Preparedness of medical school graduates for the intern year is one of the emphasised objectives of undergraduate medical training. We have evaluated the perceived preparedness of graduates undertaking the intern year in the Republic of Ireland. A 9-page questionnaire was mailed to all 497 interns in Ireland following commencement of the intern year in July 2005. Data obtained included demographics, perceived preparedness and assessment of perceived clinical skills (four sub-domains: core competencies, communication, emergencies, and educational environment). Information on intern induction was also collected. 99 questionnaires were returned (19.9%). Most of the cohort were Irish and worked in large medical school teaching hospitals. The majority of interns felt 'unprepared' for the intern year. Interns perceived themselves 'poor' in all areas of clinical skills assessed. Intern induction was attended by the majority and most stated it was too short. Medical schools are actively seeking innovative methods, through early patient contact and sub-internships, to better prepare undergraduates for the intern year. The deficiencies identified in this study are significant and emphasise the need for continued reform in the undergraduate curriculum.