Background: Despite published consensus-based statements on assessment of ECG interpretation skills, studies and curricula regarding the training needed to obtain basic ECG interpretation skills are lacking. These consensus statements have focused on at-taining competency in ECG interpretation during postgraduate training; however, recommendations regarding assessment of competency in the undergraduate curriculum are not discussed. Purpose: The purpose is to describe the current methods of teaching and assessing ECG interpretation skills across institutions on the 3rd-year internal medicine (IM) clerkship. Method: In 2005, the Clerkship Directors in Internal Medicine surveyed its institutional members. Twelve questions on the survey dealt with ECG interpretation. Descriptive statistics, chi-square, and Mann-Whitney U were used for analysis. Results: Eighty-eight of 109 members (81%) responded to the survey. Overall, 89% of institutional respondents feel that ECG inter pretation is an important clinical skill for medical students with 92% indicating that instruction occurs on the IM clerkship. Lectures (75%) and teaching rounds (44%) were the most cited methods of instruction. Most schools spend 1 to 6 hr during the IM clerkship on formal ECG instruction. Over 63% indicated that ECG interpretation skills are assessed during the clerkship. The most common assessment methods were written exam (40%) and OSCE (23%). Conclusions: Objective data regarding attainment and assessment of basic ECG interpretation competency in the undergraduate curriculum are lacking; our report provides preliminary descriptive data regarding ECG teaching and assessment on the 3rd-year IM clerkship. Further studies are needed to determine the ideal method of instruction and evaluation of this important clinical skill.