Background: Developing a culturally competent health workforce is a key strategy in the struggle to provide quality healthcare services for Aboriginal people. Since 2000, the Centre for Aboriginal Medical and Dental Health has implemented a comprehensive vertically and horizontally integrated Aboriginal health curriculum across the 6 year MBBS program at the University of Western Australia. This involves considerable core teaching, a range of options, electives and selectives plus an Aboriginal health specialisation within the MBBS degree, with assessment in each year of the course. Findings: This paper describes the context and background of the implementation of a comprehensive Aboriginal health curriculum. A key shift in understanding and engagement occurred when students were required, in their fourth year medical rotation, to complete a comprehensive case history and discussion, including reflective comments, in relation to an Aboriginal person they have seen during that rotation. From 2003-2009, 1180 students completed the Aboriginal case history in their fourth year medical rotation. 519 (44%) of the reflective comments were reviewed to reveal 14 key themes that show why this particular assessment task enhances student engagement in Aboriginal health issues. Of the reflective comments, 416 (79.6%) had statements that fitted into the identified themes. Discussion: The authors discuss their experiences, focusing on this particular assessment, some of the students’ reactions to it, and how this provides a ‘turning point’ in students’ engagement with the health of Aboriginal peoples.