In 1974, Michigan State University established the Upper Peninsula Medical Education Program (UP) to improve the physician supply in rural areas of Michigan by training students in a rural, practice-based setting. Practicing graduates of the program (N = 28) were surveyed by mail and their responses compared to a random sample of downstate MSU graduates (N = 57) with regard to practice location, specialty choice, hometown, and medical education and training. UP Program graduates showed a tendency to rural origin and chose rural practice and primary care specialties, especially family practice, more often than did their downstate colleagues. Responses of UP graduates suggested that rural residency locations would lead to increased numbers of rural practitioners. The rural UP Program has been successful to date in training medical students who ultimately pursue careers in rural primary medicine.