This study examined physicians' level of satisfaction with their job and the match between expectations and actual practice of specialty. Quantitative results suggested that physicians (N = 211) had a moderately high level of overall job satisfaction with no significant differences found between men and women physicians. Among those in primary care, medical specialties, surgical specialties, or supporting specialties, overall job satisfaction was found to be higher for surgical specialists compared to primary care physicians. Qualitative comments from two open-ended questions identified 20 themes regarding how closely the participants' expectations matched with the realities of the practice of medicine. Six themes are described in detail. Approximately 85% of physicians felt their expectations for their specialty matched their actual experience in the field. Helping students to understand how their expectations align with the actual practice of medicine and specific specialties is important to their development as a physician and to job satisfaction, and has implications for career counseling and advising in undergraduate and graduate medical education. (Contains 1 table.)