Yet another breathtaking scene from Iceland (but I don’t remember exactly where I took this photo)

July 1st is an epochal day: it’s when everyone in academic medicine gets booted upwards.  Whether it is the transition of a medical student to intern, resident to fellow, or fellow to attending, it represents big changes and unexpected challenges.

This July 1st is the last July 1st that I anticipate being a fellow.  That is pretty exciting actually – that I’m finally, inexorably reaching the end of (structured) graduate medical education and finally going to be an independently practicing doctor.  I enthusiastically look forward to ensuring that these next 365 days are the most productive of my academic career thus far.