Aims and Objectives: Approaches to learning refer to the manner in which students engage in learning tasks. Approaches encompass two signficant aspects of learning - motivation to learn and the choice of learning strategies that students make. Research has identfied two distinctly different approaches that can be broadly categorised as deep or surface approaches to learning. A number of studies have established an association between deep approaches to learning and qualitatively better learning outcomes, which are characterised by a high level of understanding. Although recent increases in graduate admissions have clouded the issues somewhat, medical students, on entry to undergraduate medicine programs are the highest achieving group among their peers. How do their approaches to learning ﬁt the paradigm? Are they consistently deep learners? This article explores the literature on approaches to learning. Method: Preliminary data from 44 Australian and 34 Sri Lankan medical students, who completed Biggs's revised two-factor Study Process Questionnaire (R-SPQ-2F), are reported. Conclusions: Some of the implications for medical education are considered, and further questions about the factors that determine students' approaches to learning are raised.