To examine the differences between the content of curriculum of medical schools in China and the USA the authors compared the curricula of 82 Chinese and 125 American medical colleges. Great disparities were found in the framework of medical curricula, processes of teaching learning, types and numbers of preclinical courses, course hours, laboratory and practical training hours, and key disciplines of clinical practice. A significant difference was also found in the number of courses, lectures and laboratory and clerkship hours among Chinese medical colleges. The authors conclude that medical colleges in China should look again at the type of courses offered, revise curricular frameworks and reform the teaching learning process and approaches. New courses should be introduced, new content should be added to existing courses, and appropriate importance should be attached to clinical practice of subjects such as family and community medicine. To improve the quality of medical education, Chinese medical colleges need national medical education standards compatible with international standards.