The results of the 2010 National Resident Matching Program (NRMP) reflect a small but promising increased level of student interest in family medicine residency training in the United States. Compared with the 2009 Match, 75 more positions (with 101 more US seniors) were filled in family medicine residency programs through the NRMP in 2010, at the same time that seven more positions were filled in primary care internal medicine (one more US senior), 14 fewer positions were filled in pediatrics-primary care (16 fewer US seniors), and 16 more positions were filled in internal medicine-pediatrics programs (58 more US seniors). Multiple forces including student perspectives of the demands, rewards, and prestige of the specialty; national dialogue about health care reform; turbulence in the economic environment; lifestyle issues; the advice of deans; and the impact of faculty role models continue to influence medical student career choices. Ninety-four more positions (90 more US seniors) were filled in categorical internal medicine. Fifty-seven more positions (29 more US seniors) were filled in categorical pediatrics programs. The 2010 NRMP results suggest that there is a small increase in primary care careers; however, students continue to show an overall preference for subspecialty careers. Despite matching the highest number of US seniors into family medicine residencies since 2004, in 2010 the production of family physicians remains insufficient to meet the current and anticipated need to support the nation's primary care infrastructure.