AbstractIn the academic year 1989–1990, the Department of Surgery at the University of Kentucky College of Medicine introduced a modified third‐year surgery clerkship. Its goals were to eliminate the lecture method of instruction, to involve students actively in the educational process, and to emphasize decision‐making and problem‐solving skills in the third year of medical school. Hands‐on training in patient care procedures would be offered in a fourth‐year acting internship after students had learned both problem‐solving and life‐long learning skills while concurrently developing a medical knowledge base. Students were removed from the traditional surgical service teams, since it was decided that team duties might be detrimental to educational goals. Problem‐based tutorial sessions were designed, and a block of unscheduled time was provided for students to use in obtaining, exploring, and reflecting on medical information. Informal comparisons of students in the previous clerkships with those in the modified clerkship have noted positive changes in the students' intellectual maturity, motivation, enthusiasm, and time‐management skills. Faculty and students have responded positively to the programs which are part of this i