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Background: Many studies have attempted to determine what factors influence medical students' career selections. This study determined students' perceptions of family practice, examined what variables influenced these perceptions, and measured whether medical students' perceptions were similar to or different from those of practicing family physicians., Methods: The two populations studied were students sampled at an Ohio medical school over the first 3 years of their training and a random sample of Ohio family physicians. Each subject was asked to complete a questionnaire that asked about perceptions of family practice and demographic information., Results: A total of 719 (69%) students and 295 (59%) family physicians responded to the survey. Sixty-seven percent of the physician responders were actively involved in medical student teaching. More than 94% of the students had exposure to family physicians during their preclinical education. Students' perceptions were different than physicians' perceptions about lifestyle issues, patient care, and practice characteristics; over time, these approached the physicians' perceptions. However, the perceptions of family physicians and students about professional issues were similar., Discussion: Medical students and family physicians have different perceptions about family practice. Students' perceptions become similar to physicians' perceptions as they progress through the educational system, while, at the same time, their interest in family practice declines.