Students at a Pakistani medical college were surveyed using instruments taken from Western research. The students who rated their courses positively tended to adopt an organised approach in their learning and studying. The students who perceived that their assessment and workload were inappropriate preferred a transmissive approach to teaching and adopted a surface approach in their learning and studying. The students who preferred a student-centred approach to teaching tended to adopt a deep approach in their learning and studying. This confirms the idea, well established in Western research, that there exists a strong relationship between students’ perceptions of their courses and the approaches that they adopt on those courses. However, the incorporation of problem-based learning in the medical curriculum had not led to any enhancement of their perceptions and preferences, nor had it led to an unambiguous improvement in their approaches to studying. This is attributed to the hybrid nature of their programmes, in which problem-based activities were combined with more conventional forms of teaching and assessment, and to the anxiety and stress which seem to be common among students at medical schools in Pakistan.
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