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Cohort study
Practice and progress in obstetrics
  1. Anjali J Kaimal
  1. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to: Dr Anjali J Kaimal, Maternal–Fetal Medicine Division, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02118, USA; akaimal{at}

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The expectation that one will become ‘older and wiser’ in parallel is intuitive and comforting. In the world of medicine, this adage fits well with our experiences: we are taught by those who have come before us. Over time, we become the teachers in a tradition of apprenticeship that assumes that more time as a physician makes you better in a process that occurs incrementally, day by day and patient by patient, but is much more easily recognised in aggregate, year by year.

While the learning curve is easier to quantify in the early portion of medical training, when the focus is on the acquisition of technical skills as well as clinical judgement, the nuances of how and when expertise continues to accumulate in …

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  • Competing interests None.