Fifty-three graduates of Jefferson Medical College who chose emergency medicine (EM) over the decade from 1981 through 1990 were compared with the other graduates of that school during that decade who chose other specialties, using the database of the school's longitudinal study of its students. As seniors, those who chose EM had the highest debt of seniors going into any specialty. However, the mean peak income they expected was higher than that expected by the other nonsurgeons, although it was below that expected by the surgeons. The EM group compared favorably with those who chose other specialties in terms of their academic records and had the highest mean Part III score on the National Board of Medical Examiners examination of any of the groups studied. The students who chose EM also indicated their great willingness to see patients from low-income households, and were willing to spend more of their practice time serving these groups than were the students who chose the other specialties. The authors discuss these findings as related to the nature of EM and medical school graduates' choices of specialties.