PURPOSE We wanted to analyze National Institutes of Health (NIH) awards to departments of family medicine. METHODS We obtained the list of NIH awards to departments of family medicine in 2003, and collected additional information from the Internet regarding each principal investigator (PI), including whether he or she worked primarily in a core (central) organizational component within a family medicine department. RESULTS One hundred forty-nine NIH awards were granted to 45 departments of family medicine, for a total of $60,085,000. Of 146 awards with a designated PI, approximately two thirds of awards (89, 61%) and awarded dollars ($39,850,000, 70%) went to PIS who were either not full-time family medicine faculty primarily working in family medicine departments, or they were not working in core family medicine organizational components. Few awards to physician Pls in these noncore areas were to family physicians (4 of 37, 11%), whereas most awards to physician Pis in core family medicine areas went to family physicians (40 of 45, 89%). In contrast, most K awards (research career programs) went to Pls in core areas (19 of 23, 83%), and most to family physicians (17 of 23, 74%). Nationally, only 17 RO1 awards (research project, traditional) went to family physicians. CONCLUSIONS Most NIH awards to family medicine departments went to Pls in noncore organizational components, where most physician Pls were not family physicians. Family medicine departments interested in increasing NIH funding may want to consider 4 models that appear to exist: individual faculty in core departmental components, K awards, core faculty also working in university-wide organizational components that provide research infrastructure, and integrating noncore administrative components into the department.