Pulse Check with Dean Nelson - January 2026
Sharing thoughts, laughs, and a little wisdom!
Pulse Check: From Foundation to Framework
Early in my career, I figured out the difference between physicians who stayed effective over decades versus those who burned out early. It wasn't who had the most impressive credentials or could quote the latest studies - we all had that. The lasting physicians had what Zen Buddhists call "shoshin," or beginner's mind: approaching each patient with fresh curiosity rather than assuming you've seen it all before.
Stanford psychologist Carol Dweck validated this intuition through decades of research on what she termed "Growth Mindset" - the belief that abilities develop through dedication and learning. Her work shows that experts who stay open to learning consistently outperform those who think they've figured it all out. The moment you believe you've learned everything is precisely when you stop growing.
This concept has guided my first year at the Schmidt College of Medicine. I arrived with experience from Rutgers and other institutions, but I knew that understanding what makes our COM unique required listening before leading. That approach wasn't uncertainty - it was strategic preparation.
My first year leading COM has shown me why this institution has built such strong foundations over the past 15 years. I've watched faculty refine their teaching based on student feedback and researchers ask questions that connect to real patient challenges. What's powerful about this isn't any single example - it is that everyone at the College stays curious. When that happens, small changes start mattering. A curriculum adjustment here, a research collaboration there, a partnership deepens over time – each one builds on the last, creating something far bigger than any individual achievement.
That's why our focus for 2026 matters so much. Earlier this month, I shared three priorities: advancing academic healthcare through educational excellence, strategic partnerships, and innovative research. But here's the thing: the what doesn't matter if we get the how wrong. These priorities succeed when approached with beginner's mind: when we learn from our health system partners, when we let real patient challenges shape our research questions, when we keep refining training based on what actually works or doesn’t.
Entering year two with this foundation, what matters isn't whether we can achieve excellence in these areas - we will. It's whether we can keep the beginner's mind that makes excellence sustainable: staying humble and open to learning from our partners, our colleagues, and our patients. The moment we think we've figured it all out is the moment we start sliding backward.
Want an example of beginner's mind in action? Consider “Severance,” where characters arrive at work each day with no memory of their outside lives - a clean slate, unburdened by assumptions or preconceptions. While the show uses this as dystopian commentary, there's something powerful about the "innie" experience: approaching complex problems without the baggage of "that's how we've always done it."
Mark Scout and his team spend their days discovering patterns, asking questions, building understanding from scratch. They aren't constrained by prior failures or past politics. Every observation is new data. Every connection is genuinely curious.
The paradox? Their fresh perspective only becomes valuable when they start connecting what they are learning to build something coherent. Discovery without application is just data collection. Application without discovery is just repetition.
Same principle in academic medicine. New faculty bring fresh eyes. Experienced faculty bring institutional knowledge. Excellence happens when you maintain both - the curiosity of someone discovering the field for the first time combined with the wisdom of someone who's been working in it for years.
That tension between fresh perspective and accumulated wisdom? That's where transformation lives.
Stay curious, MedOwls.