Several studies have documented the common use of alcohol among medical students and the significant fraction of students (7% to 17%) who show a pattern of alcohol abuse. Many authors have pointed out the implications of physician impairment due to alcoholism, presently estimated at about 10%. We surveyed 263 junior and senior medical students, and our data support earlier surveys of the prevalence of alcohol abuse and indicate that students tend to drink less heavily and less frequently after entering medical school. The clinically proven CAGE questions used in the survey showed statistically significant associations between heavy or frequent drinking before and during medical school, but only 4.2% of respondents indicated that school officials had asked whether they had a drinking or drug abuse problem. Given these findings, we suggest the routine administration of screening instruments to medical students, using education and minimal intervention strategies with individuals at risk