The results of the 2004 National Resident Matching Program (NRMP) reflect a leveling in the recent trend of declining student interest in family medicine residency training in the United States. Compared with the 2003 Match, 34 more positions (36 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2004, at the same time as 14 fewer (four fewer US seniors) in primary care internal medicine, 10 more in pediatrics-primary care (one more US senior), and 35 more (38 more US seniors) in internal medicine-pediatric programs. In comparison, one less position (one more US senior) was filled in anesthesiology and seven fewer (five more US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past several years. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty; the turbulence and uncertainty of the health care environment; liability protection issues; and the impact of faculty and resident role models, continue to influence medical student career choices. A total of 165 more positions (12 more US seniors) were filled in categorical internal medicine while 164 more positions (15 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. With the needs of the nation, especially for rural and underserved populations, continuing to offer opportunities for family physicians, family medicine experienced a slight increase through the 2004 NRMP. The 2004 NRMP suggests that the trend away from family medicine and primary care careers may be leveling off.