Objective To determine the effects of a 4.5‐week geriatric medicine course on fifth year medical students’ perception of the importance of and their competence in prescribing exercise to older people. Methods The modified Exercise and Physical Activity Competence Questionnaire was administered to 81 students before and after the course. Scores ranged from 0 to 6. One open‐ended question about perceived barriers to exercise prescription was asked. Results Students’ perceptions of the importance of designing an exercise prescription (P = 0.038), determining the training heart rate (P = 0.021), determining the body mass index (P > 0.001), referring an older person to an exercise program (P > 0.001) and identifying age‐related limitations (P = 0.029) improved significantly after the course. Students’ self‐perceived competence improved significantly across all items (P > 0.001). Barriers to exercise prescription included lack of: knowledge (57%), patient compliance (39%) and time (33%). Conclusion A geriatric medicine course contributes to improved senior medical students’ perceptions of importance of and their competence in prescribing exercise to older people.