Although educational characteristics of ambulatory clinical environments are becoming clearer, less is known concerning patient opinions about participating in medical student instruction in ambulatory settings. Such perceptions may have an important influence on recruitment and retention of community faculty. Surveys were administered to 121 patients seen by medical students during a longitudinal family medicine clerkship. The survey explored patients' opinions regarding the extent of direct student involvement in their care, students'competence, and patient feelings about participating in medical student instruction. Patients felt that students were highly involved in providing care and that they performed competently and professionally. Patients found participation in medical education enjoyable, not excessively time-consuming or disruptive, and believed that students' participation improved the quality of care they received. Patients in our family medicine clerkship do not have negative perceptions about their participation in medical student education. In fact, this study suggests that such participation may actually enhance patient satisfaction.