The perceptions and evaluations of USA training programs were investigated by interviewing 50 foreign and 50 USA residents who were in university affiliated teaching hospitals in this country. The interview was additionally concerned with their professional and educational background, their motivations for seeking specialty training, and for coming to the USA, their personality structure, their attitudes toward foreign and USA doctors, and their expectancies about working in the USA. Furthermore, supervisors were asked to rate the trainees'' performance. Differences between foreign and USA residents were observed in their educational and professional background, their reasons for choosing the specialty of internal medicine, their satisfaction with the training programs and the USA, and their performance as rated by the supervisors. Foreign residents scored less favorably on a standardized, objective, self-reporting inventory than did their USA colleagues. While a number of theoretical interpretations were made on the bases of individual results, an overview suggested that the degree of Americanization of the foreign residents was an important factor in both the supervisor''s judgment of their performance and in their personal and professional adjustment to the training programs and to the USA.