# Medical School Friendships

*The people who share the years of becoming, and what gratitude can honestly name*

Kanwar Partap Singh Gill, MD · November 7, 2026 · Becoming a Doctor

Punjabi asks one verb to do two jobs. ਬਣਨਾ, *baṇnā*, means to become, to be made: a house *baṇdā* when it is built, a dish when it turns out well, a boy when he grows into something. The hope that families in Punjab have long attached to their children's schooling is usually phrased with it. *Kujh baṇ jā*: become something, make something of yourself. But the same verb, in a slightly different construction, describes whether two people get along. *Sāḍī baṇdī hai*, we get on; *uhnāṅ dī nahīṅ baṇdī*, those two don't. Literally, something is made between them, or fails to be made.

The doubling seems to me more than an accident of grammar. The years in which a young person is becoming someone are also the years in which he finds out with whom something gets made. For a medical student those years are crowded. Between seventeen and twenty-three, roughly, a person is turned into a doctor by a syllabus, an examination system and a hospital; and at the same time, less formally and with no syllabus at all, he is turned into an adult by the people beside him. The second process is recorded nowhere. Nobody certifies it. It may matter as much as the first.

I studied medicine at Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar from 1997 to 2002. This essay will not name anyone from those years, describe a particular friendship, or reconstruct a conversation. The people who shared those years have their own accounts of them, and a memoir has no right to borrow other lives to furnish its own. What can be written about is the material such friendships are made of: the accidents that put people side by side, the choices that turn nearness into something else, the things that can be admitted between equals, the rivalry that runs underneath the companionship, and what a person can truthfully claim to owe, decades later, to the people who were becoming someone at the same time he was. The question is easy to put. What is a friendship of the becoming years made of, if not usefulness? And can it be described honestly, without either idealising a class or exposing a friend?

## The Batch

Indian English has a word for the group a medical student belongs to before he has chosen anyone in it. He is in a *batch*: the 1997 batch, the first batch, a senior batch, a junior one. Doctors who trained in India are apt to ask one another, years later and a long way from where they trained, *which batch?*, and the answer places a person more exactly than a birthplace. The word is older and homelier than its use. It comes from a presumed Old English word for something baked, a relative of the verb *to bake*; a batch was first the quantity of bread that came out of the oven at one time. It suits a medical class. The loaves did not choose one another. They were put in together, subjected to the same heat, and came out bearing the marks of the same oven.

That is the first fact about medical-school friendship, and it is a humbling one. It begins in allocation. An admissions list decides who is in the room; a roll number, in many Indian colleges, decides who stands at the same table in a practical, who is examined in the same group, who waits in the same line outside a viva. Proximity is assigned before affection has had a chance to choose.

How much proximity alone accomplishes was measured, with unusual neatness, in a study published in 1974 by the sociologist Mady Segal. She worked with trainees at the Maryland State Police training academy, where rooms and classroom seats were assigned in the alphabetical order of surnames. When the trainees were asked to name their closest friends at the academy, the people they named tended to be those whose names stood near their own in the alphabet. Nothing in anyone's temperament put the Andersons with the Bakers. The register did. Friendship, at its beginning, followed the seating plan.

Fiction knew this long before the sociologists did. W. Somerset Maugham's *Of Human Bondage*, published in 1915, draws on Maugham's own years as a medical student at St Thomas's Hospital in London in the 1890s. Its hero, Philip Carey, enters the medical school of a fictional London hospital, St Luke's, and at the beginning of the session acquires a companion, a fresh-complexioned lad just come from Clifton named Dunsford. Maugham does not dress up the reason. Dunsford attached himself to Philip "merely because he was the first person he had known at St. Luke's." The sentence has the plainness of a research finding. Of all the people who might have become Philip's friend, the first one through the door did.

The accident is only half of it. In 2012 Katherine Woolf and colleagues at University College London published a study under the title "The hidden medical school." In November 2009, 215 of the 317 second-year students at the school had reported which of their classmates they were friendly with. Students of the same sex and the same ethnic group were socially closer. So were students who had been put, at random, into the same tutor groups and small groups at the start of the course. Allocation and likeness worked together: the timetable put people side by side, and within that arrangement people drifted toward those who resembled them. The study found something else, to which I will return. Pairs who were socially closer went on to have more similar examination results the following May, even after their earlier marks were taken into account.

