You learned a lot of medicine in training. You also learned a lot of things that were never on the syllabus. Medical training conditioning is not a single lesson Be a good doctor. Be smart. Hardworking. Emotionally blunt. Perfectionist. We called al...

When I started medical school, the curriculum had just shifted to small-group case discussion. Six to ten students sat around a table every week. A faculty member graded our participation. I dreaded it. I am naturally introspective. Generally, I thi...

The first morning I signed out a patient as the attending, nobody behind me was going to catch what I missed. The pay was better. The call schedule looked lighter on paper. Vacation accrued. And I still stayed an extra hour to confirm a finding nobo...

I showed up to my first overnight call in a tie, a dress shirt, and khakis. The chief resident took one look at me and laughed. “Put on scrubs,” she said. “You’re going to be more comfortable.” She was right about the scrubs. She was also right, in...

I have been teaching physicians to audit their Energy Accounts for two years. Then I spent six weeks wearing a sensor from Arena Labs that audited them for me. The numbers did not lie. By week three, I could pull up a graph that told me, almost to t...

I trained before resident work-hour restrictions. During one stretch of residency, my car broke down. I dropped it at a mechanic at 5:30 AM before call, took a cab to the hospital, worked a full day, stayed overnight, rounded the next morning, and f...

Spring has arrived in the Midwest, and recently I’ve spent a good chunk of my Saturday blowing leaves, trimming back deadwood, and preparing the yard for the growing season. I love getting my hands dirty. Our yard is a bit of an experiment. We grow...

Author’s Note: As a pediatric cardiologist, a medical educator, and a coach, I’ve sat on every side of the table. I’ve interviewed anxious premeds, shepherded fellows through subspecialty training, served on promotion committees, and now lead an aca...

The Operating System I walked into medical school orientation in shorts and a T-shirt. Everyone else had business casual. I had showed up dressed for the wrong century. At some point that first morning, the facilitator asked us to go around the room...

Excellence is not a destination. It is a lifelong journey. And for physicians, that journey often begins with purpose, gets distorted by performance, and is restored through truth. We started with purpose. Maybe it was the optimism of youth. Maybe a...