From 1981 to 1994, 69 fourth-year students at the Albert Einstein College of Medicine participated in a 6-month medical school research project (MSRP) with the same mentor. Students could choose an original project or library project, and were required to prepare a written report suitable for submission to a peer-reviewed journal. In this article, it is assessed whether a mandatory fourth-year MSRP might substitute for traditional clinical electives. Student reactions to the experience were ascertained by using the responses to an open- and closed-ended questionnaire regarding skills gained by doing MSRPs, the impact on their careers, and their relationship to the mentor. Eighty-nine percent of the students responded that MSRPs increased their ability to formulate a hypothesis, 91% reported that this project increased their ability to conduct a literature search, 95% felt that MSRPs increased their knowledge of research techniques, and 91% reported having improved data collection skills after completing these projects. Students also reported that MSRPs increased their ability to critically evaluate the literature (95%) or to work independently (93%), and 89% responded that the project improved their ability to evaluate their individual strengths and weaknesses. Eighty-nine percent reported that the project increased their ability to write a research paper (34% of projects were original research, 35% were literature reviews, and 30% both original research and literature reviews). Thirty-three percent of respondents reported having some kind of problem completing their projects, and 90% of project reports were accepted for publication in peer-reviewed journals. Ninety-one percent of students responded that they had received appropriate guidance from their mentor, and 73% met with him at least once a week. Seventy-three percent described a relationship with the mentor that went beyond project advising. Eighty-five percent responded that the project impacted their careers in medicine, 97% felt that the research experience was a useful replacement for fourth-year electives, and 91% felt they were as well prepared for residency training as their classmates who had regular fourth-year electives without research. Fifty percent of students indicated that completion of an independent research project should not be required for graduation, whereas 18% responded it should be a requirement and 32% were undecided. Incorporating an MSRP in the fourth year appears to increase research skills and is considered to be a useful replacement for traditional elective rotations. The MSRP impacts favorably on future careers; however, many students do not think it should be a mandatory requirement for graduation from medical school.