The aims of this study were to determine whether harassment occurs in the authors' school, the Sackler Faculty of Medicine at Tel Aviv University, and to address the possible influence of cultural background on the perception of harassment. The unique makeup of the school was utilized, with two separate programs for American and Israeli students trained at the same sites and by the same faculty. A two-part questionnaire was developed that included students' reports on the occurrence of harassment, at what stage of their studies, by whom and its nature as well as demographic data. In the second part, students reported on their perception of harassment. Seven common scenarios were presented, and they were asked to indicate (on a four-point scale plus a non-applicable option) to what extent each scenario constituted harassment. A total of 115 Israeli and 81 American students in their clinical years responded during 2000-2001. About 50% experienced harassment, mainly in the clinical years. Significant differences were identified between the Israeli and the American students in their: (1) reporting of the amount (Israeli 59% vs. American 38%) and nature of harassment, and (2) perception of harassment (differed in six out of the seven scenarios), that can be related to their different cultures. These findings suggest that medical school faculty should be made aware of cultural differences in students' perception of harassment, thus enabling them to adapt their approach towards the students and take action to prevent its occurrence.