The values of pre-testing senior medical students at the start of their surgical terms are the perception that they acquire of the scope of the subject and the extra practice they gain in the technique of sitting multiple choice question (MCQ) exams. The purpose of this study was to determine whether MCQ in a pre-test that were repeated in a post-test were answered more accurately than questions that had not been repeated. For the past 3 years at the University of Queensland, fifth year medical students have been voluntarily sitting pre- and post-tests in each of the four surgical terms. Each examination consisted of 60 clinically oriented surgical questions of a difficulty appropriate for senior medical students. A total of 404 students did both the pre- and post-tests during 1990 and 1991. The two examinations were carefully chosen for comparability. Of the 60 questions in each examination, 30 were repeated in the post-test and 30 were fresh questions in the post-test. The pre- and post-tests were reversed for the second of the two years to increase consistency. There was a general improvement in the standard of results from the pre-test to the post-test. There was also a small improvement for the repeated questions compared to the non-repeated questions (P < 0.0001). The authors conclude that the marked improvement of the post-test compared to the pre-test is mostly attributable to the students increasing their knowledge base through learning during their surgical term.(ABSTRACT TRUNCATED AT 250 WORDS)