The Fifth Channel in New Jersey is a Fifth Pathway program for US foreign medical graduates. In its third year, 83% of its 81 graduates are house officers at 18 US medical school-affiliated hospitals. Performance as house officers is characterized as competitive with peers, including US graduates. Positive attitudes toward work load, fellow workers, and patients compared with those of fellow house staff are noted. Quality of performance as house officers correlates most strongly with the change in mean scores of two batteries of clinical National Board examinations taken during the Fifth Pathway and less strongly with mean scores of single batteries of National Boards, intelligence quotient, Educational Council for Foreign Medical Graduates (ECFMG) examination, and age. Recommendations concerning the implementing of similar programs in other states are presented. (JAMA232:1031-1033, 1975)