During the academic year 1975-76, 259 students were enrolled in "fifth pathway" programs in New York and New Jersey. An analysis of students participating in programs in New York state schools revealed that a majority (87 percent) had received their undergraduate training at the Autonomous University of Guadalajara. The choice of graduate training of these students was similar to that of American graduates; however, the proportion of fifth pathway students selecting primary care specialties was significantly smaller than that of their American trained counterparts. Although the desirability of the fifth pathway has been a topic of frequent discussion, it is anticipated that for the next several years increasing numbers of students will be participants. It is, therefore, important to develop, at least on a regional level, uniform standards for admission and performance to assure the quality of this educational experience.