Objectives: The aim of the study was to assess the acceptance and usefulness to students of a student-developed portfolio of Guidelines (GLs) in clinical skills, as a tool for competency development in the early years of the undergraduate medical program. Methods: A mixed-method design was employed to explore students' perceptions of the general usefulness of their portfolio of GLs in focus group discussions. From the results of these discussions, a questionnaire was developed to ascertain the prevalence of the views that emerged from the qualitative data amongst a whole cohort of Year 6 students. Results: Students rated the usefulness of their portfolios very highly and the uses of the portfolios evolved as students progressed to their final year, when they were also able to perceive the importance of the acquisition skills required whilst developing their own GLs, for use in subsequent years. Conclusions: Based on the students' responses in Year 6, the student- developed portfolio of GLs in clinical skills was accepted and found useful. Other than being used as a tool for competency development, it also seems possible that the portfolio could be used as a tool for reflection in clinical skills, even in the early years.