Objective: This study examined the differential impact of factors hypothesized to affect the choice of psychiatry as a specialty in Italy. Method: A 38-item Likert-type questionnaire about factors that potentially affect the choice of a career in psychiatry was administered to 97 Italian medical school graduates sitting for an admission examination to psychiatric residencies and to 82 colleagues sitting for an admission examination to an internal medicine residency. The two groups’ ratings on the questionnaire items were compared. Results: Response rates were 49.5% and 45.1%, respectively, for the psychiatry and the internal medicine groups. Future psychiatrists did not differ from future internists in sociodemographic characteristics. They rated 13 factors on the questionnaire more positively than did their colleagues who were pursuing internal medicine, and many had chosen psychiatry very early (40% had done so before medical school). Some of the more positively rated factors were experience with mental illness either personally or by a relative or close friend, efficacy of psychiatric treatments, the degree to which psychiatric practice is perceived to be evidence based, research opportunities, and curiosity about the topic of “madness.” Conclusions: Findings confirm earlier work in North American samples showing a substantial cross-cultural consistency in motives for choosing psychiatry as a discipline. A strong, early interest and curiosity among these students, often present in the premedical and preclerkship years, suggests some benefit in targeting this group for recruitment.