School reports of that era, in India as in most places, followed a familiar layout. Subjects ran down the left margin. Marks ran across, term by term, with a total at the foot and sometimes a rank. There was a line for attendance, expressed as a fraction, and a line for conduct, usually expressed in a single word. Near the bottom, squeezed in above the signatures, was a narrow space headed Remarks, in which a teacher who had spent a year with a child was permitted roughly one sentence to say so.
It is an admirably confident document. It places a young person in boxes, assigns numbers, and sends the result home as though the more interesting parts of becoming someone could be ruled into columns. I attended Spring Dale School in Amritsar, and the form is useful for thinking about those years. It shows what a school could measure, and in its margins it hints at everything a school gave that no column was designed to hold.
There is a second confident document that I distrust more: the biography read backward from a profession, in which the school years line up obediently behind medicine, each subject a rehearsal, each good mark a down payment on a white coat. I would like to grade those years on their own terms, and the simplest way to do it is to borrow the report’s headings and fill them in differently.
Even the title of this essay concedes something to the backward reading. “The years before medicine” names a stretch of childhood by what came after it, as though those years had been a waiting room. Nobody at the time would have described them that way. They were not before anything; they were the present, as full and as unfinished as any present, and the people living them had no idea which of their many possible sequels would arrive. I have kept the title because it is honest about the vantage point from which I write. I want the essay to work against it.
One limitation belongs at the start, stated once. I have no report card in front of me and quote none. I name no teacher and no classmate, and describe no lesson, examination or school event. The layout above is the general form of Indian school reports in those decades, not a facsimile of Spring Dale’s. I borrow its columns as a way of thinking, not as evidence about any child, least of all about me.
The Report as an Argument #
Every form is an argument, and a report card argues more than most. Each column presumes that something can be measured. Marks presume that learning becomes visible on a particular date, in a particular hall, in answer to questions set by someone else. Attendance presumes that presence can be counted in days. Conduct presumes that character shows itself in behaviour an adult can observe and summarise in a word. Remarks presume that a year of a child’s life can be compressed into a sentence without losing what mattered. None of these presumptions is absurd, and each is partly true. The trouble begins when the form’s confidence is mistaken for completeness, and a document that measures some things well is read as a document that has measured the child.
Rabindranath Tagore, who had founded a school of his own at Santiniketan in 1901, wrote the sharpest parable I know about that mistake. Tota Kahini, published in Bengali in 1918 and in English the same year as The Parrot’s Training, begins: “Once upon a time there was a bird. It was ignorant. It sang all right, but never recited scriptures.” A Raja decides that the bird must be educated. A golden cage is built at great expense. Pundits are engaged, and “had their rewards and went home happy.” Scribes are set to work producing texts for the bird, and Tagore gives them one of his best sentences: “They copied from books, and copied from copies, till the manuscripts were piled up to an unreachable height.” The Raja’s nephews report regularly on the progress of the enterprise, and everyone involved prospers. The bird is stuffed with pages. Eventually, in the plainest sentence of the story, “The bird died.” The nephews report: “Sire, the bird’s education has been completed.” The Raja pokes it with his finger. “Only its inner stuffing of book-leaves rustled.”
What makes the parable more than a joke about pedants is the shape of the record it describes. Every part of the education is visible and reportable: the cage, the fees, the copying, the ceremonies. All of it can be entered in a ledger. The only thing nobody reports on is the bird, because the bird is the one element of the enterprise that does not generate paperwork. Tagore’s satire is not aimed at learning. It is aimed at an education whose evidence consists entirely of the educators’ activity and the pupil’s capacity to hold what has been put into him.
A report card is not a golden cage, and the teachers who fill one in are not the Raja’s nephews. But it shares the temptation the parable exposes, because what is easiest to report is what the institution does and what the child can produce on demand, while what is actually happening inside the child, the slow change in what he notices and what he cares about, leaves almost no trace. It is worth remembering, too, what the bird was faulted for at the beginning. It was not silent. It sang. Its crime was that its singing could not be recited.
Marks #
Marks measured whether something had been learned by the date of an examination. They were reasonably good at that, and the discipline of being measured has its uses. What they could not measure was why a thing was worth learning, and the honest answer for much of a school curriculum is that nobody yet knows. History, geography, mathematics, languages, literature: they arrive in a child’s week without any account of what they will be for. That is their particular gift. School is one of the few places where a person is asked to learn something before its use has been established. Sometimes the use never is established, and the learning was worth having anyway.
Montaigne saw the problem more than four centuries ago, in the essay on the education of children he addressed to a noblewoman who was expecting a child. He wanted a tutor for the boy with a head well made rather than well filled, plutôt la tête bien faite que bien pleine, and he described what learning ought to do with an image from the garden. Bees, he wrote, in my rendering, gather here and there among the flowers, but afterwards they make honey that is wholly their own; it is no longer thyme or marjoram. That is the whole argument in a sentence. Learning is not judged by how much of the original flower can still be identified in the student, or by how soon the honey can be sold. It is judged by whether it has become his.
