Purpose: Clinical skills are often taught in preclinical courses such as "Introduction to Clinical Medicine" (ICM). We sought to define current national course objectives, roles of standardized and real patients, and methods of assessment in ICM courses, and to readdress the need and desire for establishing consensus. Methods: In April 2005, the Clerkship Directors in Internal Medicine (CDIM) organization conducted its annual, voluntary, and confidential survey. The survey contained a section (24 questions) on preclinical education teaching methods and evaluations. Results: Wide variations exist in the teaching and assessment methods used by ICM courses in 4-ycar medical schools. Respondents indicated a desire for a consensus statement concerning ICM course objectives in addition to guidance on case development, use of standardized patients, and student assessments. Conclusion: Our findings suggest that consensus remains elusive for preclinical education teaching objectives, but would be embraced by ICM course directors.