Problem Based Learning (PBL) has been forwarded as a more favorable way of teaching medical curricula than more classical, discipline oriented way of knowledge transfer. From 1974 on PBL has been introduced in the curriculum of the Medical Faculty of the Maastricht University. In the latest, reviewed form of the curriculum (start in 2001) a more gradual transition from pure theoretical knowledge transfer to patient oriented learning approach has been introduced. In the first 2 years, 6 teaching blocks of 6-8 weeks each were constructed. Emergency care and general homeostatic mechanisms were key issue in the first year, and stages of life and diagnostics were the leading issues in the second year. Basic physiological principles were transferred via integrated patient cases to be discussed in small tutorial groups. Integration of knowledge was evaluated in a summative manner. From the 4th year on clinical clerkships were preceded by an introductory week in which, among others, the pathophysiological background of the patients to be encountered was discussed. At the end of the clerkship student were asked to present the pathophysiological background of the diseased patient. Ongoing internal and external evaluation will learn whether PBL is a better knowledge transfer carrier than the more classical discipline oriented transfer. At present, comparison of the summative evaluation, as carried out at medical faculties in 3 Dutch universities does not provide exclusive evidence for a better learning result of PBL. However, in a comparison between the results of Maastricht and Groningen students, the latter of which still follow a more classical discipline oriented curriculum, Maastricht students obtain significantly better results on OSCE (Objective Structured Clinical Encounter) tests. Aside from this, annual interviews of students learn that PBL is preferred over the more classical way of learning.