The purpose of the study was to assess the role of medical students' social desirability scores on influencing their attitudes toward either a geriatric or hypochondriac patient. To carry out this investigation, we developed a social desirability scale that was domain-specific for medicine. Students' medical social desirability scores predicted negative attitudes and beliefs toward the geriatric but not the hypochondriac patient. This difference suggests that medical students find it acceptable to dislike the hypochondriac as a patient but not the elderly person. Social desirability scores were inversely related to Machiavellan scores, suggesting that medical students with a Machivellian response pattern tended to view their role as a physician in a less idealized way. Students who scored highest on social desirability tended to choose obstetrics-gynecology for their future career and those with the lowest scores either pathology or surgical subspecialties. Research with this scale should help access social desirability's role in medical students' in managing the impression they leave with patients.