It has been documented previously that nutrition knowledge of senior medial students at ten southeastern medical schools varies and is positively correlated with student assessment of the quantity and quality of nutrition education. To determine whether the differences in knowledge are related to the medical educational experience or are simply a reflection of differences in the students’ knowledge on entry to medical school, the same examination was administered to entering freshmen at eight of the medical schools. The knowledge scores of freshmen were remarkably homogeneous from school to school (53 ± 1%, range 51—55%), and nutrition knowledge was significantly higher for seniors than for the freshmen at all schools (mean 69 vs 53%, p < 0.0001). On the basis of responses to survey items on the examination, the freshman medical students were more inclined than senior students to take a nutrition elective (62 vs 34%, p < 0.0001), and more freshman rated nutrition as being important to their careers (74 vs 59%, p < 0.05). These data indicate that 1) entering freshman medical students at the different schools studied have comparable levels of nutrition knowledge and are receptive to nutrition education, and 2) differences in medical training programs most likely explain the previously documented variability in nutrition knowledge of graduating medical students. These findings have important implications for professionals planning curricula for medical-nutrition education. © 1988 by John Wiley & Sons, Inc.