Given the highly competitive and motivating nature of today's students, gamification, when properly implemented, can be an effective learning tool. Here we studied which gamification (gaming) elements that medical students would be interested in having when using an online learning system to acquire clinical skills. Focus groups sessions were held with medical students, game developers, and game designers to develop an understanding about their perception and preferences regarding gamification. Overall it was determined that gamification will lead to increased engagement and motivation and should include both competitive and social elements.