One school, one year group, friendships reported on a questionnaire: the study cannot say what happens in a medical college in Punjab, and it would be dishonest to pretend it does. But the two forces it names are general. A class in Amritsar sorts itself as any class does, by the accidents of the register and by the comfort of resemblance: the language spoken at home, the district, the school one came from, city or village, gender, money, and sometimes, in ways a polite account prefers to leave out, community and caste. The friendships that feel, from inside, entirely chosen were partly arranged in advance. That does not make them less real. It makes them less innocent of the world than they seem.

## Chosen Time

If allocation explained everything, every pair of neighbours at a dissection table would become friends, and they do not. Something has to be added to nearness, and the simplest name for it is choice. A friendship begins at the point where the timetable no longer explains why two people are together.

Maugham marks that point precisely. Philip and Dunsford are thrown together by the opening weeks of term; what makes them friends is what they do with the hours nobody assigned. Dunsford has no friends in London, and on Saturday nights the two of them fall into the habit of going together to the pit of a music hall or the gallery of a theatre. The medical school has no interest in this. It is the first thing in the relationship that belongs to them alone.

Maugham is also honest about what the chosen hours contained, and the honesty is useful. Philip thinks Dunsford stupid. He makes him his butt, laughs at him, and Dunsford merely smiles; and Philip, who is not a kind young man, likes him all the same, because Dunsford has a charm that Philip is "acutely conscious of not possessing." This is an ordinary friendship, uneven in intelligence and in kindness, held together by habit, company and a degree of mutual need. Most of the friendships of a medical class are probably like that, and a warm memory has a way of smoothing them into something more symmetrical than they were.

Chosen time has a further property that matters in medicine particularly. A medical student is almost never unobserved. He is examined in writing, in practicals, in vivas, and eventually at the bedside, where his ignorance is displayed in front of teachers, peers and patients. Most of his hours are spent performing a competence he does not yet possess. The time he chooses to spend with friends is time in which, by general agreement, the performance can stop. I have written in [another essay](../tea-between-classes/index.html) about the minutes between classes, and about research suggesting how many hours of unassigned company a friendship takes. The point here is narrower. Chosen time is pleasant, and it is also the condition under which the next thing becomes possible: saying what one would not say anywhere else.

Not everyone has the same amount of it to choose. A student with a long commute at each end of the day, with duties at home, with every evening out to be paid for and counted, has fewer unassigned hours to spend, and fewer friendships grow in them. A class is no more a level field for friendship than for anything else. That, too, is part of what an honest account owes to the people it leaves unmentioned.

## What Could Be Admitted

Medical training teaches a particular reticence. Its students learn early that not knowing is dangerous, that weakness is noticed, that illness in a doctor is an embarrassment to be managed quietly. Much of this is protective. A profession that holds people's lives cannot be casual about its own competence. But the reticence has a cost, and the cost falls where it is least visible. A student who cannot admit that he has not understood, that he is frightened, that he is unwell or short of money, has nowhere to set those things down.

The friendship of equals is one of the few places he can. A teacher who is told *I don't understand this* hears an admission; a friend hears a question. A friend can be told that an examination went badly before the result is posted, that a ward has been upsetting, that home is difficult, that the whole course was a mistake. What makes such admissions possible is less intimacy than the absence of judgment with consequences. The friend does not mark you, rank you or write your reference, and that is exactly why his opinion can be trusted.

Maugham gives this its most exact scene. Philip falls ill in his lodgings. On the floor above lives Griffiths, a fifth-year student, cheerful, generous, liked by everybody, whose noisy evenings Philip has listened to, sick at heart, from his solitary room below. "They had lived in the same house for over a year," Maugham writes, "but had never done more than nod to one another in the passage." Hearing that Philip is unwell, Griffiths knocks and comes in. Philip, "blushing he knew not why, made light of the whole thing." Griffiths has him take his temperature, reads the thermometer and tells him he must stay in bed; Philip, closing his eyes with a smile, murmurs that Griffiths has a wonderful bedside manner; and Griffiths smooths the bedclothes, fetches a siphon from his own room and draws the blind. When the physician arrives and suggests the hospital, Griffiths says at once that he can look after him. "I'm day-nurse and night-nurse all in one," he tells Philip.

