OBJECTIVE: To determine the impact that an educational intervention has on students' perception of the relative importance of efficiency and equity in the rationing of health care. METHODS: Over two years, a survey was provided to students in a graduate health economics class. The survey asked the students (n=54) how they would allocate organs amongst patients who had varying chances of benefiting from them. Participants were asked to complete the survey at two points in time: the first day of class and prior to receiving the final examination on the last day of class. Responses were anonymous. Between the 2 administrations the subjects received a 3-hour lecture on health economics once a week for 13 weeks. The lectures included: pricing, cost-minimization, effectiveness, utility, and benefit analyses, the use of pharmacoeconomic data, and the Oregon experiment. RESULTS: Prior to receiving instruction in health economics, the students weighed equity and efficiency equally: 32% of respondents allocated organs regardless of the patient's prognosis compared to efficiency arguments that stated that the organs should be allocated to the group with the greatest chance of survival (36%). After completion of the course most respondents (50%) allocated organs so as to maximize health outcomes; however, many (30%) still felt that organs should be allocated based on principles of fairness to all. After the course was completed there was evidence to suggest that nearly all students understood the trade-offs and the implications of non-health maximizing behavior better. CONCLUSIONS: Previous research has indicated that equity considerations in allocation decisions are important to members of the general public. This study provides preliminary evidence that an educational intervention may change this perception, although there is still a high value placed on equity concerns. Equity arguments should be incorporated formally in cost-effectiveness evaluations and medical decision making.