Declining lecture attendance has been an ongoing concern for educators involved in undergraduate medical education. A survey was developed (a) to gain insight into the reasons students skipped class, (b) to identify the type of study materials they were using, and (c) to determine what they thought would motivate them to come to class. The survey was sent to 317 first-year and second-year medical students, and 145 (45%) responded. Only 63% of first-year students and 53% of second-year students attended any lectures that were not mandatory. The attendance was higher for students who aspired to less competitive specialties such as pediatrics and family medicine. The most popular reasons for not coming to class were related to the efficiency of information intake and instructor or class style. The most heavily used resources (> 60%) were materials or recorded lectures provided by the instructor. The second-year students also heavily used outside study materials for Board exams, such as Pathoma (50%). Students’ ideas for what might increase their attendance suggest that they perceive that the lectures may not prepare them for Board exams, and they would like faculty to address Board related content more often in class and on assessments. Respondents also suggested that teaching practices might be improved through faculty development. Faculty awareness of and references to Board exam content, embedded in strong teaching practices, may help students find more value in live lectures. Carefully designed active learning sessions may change students’ minds regarding the relevance and value of these sessions.