This is an interesting article by a physician early in their career. I have been out of residency and fellowship for close to 20 yrs and have a bit of a different take than the author. Sadly, the author's view reflects an element of being trapped in a field that the author would not recommend to others. I have always viewed being a physician as a privilege that was earned through years of hard work. I have spent most of my career as a full time academic surgeon/educator at a major university hospital until 6 yrs ago when I started a private practice. The author seems to feel that the subjective evaluation of his faculty is somehow unfairly inhibiting individuality and that the societal forces of medicine are pushing against the individuality of the physician practice. It is true that medical students and residents are evaluated by both subjective and objective methods, but education research has demonstrated the validity of the subjective observations of trained observers. The issue of when individual expression becomes a question of "professionalism" is a good one. The societal forces impacting medicine with increased regulation, governmental and corporate interference with the doctor patient relationship is a real issue. However, at the end of the day, the physician is granted a unique experience and responsibility in the doctor patient relationship, which is why medicine still offers exceptional opportunities to intervene in the suffering of others.