We third-year medical students visited Thomas Jefferson University during the last spring vacation. We attended classes and received clinical practical training with American medical students for three weeks. In classes the students learn actively through discussions, and for three days a week they study cases through small group discussions. In the clinical clerkship they actively participate in patient care and the learning of clinical reasoning rather than just diagnosis is emphasized. This 3-week visit gave us a great opportunity to reconsider not only ourselves but also the Japanese systems for medical care and education.