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The focus of pharmacy practice and education has changed over the past decade. In the past, pharmacy practice and education were focused primarily on drugs and their distribution. The suggestion of pharmacy practice centered on the patient was first articulated by Hepler and Strand in 1990 as pharmaceutical care. 1 The concept of pharmaceutical care quickly became adopted by the profession. By the end of the 1990s, major pharmacy organizations and pharmacy educators embraced pharmaceutical care as the primary focus of pharmacists' activities.Despite the rapid adoption and widespread acceptance of pharmaceutical care as the focus of pharmacy, the implementation of pharmaceutical care practice proved to be a major challenge. Even now, in the first decade of the 21st century, the implementation of pharmaceutical care is not widespread. There were scant reports of pharmacists performing direct patient care activities in the health-systems (hospital) settings and even fewer reports of this type of practice in ambulatory and community settings. For many pharmacists, there is a clear disconnect between what pharmacy leadership says pharmacists should be doing and the reality faced by practicing pharmacists on a daily basis. 2 By circumstance, pharmacy students are put squarely in the middle of this paradoxical situation-hearing one message from pharmacy leaders and educators and another message from working pharmacists. Many pharmacy students today have worked or are currently working in a pharmacy-related job. Pharmacy students hear about the importance of patient-centered care from faculty members and professional leaders, but these students usually face a very different reality when they work in a pharmacy. All too often students find themselves in a setting that is limited by older models of pharmacy practice. 3 Many schools and colleges of pharmacy have adopted a patient-centered focus to their curriculum. 4 This is in contrast to previous pharmacy curricula that were primarily focused on the pharmaceutical product and to some degree on clinical pharmacy activities. As a result Objectives. The purpose of this study was to determine factors that influence the career aspirations of third-year pharmacy students given the students' educational environment, current work environment, and personal situation. Materialism, career commitment, shared class attitudes, and individual attitudes towards the institution were considered. Methods. A survey was developed using literature sources and results from focus groups of fourth-year pharmacy students. Subsequently, students from 8 pharmacy schools completed the survey and viewed a videotape that visually portrayed and structured 3 broad career scenarios: direct patient care, indirect patient care, and drug distribution management. Results. Survey results from 509 students were evaluated. Sixty-six percent and 71.1% of students chose direct patient care as their immediate and 10-year career aspiration, respectively. Career commitment, educational experience, and shared class a...