THE PRACTICE of medicine involves working with patients. There are some medical specialties that emphasize the orientation to the "entire patient in his total milieu," while other specialties almost exclusively focus on particular areas of the body, special technical skills or instrumentation. There are also nonclinical activities, such as teaching, research, and administration, which involve a different type and degree of interaction than does clinical therapy. Any one or more of these activities may become the major career preoccupation of a given individual. Because of the wide range and diversity of available choices, the medical student presents a natural field in which to study the process of vocational specialty choice, in "status nascendi." Our experience and theoretical constructs indicate that given a conflict-free choice, an individual will select a type of work that is satisfying for various reasons. For example: 1. Gratification is derived from