To explore factors that influence senior medical students to pursue careers in family medicine. Qualitative study using semistructured interviews. University of Western Ontario (UWO) in London. Eleven of 29 graduating UWO medical students matched to Canadian family medicine residency programs beginning in July 2001. Eleven semistructured interviews were conducted with a maximum variation sample of medical students. Interviews were transcribed and reviewed independently, and a constant comparative approach was used by the team to analyze the data. Family physician mentors were an important influence on participants' decisions to pursue careers in family medicine. Participants followed one of three pathways to selecting family medicine: from an early decision to pursue family medicine, from initial uncertainty about career choice, or from an early decision to specialize and a change of mind. The perception of a wide scope of practice attracts candidates to family medicine. Having more family medicine role models early in medical school might encourage more medical students to select careers in family medicine.