In 1977 the Department of Anesthesiology of the Medical College of Virginia coordinated a compulsory 72-hour course for first-year medical students fulfilling all requirements of the Department of Transportation and leading to eligibility for certification of the medical student as an Emergency Medical Technician (EMT-A). We describe the methodology and content of this course, as well as problems encountered and lessons learned. This sound foundation in emergency care concepts will enable the medical student to develop greater competence in critical skills during the clinical years.