This study conducted in the Netherlands examines the role of student-generated learning issues in a problem-based curriculum. The first questions was in which way students make use of the learning issues generated (as strict guidelines or as global guidelines) and does this differ between years of training? The second questions was what the relation is between the way students make use of their learning issues and the time spent on individual study and achievement? Questionnaires were completed by 479 students in the first 4 years of a 6-year medical training program. Results show that students in the first year study strictly according to the content of the learning issues. In later years, students who tend to study beyond the generated learning issues spend more time on individual study and also achieve better. (Contains 4 tables and 15 references.) (Author/SLD)