BACKGROUND AND OBJECTIVES: As the US population ages, more physicians will be needed to provide care for older patients. We characterized family medicine residents' plans to include care of the elderly and to patients in nursing homes in their future practices. We also assessed whether residents' plans were related to their attitudes toward the elderly and the professional and financial satisfaction they foresaw in providing care to the elderly. We further examined the obstacles and incentives they perceived for providing nursing home care. METHODS: A written survey of residents in the seven residency programs of the Department of Family Medicine of the University of North Carolina. RESULTS: In total, 116 of the 139 residents responded (83.5%). Residents generally reported positive attitudes toward elderly patients. Nearly all residents (92.1%) planned to care for geriatric patients in their office, but only two thirds (68.1%) anticipated that older people will comprise a significant percentage of their practice. Interns were more interested in care for the elderly than were second- and third-year residents. Most residents did not anticipate that they will be professionally or financially satisfied with or enjoy nursing home care, and only 26.1% planned to provide care in nursing homes. Time constraints and financial concerns were often cited as obstacles to nursing home care. CONCLUSIONS: Family medicine residents have limited interest in nursing home care and may generally underestimate the influence of an aging society on their future practice. Meeting the health care needs of an aging society will require innovations in reimbursement, health care delivery systems, and residency curricula.