One substudy of the Collaborative Ocular Melanoma Study (COMS) is a randomized trial examining surgery versus radiation therapy for ocular melanoma. To understand the perspective of the physician investigators, a survey of the 101 COMS physicians from 29 major institutions in the United States and Canada was completed before randomization of the first patient. A 95% response rate was obtained, and follow-up interviews were conducted with 87% of the physicians. The study found that (1) COMS physicians identified significant differences between incentives and disincentives to participate in any trial compared with participating in COMS, (2) COMS physicians could be differentiated and had a stronger clinical rather than research orientation, and (3) COMS physicians exhibited a high intention to recruit an identifiable subset of eligible patients. These data suggest that continued support of individual investigators and a close examination of incentives and disincentives to physician participation would be useful in enhancing accrual in this study. A follow-up of this group is planned throughout the anticipated ten-year duration of patient recruitment of this COMS trial.