the Medical University of South Carolina to the demand for a‘new’ curriculum in biostatistics for medical students ar