The blush is the most truthful thing in the passage. Philip is embarrassed less by his illness than by being seen to need something, and he reaches at once for the medical student's reflex: it is nothing, it will pass. Griffiths's kindness consists partly in ignoring that reflex. He does not argue with Philip's account of himself. He simply takes the temperature. A great deal of what friends do for one another in a medical school is a version of this: declining, gently, to accept the competent face a frightened person is holding up. And Philip's murmured joke about bedside manner catches something else. A student nursing a friend is practising, on someone who can forgive his mistakes, the manner he will one day need with strangers.

Two cautions belong here. The first is that a confidence received becomes an obligation. Things admitted between friends in those years were admitted on the understanding that they would go no further, and a friend who later publishes them, even fondly, even disguised, has broken the terms on which they were given. That is the plainest reason this essay contains no friend's confession. The second caution comes from Maugham too. The same Griffiths who nursed Philip later betrays him, in the most painful way open to him, over the woman Philip loves. The novel does not resolve the contradiction, because people do not. The friend who took your temperature can also be the friend who wrongs you, and a memoir that keeps only the first has written a different man.

## Borrowed Convictions

Friends in a medical school do more than console one another. They form one another's opinions, and in a profession whose ethics are learned largely by watching, that is a serious matter.

The formal moral education of a medical student is brief: some lectures, an oath, a code. The practical one happens on the wards, where students see how doctors actually speak to the poor, the frightened and the difficult, and it continues in a place nobody examines, which is the conversation afterwards. In 1992 and 1993 Chris Feudtner, Dimitri Christakis and Nicholas Christakis surveyed the third- and fourth-year students at six medical schools in Pennsylvania about the ethical situations they had met on their clinical rotations. Only about a third replied, which limits what the figures can bear, but the replies were sobering. Almost all had heard doctors refer to patients in derogatory terms. Sixty-one per cent had witnessed what they believed was unethical conduct by members of the team, and more than half of those had felt like accomplices. Sixty-two per cent believed that at least some of their own ethical principles had been eroded or lost. Students who had acted improperly in order to fit in with the team were more likely to report that erosion.

The survey was of American students a generation ago, and it would be careless to export its percentages to Amritsar. Its mechanism travels better. A young person's conscience seldom erodes in private. It erodes, or holds, in company: in the remark made afterwards about a patient, in the laugh that follows or fails to follow, in whether anyone says *that was wrong* and whether the others agree. The friends of a medical class are the first jury before which a student tries out what he has seen. They can make a cruelty seem normal by finding it funny, or make it seem what it was by refusing to. Most of the time, nobody notices which of these is happening.

Turgenev wrote the classic novel of this kind of influence. In *Fathers and Sons* (1862), Arkady Kirsanov comes home from the university with his friend Yevgeny Bazarov, who, as Arkady explains proudly to his father, is in the medical faculty and is "to become a doctor next year." Bazarov dissects frogs, dismisses art and sentiment, and calls himself a Nihilist; and Arkady, who adores him, recites the creed to his uncle as though it were his own: a Nihilist is a man who declines to bow to authority or to accept any principle on trust. Readers have always enjoyed the comedy of a young man speaking in his friend's voice. The novel is subtler than its comedy. Over its course Arkady discovers, mostly by falling in love, that he is no Nihilist at all, and he drifts out of Bazarov's orbit without ever quite deciding to.

Their parting is one of the great scenes of friendship in fiction because neither man can say what it means. Bazarov, packing his trunk, tells Arkady that they are parting for ever, that Arkady was not made for the hard, bitter life of Nihilism, and that he is a fine young fellow but a soft, well-bred gentleman. Arkady, weeping, protests that this is all his friend has to say to him. Bazarov admits there is something else he could say: "But I will not say that something—it would savour too much of Romanticism." Then he asks for one more embrace.

