Problem-based learning (PBL) is an innovative educational approach to enhance student-centered and integrated learning through small group tutorials. In 1998, PBL tutorial was introduced to the medical curriculum of Kinki University. The purpose of this study is to examine the effect of PBL on learning outcome, in comparison with the traditional lecture-based education. Students’ view on PBL was surveyed on a yearly basis. Generally students felt that PBL results in an improvement of self-directed learning skills and has a positive effect on their learning attitude. A more detailed comparative study (PBL versus lecture-based) on the learning outcome of the locomotion system block was also undertaken. The PBL students performed significantly better in the test than the lecture-based students. One year later, the PBL students performed better in the pre-and post-clinical clerkship tests on the Locomotion System. It therefore appears that the knowledge acquired through PBL is better retained after one year, in comparison with the lecture-based students. This preliminary study suggests that PBL promotes long-term memory and has beneficial effects on learning attitude.