BACKGROUND: Ethical issues in medical practice focuses mainly on critically ill hospitalized pateints or sophiscated technologic developments. However, in the outpatient setting physicians enco unter many problems that require ethical decision making. This study is an assessment of awareness and understanding of ethical issues commonly encountered in ambulatory setting in order to develop education curriculum. METHODS: A questionnaire was designed to evaluate general knowledge of medical ethics using 12 clinical vignettes. The questionnaire was distributed to medical students and residents who were asked to answer whether an ethical issue was present, its significance, and what the specific issues was involved. RESULTS: The response rate was 53%, with 106 of 200 students or residents completing the questionnaire-63 medical students, 14 interns and 25 residents. Respondents ability to identify that an ethical issue was involved in each vignette ranged from 42.9% to 78.3%. The significance rating ranged from 2.9 to 4.1 on the Likert scale of 1 to 5. A majority of respondents did not identify the correct ethical issue invloved in each vignette. CONCLUSION: This survey showed that the medical students and residents seem to have insufficient knowledge to recognize ethical dilemmas in ambulatory setting. Appropriate medical ethics education should be developed in medical education with particular emphasis on commonly encountered situation.