Two lessons follow from that scene for the friendships of a medical class. The first is that borrowed conviction is how young people begin to have convictions at all. A student repeats a friend's opinions, about medicine, politics, God and money, before he has earned any of his own, and there is nothing shameful in it; the alternative is to hold no opinions until it is too late for anyone to argue with them. The second is that the healthy end of such borrowing is departure. Arkady's growing away from Bazarov is the sign that the friendship did its work: it gave him ideas firm enough to push against. A friend whose opinions you held at twenty and do not hold now has not been betrayed. He has been outgrown in the only way that honours what he gave. What Bazarov cannot bring himself to say, Turgenev leaves the reader to supply. Something like gratitude was owed in both directions, and the creed both young men had adopted gave them no words for it.

## Rivals at the Same Table

Medical education in India is competitive from its first gate. Students arrive by rank in an entrance examination, and inside the college they are ranked again: marks in professional examinations, positions, distinctions, the order of names on a notice board. Friendship in a medical class grows inside this machinery, never outside it. The people you study with are the people you are measured against.

Maugham, once more, is unsparing. Philip goes up for an examination confident that he has passed. The next day he goes to the examination buildings to read the results posted on the door, does not find his number, and reads the list three times. Dunsford is with him, and Dunsford's number is there. "I say, I'm awfully sorry you're ploughed," Dunsford says. Philip answers that it does not matter a bit and that he is jolly glad Dunsford is all right. On the walk back along the Embankment, Dunsford good-naturedly wants to talk about why Philip failed, and Philip, Maugham writes, "was obstinately casual." He was horribly mortified, and what made it harder to bear was that Dunsford, whom he looked upon as a very pleasant but quite stupid fellow, had passed.

Everything about competition between friends is in that walk. The successful friend's sympathy is real, and to its recipient unbearable. The unsuccessful friend's graciousness is real, and also a mask. The offer to talk about what went wrong, which is the most useful thing one student can offer another, is refused because accepting it would mean admitting the wound. Underneath it all, unspoken, lies the private ranking each young man has made of the other's intelligence, which the examiners have just declined to confirm.

The ethics of describing this are narrow. I can say that examinations put strain on friendships, because they do, everywhere; I cannot say what anyone else felt about a result, or attribute to a friend a resentment he may never have had. Envy is invisible from outside, and imputing it is a way of winning, in retrospect, a contest that should have been left alone. What can be said is that the strain and the companionship were inseparable. The London study found that friends came to have more similar marks over the following months, after allowing for how they had done before. The finding is an association in one cohort, and its authors say only that friendship may influence learning. But it suggests that the friend beside you was neither merely a rival nor merely a support. He was part of the conditions under which you learned, as you were part of his.

Tennyson has an image for unequal ability among friends that is more generous than most. *In Memoriam*, published in 1850, is the long elegy for his friend Arthur Hallam, who died in 1833 at the age of twenty-two. In one of its sections the poet remembers the debates of their Cambridge circle and pictures the friends as archers. One would aim an arrow fair but send it slackly from the string; one would pierce an outer ring, and one an inner, here and there; and last the master-bowman, Hallam, "would cleave the mark." What follows is attention, without a trace of grievance: "A willing ear / We lent him." The poem admits the inequality outright. It does not pretend that everyone in the circle was equally gifted. It records that the less gifted listened, with pleasure, to the most gifted. Among competitive young people that is no natural state of affairs. It is an achievement, and in Tennyson's case one sharpened by grief. But it describes something the best friendships of a competitive class manage: the ability to admire a friend's better aim without wishing his arrow had fallen short.

## Mind and Art, and the Changing Mart

The archers belong to a section of the poem that pauses, just before them, to list what the friends used to talk about:

> Where once we held debate, a band
> Of youthful friends, on mind and art,
> And labour, and the changing mart,
> And all the framework of the land;

The circle Tennyson remembers was the Cambridge society known as the Apostles, to which both young men belonged, and its debates ranged over philosophy, literature and politics, far from anything its members would be examined in. That is the point of the stanza. The friends of the becoming years are the people with whom one argues about the world before one has a place in it: politics and poetry, religion and money, how a country ought to be run, whether a film was any good, what one actually believes. In a medical college in Punjab at the end of the 1990s the subjects would have been different and the register less grand. The function was the same.

