Different ways student-generated learning issues are used to deal with disciplinary content were assessed at seven North American medical schools with problem-based curricula. Structured interviews with key faculty representing the schools being studied suggested that the seven programs are encouraging the development of self-directed learning skills to differing degrees. Reports from administrators and librarians also suggested that at those schools where student-generated learning issues have been de-emphasized in favor of faculty learning objectives and reading lists, students may not be helped to become independent self-directed learners by that aspect of the curriculum. It is postulated that when students are given specific reading assignments and are not evaluated on their self-directed learning skills, the motivation for self-directed learning is likely to be diminished. It is also assumed that students at the problem-based learning programs that are using their own learning issues are developing self-directed learning skills through the process involved in case discussions; an assumption that requires validation. Contains eight references. (GLR)