The authors were members of the first group of medical students to participate in a newly modified third-year surgery clerkship at the University of Kentucky College of Medicine. The primary teaching methodology of this clerkship is problem-based learning (PBL). In this type of learning experience, students work with paper cases as though they were actual patients, using a method similar to that which they will later use as residents or practising physicians. The students make the decisions themselves, formulating differential diagnoses, eliciting relevant items from a history and physical examination, proceeding with a diagnostic work-up, and creating a treatment plan. This problem-based method increases students' use of resources, improves their retention of information, and helps them develop time management skills. Although the students believe that the clerkship as a whole should offer more opportunities for hands-on experience, they found the PBL component of the clerkship highly motivating, intellectually stimulating, and experientially satisfying.