The objective of this study was to survey medical students for a measurable opinion or knowledge increase in prehospital care after a fourth-year clerkship in emergency medicine (EM). The goal of the mandatory prehospital care aspect of the clerkship was twofold: to diminish the prehospital knowledge gap in medical school by teaching students about prehospital protocols and disaster medicine and to increase student interest. The study setting was within a university-based academic EM department with a prehospital system of 250 prehospital personnel. Data were collected from two similar questionnaires administered pre- and post-rotation to 49 fourth-year medical students. Statistical analyses were applied to collected data to quantify the changes of opinion and knowledge. Questions used a Likert five-point Scale. The data verified the improvement of students' knowledge in multiple areas of assessment. Greater than 35% opinion change (two points on the Likert Scale) was found in areas of prehospital care, 911 dispatch and education differences in prehospital providers (all p<0.0001; 95% CI 0.90 to 1.02, 0.66 to 0.90 and 0.66 to 0.90, respectively). Greater than 35% opinion change was also found in understanding triage (p=0.03; 95% CI 0.29 to 0.58) and general teaching of prehospital care, fellowship opportunities and use of a monitor/defibrillator (p<0.0001, p<0.0001 and p=0.04, respectively). We found medical students developed a significantly improved understanding of prehospital care. Without extraordinary effort, academic emergency departments could easily include a significant experience and education within fourth-year EM clerkships.