For medical students the function matters more than usual, and the reason is structural. The psychologist Erik Erikson described adolescence and early adulthood as needing a *moratorium*: a period in which society allows a young person to try out roles and beliefs before committing to them. In 1966 James Marcia, building on Erikson, proposed a way of classifying where young people stood. Some had explored and then committed; some were still exploring and had not yet committed; some had committed without exploring at all, often by taking over a path laid down for them by others, a condition he called foreclosure. Marcia's categories describe people, and I do not want to use them to diagnose anybody. They also describe institutions. A system that asks a seventeen-year-old to sit an entrance examination for a profession, and then fills the next five years with that profession's syllabus, leaves very little room for a moratorium. The commitment comes first. The exploration has to find somewhere else to happen.

Friends are where it happens. The syllabus makes a student into a doctor; the arguments in rooms and corridors late at night are where he discovers what sort of person the doctor is going to be. A friend who knows you as someone with opinions about poetry, or cricket, or the politics of the state, knows that you are not only a future physician, and that knowledge is a kind of protection. Medicine is greedy for identity. It would happily become the whole of a person, and in the long years after training it often does. The friendships formed while one was still a student, among people who argued about mind and art and labour and the changing mart, are a standing reminder that there was once more to the person than the profession, and that there still could be.

## Rabb Rākhā

Then the class disperses. Internship ends, and with it the last structure that held the batch together. People go to different specialties, different hospitals, different cities, and in time different continents. The friendships made in the oven are tested by the one thing the oven never asked of them: distance.

Tennyson's return to Cambridge is the extreme case, because Hallam is dead. But the same section of the poem opens with an experience that anyone who has gone back to the place of his education will recognise. The poet passes the old walls, hears the organ and the shouts from the river, paces the same gray flats, and feels "the same, but not the same." Then he walks up the avenue of limes to see the rooms in which his friend had lived:

> Another name was on the door:
> I linger'd; all within was noise
> Of songs, and clapping hands, and boys
> That crash'd the glass and beat the floor;

These are among the truest lines I know about returning to the place where one was young. The rooms have not been kept as a shrine. Other young men live there now, as loudly as the poet and his friends once did, with no idea who lived there before them. An institution goes on making batches; the oven is never cold for long. And the people who once filled it have scattered into lives that no longer pass through that door.

Punjabi has an old way of letting a friend go into such distances. ਰੱਬ ਰਾਖਾ, *Rabb rākhā*, people say at a parting: God keep you, or more literally, God is the keeper. The phrase is often said lightly, but it has a precise structure. It hands the departing person over to a guardian who can go where the speaker cannot. It concedes, without saying so, that the friend's life is about to pass out of one's own sight, and that care for him will now have to take the form of a wish.

That seems to me the right model for friendship after dispersal, and it is a model that forgives a good deal of silence. Affection between people who trained together does not depend on constant contact, and the absence of contact is not a verdict. People who have not spoken for years can meet and find the old ease intact within minutes, an experience common enough that most people have had it from one side or the other. Others drift, and the drift is no betrayal. Some friendships are made for a season and complete their work within it. The modern habit of keeping whole batches together in group messages has its uses; it keeps people informed of one another's lives. It can also impose a false standard, as though a friendship that does not perform itself daily has failed. Punjabi has a word for a friend that holds a better standard. ਸੱਜਣ, *sajjaṇ*, a friend or a beloved, descends from a Sanskrit word for a good person. The word does not measure frequency. It measures what kind of person one was, and is, to the other.

All this warmth meets a harder view, and it should be put without sentiment. Medical-school friendships, the view holds, are among other things a professional network, and an excellent one. The batch becomes a web of referrals, advice, introductions and favours that lasts a career. A physician who needs a second opinion late at night, a reference for a post, a colleague in another city to see a relative, will often call someone he trained with. To describe these friendships as though they were innocent of usefulness is to describe them falsely, and perhaps to flatter oneself.

