The beginning of the 20th century brought huge changes to medicine; we’re still trying to cope with them. Special guest Dr. Adam Rodman, visits with M1s Jeff, Faith, and Linda and PA1 Kelsey, to talk about “path dependency,” the idea that a complex system (like medical education) is almost impossible to change without starting over. The path we have taken to today constrains what we can do tomorrow. We discuss the founding of medical education as we know it today and how that has created an academic medicine system that values facts, science, and publication more than things like equity, empathy, and work-life balance. The good news is that very dedicated people are working to make the sorely needed adjustments to these areas and more…without burning it all down and starting again.