Background: The determinants of medical students' attitudes to communication skills training have for long been a concern among medical educationalists. The present study was undertaken to assess the attitudes of undergraduate medical students towards the teaching of learning communication skills courses and their determinants. Methods: A total of 472 undergraduate medical students from the Universiti Sains Malaysia participated in this study. Students' attitudes were measured using a modified communication skills attitude scale (CSAS). Univariate and multivariate statistics were applied to find the correlates to students' attitudes. Results: More than 95% of the students desired to learn communication skills. The majority of the students preferred formal courses on communication skills during their clinical training years. Demographic characteristics, e.g. gender and place of family residence, and education-related characteristics such as a preference for a formal communication skills training program during clinical years, and perception of a curriculum content overload were identified as the important determinants of students' attitudes towards learning communication skills. Conclusions: The demographic and education-related profiles of the participating medical students should be considered when designing a communication skills teaching program. Further studies are recommended to explore the underlying causes of less interest from rural students and the negative attitudes of male students towards learning communication skills. ß 2012 WPMH GmbH. Published by Elsevier Ireland Ltd.