Although recent reports suggest that women choosing a medical career encounter unique stressors, little attention has been given to whether this additional stress places them at greater psychological risk than men. This investigation delineates sex differences in the psychopathology of medical students seeking treatment. Men and women did not differ in primary diagnosis, type of complaint, problem areas, or type of termination. However, women reported more depressive and total symptomatology, and men were more likely to receive a secondary diagnosis of personality disorder and evidenced a particular excess of obsessive-compulsive disorders. Men often requested treatment following a relationship loss or when school performance fell short of expectations. Women were frequently struggling to reconcile career desires with a feminine identification and with affiliation needs. Conflict about deviating from a traditional role was exacerbated by expressed disapproval from significant others.