To evaluate students' overall assessment and effectiveness of the web-based blended learning conception "Unified Patient Project" (UPP) for medical students rotating on their otolaryngology internship (ear, nose, and throat [ENT] tertiary). Prospective comparison group design of the quasiexperimental type. Medical education. The experimental group (preintervention test [pretest], intervention, and postintervention test [posttest]) comprised 117 students, and the comparison group (pretest, alternative intervention, and posttest), 119. In the experimental group, lecturing of case studies was replaced by the blended learning concept UPP. A standardized questionnaire evaluated students' overall assessment of teaching otolaryngology. A pretest and posttest using multiple choice questions was administered to clarify whether the UPP has led to a knowledge gain. The comparison group was more satisfied with their teaching; however, this was not statistically significant (P = .26) compared with the UPP. Students with higher preknowledge benefitted from the UPP, while students with lower preknowledge did not (P = .01). On average, posttest results in the experimental group exceeded those of the comparison group by 8.7 percentage points for a 75% preknowledge of the maximum attainable score, while they fell below those of the comparison group by 8.1 percentage points for a 25% preknowledge. Students' satisfaction with the blended learning concept UPP was lower than in the face-to-face teaching, although this was not statistically significant. The new web-based UPP leads to an improved knowledge in clinical otolaryngology for all students. Students with lower preknowledge benefitted more from face-to-face teaching than from the UPP, while students with higher preknowledge benefitted more from the UPP. This implies students with poor preknowledge need special promotion programs.