Pulse Check with Dean Nelson - May 2026
Sharing thoughts, laughs, and a little wisdom!
Theme: The Long Game
The students who struggle most in medical school are rarely the ones who lack ability. They are the ones who run out of reasons to keep going. Talent earns admission. What carries you through the hardest moments of training — that is something else entirely. Angela Duckworth, a psychologist at the University of Pennsylvania, has a name for it: grit.
In Grit: The Power of Passion and Perseverance , Duckworth defines grit as the combination of sustained passion and consistent effort over time. Her research, drawn from military academies, spelling competitions, and high-performing organizations, reaches the same conclusion across every context: the best predictor of long-term achievement is not how gifted you are at the start. It is whether you keep showing up after the novelty wears off.
Talent, she found, can actually work against you. The student who excelled as an undergraduate — accustomed to being among the strongest in the room — can suddenly feel mediocre in medical school. That first experience of real struggle does not mean they do not belong. It means they have arrived at the place where grit begins to matter.
Medical education tests this in ways few other professional training paths match. Discipline carries you through the first year. Something deeper sustains you through the licensing exams, the rotation that does not go well, the patient who turns out to be sicker than initially suspected. That something is grit — and Duckworth's research is clear: it is not fixed at birth. It develops in environments that challenge and support in equal measure.
We do not build grit through inspiration alone. We build it by designing a place where perseverance is modeled — where the team stays after hours to make sure a patient gets the test they need, where the attending advocates for their patient with a recalcitrant insurance provider, where you take one more practice exam to make sure you truly understand the material. These are not soft elements of medical education. They are the infrastructure of grit.
May makes that infrastructure visible. Students who arrived here four years ago walked across the stage this month. Alumni from across graduating classes are returning for reunion. What they share, regardless of specialty or institution, is not where they started — it is how they finished. That is grit made visible.
Talent gets you admitted. Grit gets you graduated. And the passion you reconnect with — the reason you chose this work in the first place — is what keeps you practicing for decades. To the Class of 2026: what you have built here is not a transcript. It is grit — hard-won, tested, yours. That will serve you longer than anything else.
Pop Culture Reference: Shrinking, Season 3 (Apple TV+)
Shrinking follows Jimmy Laird, a therapist who responded to the death of his wife by abandoning professional restraint — telling his clients exactly what he thought, regardless of protocol. Seasons 1 and 2 traced grief and forgiveness. Season 3, which wrapped this spring, is about something harder: moving forward.
Jimmy is learning what it means to keep showing up not out of desperation or guilt, but because the work still matters. His mentor Paul — played by Harrison Ford, whose own Emmy-nominated performance has been one of the series' anchors — continues practicing despite a Parkinson's diagnosis that is progressing. This season, Paul is joined by a patient played by Michael J. Fox, who has lived with Parkinson's for more than three decades and has never stopped working. The scene is not played for sentiment. It is played as one professional recognizing another — two people who chose to stay.
Duckworth would recognize all of them. Paul and Fox's character are grit in its most durable form: not the intensity of early career, but the sustained commitment of people who have built lives around work that matters and are not prepared to walk away because it has become difficult.
What Shrinking gets right is that grit is never a solo performance. Jimmy persists partly because Paul will not let him quit. Paul continues partly because his community still needs him. Medical careers last decades. The people you are training alongside right now are the reason you will be back in five and ten years.
Stay curious, MedOwls.