<p>Abstract</p> <p>Background</p> <p>The increasing burden of illness related to musculoskeletal diseases makes it essential that attention be paid to musculoskeletal education in medical schools. This case study examines the undergraduate musculoskeletal curriculum at one medical school.</p> <p>Methods</p> <p>A case study research methodology used quantitative and qualitative approaches to systematically examine the undergraduate musculoskeletal course at the University of Calgary (Alberta, Canada) Faculty of Medicine. The aim of the study was to understand the strengths and weaknesses of the curriculum guided by four questions: (1) Was the course structured according to standard principles for curriculum design as described in the Kern framework? (2) How did students and faculty perceive the course? (3) Was the assessment of the students valid and reliable? (4) Were the course evaluations completed by student and faculty valid and reliable?</p> <p><b>Results</b></p> <p>The analysis showed that the structure of the musculoskeletal course mapped to many components of Kern's framework in course design. The course had a high level of commitment by teachers, included a valid and reliable final examination, and valid evaluation questionnaires that provided relevant information to assess curriculum function. The curricular review identified several weaknesses in the course: the apparent absence of a formalized needs assessment, course objectives that were not specific or measurable, poor development of clinical presentations, small group sessions that exceeded normal 'small group' sizes, and poor alignment between the course objectives, examination blueprint and the examination. Both students and faculty members perceived the same strengths and weaknesses in the curriculum. Course evaluation data provided information that was consistent with the findings from the interviews with the key stakeholders.</p> <p>Conclusions</p> <p>The case study approach using the Kern framework and selected questions provided a robust way to assess a curriculum, identify its strengths and weaknesses and guide improvements.</p