Background: Since teaching is an important skill for future residency training and practice, training for this role should optimally be introduced as well as practiced in medical school. Studies have not fully explored the benefits and potential challenges of more senior medical students teaching more junior medical students. We define a near-peer as a trainee who is one or more years senior to another trainee on the same level of medical education training (i.e. medical students teaching other medical students, residents teaching other residents) Aim: The aim of this study was to investigate the perceptions of medical students regarding near-peer teaching and near-peer learning and to identify relevant teacher roles for near-peer teachers at two institutions from two different countries. Methods: The authors developed two questionnaires that were filled out by a convenience sample of students who have participated in near-peer teaching (as either learner or teacher). These questionnaires were distributed at the University Medical Centre Utrecht (UMC Utrecht), the Netherlands and the Uniformed Services University (USU), USA. Results: The majority of near-peer learners and near-peer teachers from both sites identified information provider, role model, and facilitator as suitable roles for near-peer teachers. Both groups agreed that planner and resource developer may be less suitable roles for near-peer teachers. Conclusion: Information provider, role model, facilitator appear to be appropriate roles for a near-peer teacher from the perspective of near-peer learners and teachers. Given the demands of future physicians to serve as educators for both junior physicians and patients, near-peer teaching during medical school appears to be an important curricular consideration.