The view is right about the facts. The usefulness is real and nothing to be ashamed of; a profession runs partly on trust between people who have known each other since they were young, and patients benefit from that trust. Where the view goes wrong is in what it would have us measure. If friendships are judged by later usefulness, memory begins to rewrite itself around the people who became useful: the friend who became a professor, the friend who became a well-placed specialist. The friend who failed his examinations and left, the friend who chose a quiet practice in a small town, the friend who stopped practising altogether, all fall out of the account, though at twenty they may have mattered more than anyone. Usefulness is a consequence of some of these friendships. It was never their substance, and an account that treats it as the substance has allowed the professional self to edit the life.

## What Gratitude Can Name

The most exact statement of debt to a friend of the becoming years that I know in English was written by a man who had long since fallen out with the friend in question. In 1823 William Hazlitt published "My First Acquaintance with Poets," his recollection of January 1798, when he was nineteen, the son of a Dissenting minister in Shropshire, and rose before daylight to walk ten miles in the mud to hear Samuel Taylor Coleridge preach. The essay is one of the great accounts of a young mind waking in the presence of another. By the time Hazlitt wrote it, the friendship was long over; he had quarrelled with Coleridge and attacked him in print. Yet in its opening pages he pauses to say precisely what he owes. His soul, he writes, has remained in its original bondage, and his heart has never found, nor will ever find, a heart to speak to; "but that my understanding also did not remain dumb and brutish, or at length found a language to express itself, I owe to Coleridge." Then, briskly: "But this is not to my purpose."

The sentence is a model of accurate gratitude. It does not claim that Coleridge made Hazlitt's life, or that the friendship was its centre, or that what came after can be forgiven because of what came before. It names one thing that was given, a language, and it concedes that this one thing was real, against every motive Hazlitt had by then for withholding the concession. And then it moves on. The estrangement does not cancel the debt, and the debt does not oblige anyone to pretend the estrangement away.

That combination is what the friends of the becoming years make possible, long after the becoming is over. They are witnesses. They knew you when your intentions were still audible, when you said, at twenty, what kind of doctor you meant to be and what you would never become. Their memory of that person is a check on the one you have turned into; a friend from those years who asks, mildly, whether you still believe what you used to say is asking the most useful question anyone can ask a person in mid-career. And whether or not you are still close to them, whether or not the friendship survived distance, quarrel or simple drift, what they gave at the time remains given.

Most gratitude of this kind is less disciplined than Hazlitt's. The inflated version claims too much: that a friend made you who you are, that the friendship was the making of a life, that it changed everything. These are claims about another person's part in your story, and that person may see it quite differently. The accurate version is smaller. It names acts. The acts that gratitude of this sort can honestly name are almost always modest: an explanation given late at night to someone who had not understood, notes lent before an examination, a temperature taken by someone who would not accept *it's nothing*, a confidence kept, a defeat sat through without commentary, an argument that changed a mind. Each is something a person did. None requires the one who is grateful to say what it meant to the one who did it. Their interpretation of those years, and their present lives, remain their own.

Punjabi lets the essay end where it began. *Sāḍī baṇdī sī*: we got on; literally, something was being made between us. The tense is past, and the verb is still the verb for becoming. Whatever was made between people in those years went into what each of them became, in proportions nobody could now calculate, and that may be the most that can truthfully be said about the friendships of a medical school. The syllabus made the doctors. The rest of each person was made, in part, between them.

