Purpose: To motivate students to participate in debates and to secure the quality of discussion, score-keeping team competition was introduced to middle- to large-sized discussion groups. Methods: 95 students of a medical ethics class were divided into 20 teams. After each team presented its opinion on a few ethical issues debatable, all teams began debating on the issues. In each session, a certain number of points was given to the presenters. Randomly selected nine students made up a jury. The jury decided on the quality of the debate and judged whether the teams participated lost or kept their points. At the completion of the module, the students were surveyed about their experiences with the score-keeping competition. Results: The motivation for participation from a score-keeping competition was so powerful that in most sessions, many students did not have a chance to speak due to overwhelming number of debaters. Students who participated less eagerly ascribed their experience to their lack of ability to speak out. A major problem expressed by many students was that they felt morally bad about taking away points from their friends. In actuality though, this moral inhibition was weaker than the motivation for competition they felt. The opinion survey showed that the students who felt moral inhibition participated even more eagerly in the debates than those who did not feel bad. Conclusion: In middle- to large-sized groups, score-keeping competition was a strong motivation for students to participate. And lessening the moral inhibition would lead to livelier debates. Thus, it would be helpful to develop modified methods of distributing points such as giving out new points and not simply relocating those already given out.