To determine how internists would respond to out-of-hospital emergency medical situations, we surveyed internal medicine residents and attending physicians at urban academic medical centers regarding their willingness to help in five such scenarios. For those scenarios in which they were reluctant to help, they were asked why. Knowledge of Good Samaritan statutes was also assessed. Respondents were most likely to give aid, including mouth-to-mouth resuscitation if necessary, in scenarios involving a man complaining of chest pain in a restaurant (69%) and a call for help on an airplane (54%), and least likely to help a disheveled man lying on the sidewalk (2%). The most common reasons for not helping were a reluctance to perform mouth-to-mouth resuscitation, feeling that it was not one's responsibility to help, and concern about infectious disease. Knowledge of New York's Good Samaritan law was not associated with willingness to help.