## Evidence and Editorial Note

**Documented findings.** Public biography relied on: MBBS at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, 1997–2002; Punjabi as first language. W. Somerset Maugham, *Of Human Bondage* (1915), quoted from the Project Gutenberg text (eBook 351): Dunsford's attachment to Philip "merely because he was the first person he had known at St. Luke's," the Saturday-night music halls, Philip making Dunsford his butt and Dunsford's charm, the examination result posted on the door and the walk along the Embankment ("I say, I'm awfully sorry you're ploughed," "obstinately casual"), and Griffiths nursing Philip ("They had lived in the same house for over a year…," "blushing he knew not why," "I'm day-nurse and night-nurse all in one," the bedside-manner remark); Griffiths's later betrayal over Mildred is from the same novel. Ivan Turgenev, *Fathers and Sons* (1862), quoted from C. J. Hogarth's translation (1921; Project Gutenberg eBook 47935): Bazarov in the medical faculty and "to become a doctor next year," Arkady's recitation of the definition of a Nihilist, and the parting scene ("But I will not say that something—it would savour too much of Romanticism"). Chris Feudtner, Dimitri Christakis and Nicholas Christakis, "Do clinical clerks suffer ethical erosion?", *Academic Medicine* 1994;69(8):670–679 (PubMed abstract, PMID 8054117): 1992–93 mail survey of 1,853 third- and fourth-year students at six Pennsylvania schools, 665 (36%) responding; 98% had heard derogatory references to patients; 61% had witnessed unethical conduct, 54% of whom felt like accomplices; 62% reported erosion of some principles; association with acting improperly to fit in with the team. Maugham's medical training at St Thomas's Hospital in the 1890s: standard reference knowledge. Alfred Tennyson, *In Memoriam A. H. H.* (1850), the section beginning "I past beside the reverend walls" (numbered LXXXV in the first edition, LXXXVII in later ones), quoted from the Project Gutenberg text of the 1850 Moxon edition (eBook 70950); Hallam's death in 1833 at twenty-two and both men's membership of the Cambridge Apostles: standard reference knowledge. Mady W. Segal, "Alphabet and attraction: an unobtrusive measure of the effect of propinquity in a field setting," *Journal of Personality and Social Psychology* 30 (1974): 654–657; the Maryland State Police academy setting and the alphabetical assignment of rooms and seats: standard reference knowledge of the study. Katherine Woolf, Henry Potts, Shilpa Patel and Chris McManus, "The hidden medical school," *Medical Teacher* 2012;34(7):577–586 (PubMed abstract, PMID 22746963): 215 of 317 Year 2 students, November 2009; closeness by sex, ethnic group and randomly allocated tutor and small groups; more similar May 2010 grades among closer pairs; friendship "may influence learning." James Marcia, "Development and validation of ego-identity status," *Journal of Personality and Social Psychology* 1966;3(5):551–558 (PubMed record, PMID 5939604); the identity statuses and Erik Erikson's psychosocial moratorium: standard reference knowledge. The etymology of *batch* from an Old English word for something baked: Wiktionary, "batch." William Hazlitt, "My First Acquaintance with Poets" (1823), quoted from *Winterslow: Essays and Characters Written There* (Project Gutenberg eBook 39269): January 1798, the ten-mile walk, "but that my understanding also did not remain dumb and brutish, or at length found a language to express itself, I owe to Coleridge," and "But this is not to my purpose"; Hazlitt's later estrangement from Coleridge and his attacks on him in print: standard reference knowledge. The Punjabi ਬਣਨਾ in its senses of becoming and getting along, ਰੱਬ ਰਾਖਾ as a farewell, and ਸੱਜਣ from Sanskrit *sajjana*: standard reference knowledge of Punjabi usage. Selection to medical colleges by entrance examination and rank, and the Indian-English sense of *batch*: standard reference knowledge. **Vendor representations.** None.

**Recollection and tradition.** Beyond the public biography, the essay asserts no remembered scene, friendship, conversation or classmate. No one from the author's medical-school years is named, described or given a trajectory; the kinds of friend and the kinds of act mentioned near the end are general categories, not claims about particular people. All scenes are taken from Maugham's novel and Tennyson's poem and are identified as such; the essay contains no hypothetical scene.

**Analysis and forecast.** The reading of ਬਣਨਾ, the application of studies of proximity and homophily to an Indian medical class, the readings of Maugham, Tennyson, Turgenev and Hazlitt, the argument about moratorium and foreclosure as features of institutions, and the case against measuring friendship by usefulness are the author's interpretation and ethical preference. **Independence.** This essay is not sponsored by any institution, company, health system or technology developer.



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- [The First Time Someone Called Me Doctor](https://personal.kpsgill.com/essays/the-first-time-someone-called-me-doctor/)
- [The Hostel Years](https://personal.kpsgill.com/essays/the-hostel-years/)
- [The First Patient I Examined](https://personal.kpsgill.com/essays/the-first-patient-i-examined/)