Objective: This study describes medical students' perceptions of the field of psychiatry and identifies the impact of those perceptions on their career choices in order to explore the questions: Are we as a field doing all that we can to enhance the educational experience of all medical students, regardless of their career preferences? What are the most appropriate ways to encourage interested medical students that would allow for more targeted recruitment efforts toward the most receptive students? Methods: Third-year (n=131) and fourth-year medical students (n=117) at a northeastern, urban, private university medical school completed anonymous self-report questionnaires. Students rated the impact of intellectual interest, status, earning potential, healthcare reform, quality of life, satisfaction, and stress of working with psychiatric patients on their consideration of a psychiatric career. Respondents were then systematically divided into two groups: 1) those who considered psychiatry as a possible career choice and 2) those who did not. Results: When compared to students who had been coded as "not seriously considering" a career in psychiatry, students coded as "seriously considering" gave significantly higher positive ratings to the field's intellectual content and quality of life. There were also significant differences between the groups regarding the satisfaction involved in working with psychiatric patients. Students from both groups were equally concerned about stress levels in the field. Conclusions: Acknowledging, discussing, and providing a context for stressful experiences during the psychiatry clerkship are likely to bring about productive approaches to improve recruitment into the field as well as to improve all students' psychiatric education.