I took the PADI rescue course two years ago. It's a great course, and like all others, depends to some extent on how good the instructor is. A good (and realistic) instructor will gear the course and exercises to the students, and won't expect an 80 pound woman to drag a 300 pound guy with dive gear up the beach unassisted. However, like any course, it only introduces you to the skills you need for the course, but doesn't necessarily make you proficient in the skills. There's a lot of material in the class, and if you don't reinforce it following the class your skills will quickly decrease. My LDS lets anyone who took the rescue class come back and participate in future rescue classes. The first couple of times I did this I wondered if I really took the class - there was so much I either forgot or didn't pick up on in the class it was amazing. After the third time going along with rescue classes I finally felt proficient with most of the rescue class skills. Another reason to go along with the class multiple times is you will probably be exposed to multiple rescue scenarios - the first 5 times I participated in rescue classes it was always beach/shore rescues; boat rescues (probably more realistic for most of us) are different in a number of ways. Despite PADI's class standardization, there's a lot of different experiences each instructor brings to the class (unlike the OW certification), so working with several different instructors will also improve your rescue skills.