Research on safety culture has primarily focused on practicing clinicians and staff. Medical students are an integral part of the clinical team and are increasingly being integrated into safety efforts, but their views on safety culture are not often taken into account. This survey of senior medical students used a modified version of the AHRQ Hospital Survey on Patient Safety Culture to investigate students' perceptions and found that while students generally had positive impressions of teamwork and felt there was adequate supervision, they did not feel comfortable reporting errors and were concerned that errors would be held against them. The results of this study mirror prior research that consistently finds lower perceptions of safety culture among frontline workers compared with management. Authority gradients play a major role in inhibiting students' desire to report safety problems, an issue discussed in an AHRQ WebM&M commentary.