SUMMARYMany factors play a part in determining the performance of students in examinations, but the extent to which students use library facilities does not appear to have been recently considered as a factor, in medicine or in any other academic subject. In this study, the number of books borrowed from the library by undergraduate medical students was used as a simple measure of library use, and significant differences in book‐borrowing levels were found between students in different years of the medical course, students from different regions of the world, and men and women students. In the first year of the course, students who borrowed most also performed best in their end‐of‐year examinations, and this association was only partly explained by regional differences. No such association was found among final‐year students, suggesting different study habits and different assessment criteria in the clinical years of the