The major causes of adolescent morbidity and mortality are lifestyle related and are all amenable to intervention through counselling. In order to identify concerning health behaviours, physicians must be skilled in appropriately assuring confidentiality and in obtaining the social history. To assess internal medicine residents' perceived preparedness to care for adolescents, particularly with regard to counselling on adolescent-specific health issues, a survey assessing these skill sets was administered to senior internal medicine residents at two universityaffiliated programmes. Senior residents surveyed feel uncomfortable counselling on 94% of the adolescent health issues assessed. Nonetheless, 60% are willing to care for adolescents in the future, and 75% are interested in additional residency training in adolescent medicine. Despite exposure to adolescent patients during residency training and an expressed interest in adolescent medicine, residents are poorly prepared to care for adolescent patients. Future curriculum development should focus on increasing the opportunities to directly care for adolescents, during which residents can practice and develop the interviewing and counselling skills necessary for care of adolescent patients.