A marks column cannot see that transformation, because it is designed to check for the flower. It asks whether the thyme can be produced on demand. That is a legitimate question, and it has to be asked; but a curriculum judged only by it will reward the student who keeps his learning undigested and portable, in the form in which it was handed to him, and will have no way of noticing the one who has turned it into something else. Much of what a school gives is of the second kind, and it shows up years later, unlabelled, in a way of reading or a habit of attention whose origin nobody could trace.
I notice that I want to justify that paragraph by its usefulness to medicine. The languages I speak, Punjabi first and then Hindi, Urdu and English, are plainly useful in a California clinic, and I was about to say so as though that settled their value. It is exactly the habit I am trying to put down. A first language is not a pre-clinical skill. It is the language in which one was a child.
The languages of an Indian school carry a history of their own valuation, and it is worth being exact about it. On 2 February 1835, Thomas Babington Macaulay, then the law member of the Governor-General’s council, circulated a minute on education that settled, for the purposes of the colonial government, which knowledge counted. He declared that “a single shelf of a good European library was worth the whole native literature of India and Arabia,” a judgement he passed while admitting, in the same document, that he read neither Sanskrit nor Arabic. The minute’s purpose was to form “a class of persons, Indian in blood and colour, but English in taste, in opinions, in morals, and in intellect,” who would serve as “interpreters between us and the millions whom we govern.” Within about a month the Governor-General had made its policy his own.
The minute is, among other things, a marks sheet. It ranks whole literatures, with complete confidence, by a single criterion, and it was written by a man who had not sat the examination in the subjects he failed. Its ghost has never left English-medium schooling in India, though the schooling itself long ago changed hands. Generations of Indian families, Punjabi families among them, have chosen English for their children not as an act of deference but because it opened doors, and many of those children have written in English things Macaulay could not have imagined. The injury in the minute was never the English. It was the hierarchy: the conviction that one shelf outweighs a civilisation, and that a child’s home language belongs to the kitchen while the language of the examination belongs to the mind.
The repair, as I have come to see it, is not to give up English. It is to refuse the ranking. A child who learns physics in English and proverbs in Punjabi has not acquired a first-class language and a second-class one. He has acquired two instruments for thinking, and each can see things the other cannot. If those years taught me anything I can still defend, it is that a language does not need to justify itself by its usefulness on a later marks sheet, clinical or otherwise.
Rank #
Marks also rank, and ranking teaches a lesson of its own, not always a good one. Charles Dickens wrote the classic scene in 1854, in the second chapter of Hard Times, which he called “Murdering the Innocents.” Mr. Gradgrind, who has already announced in the novel’s first line, “Now, what I want is, Facts,” points at a girl in his model school and addresses her as “girl number twenty.” She gives her name as Sissy Jupe. “Sissy is not a name,” he replies. “Don’t call yourself Sissy. Call yourself Cecilia.” Her father, it emerges, works with horses in a travelling circus. Gradgrind asks her to define a horse, and she cannot, so he calls on a boy named Bitzer, who can. His answer is a column of entries rather than an animal: what the horse eats, how many teeth it has of each kind, when it sheds its coat, why its hoofs need iron, how its age is read from its mouth. Gradgrind turns back to the girl and tells her that now she knows what a horse is.
The scene is often remembered as a joke at the expense of facts. It is better than that. Every item in Bitzer’s definition is correct and checkable. Dickens’s target is the format in which knowledge is allowed to count. Sissy has lived among horses all her life; she knows how they move and what they need and how the people who depend on them speak of them. None of that can be entered in the column. Bitzer’s knowledge can, and so Bitzer ranks first. Dickens adds a physical detail that has stayed with me since I first read it: Bitzer is so pale that he looks as though, if he were cut, he would bleed white. The child most perfectly adapted to the format has lost his colour. Later in the novel he grows into a careful, self-interested functionary who applies his schooling’s principles more consistently than its founder can bear.
Every classroom holds kinds of intelligence that a marks sheet cannot see: the child who can mend anything with moving parts, the one who reads the mood of a room before the teacher does, the one who stays kind when the pressure is on. I do not mean these as portraits of anyone I knew. I mean them as categories, and I mean that they cannot be ranked by their resemblance to the kind of intelligence that examinations happen to reward. A school does well simply by putting them in the same room long enough for a child to notice that they exist. A rank in a column says where a child stood on one measure on one day. It says nothing about the others, and the danger is that a child, or a parent, or eventually an adult remembering, reads the one number as the whole of the standing.
In Defence of the Examination #
There is a strong case on the other side, and I want to give it its full weight, because an essay like this one can slide into an easy contempt for measurement that its author would not tolerate anywhere else.
Examinations are, among other things, a protection. Before them, selection to many positions of consequence ran on acquaintance, family and favour. A written paper marked by a stranger is one of the few places where a child without connections is read entirely on his work. The history is instructive. Two decades after the minute on education, Macaulay lent his name and his considerable weight to the case for selecting the Indian Civil Service by open competitive examination, in place of nomination through the patronage of the East India Company’s directors. The same man who ranked literatures from ignorance also championed a ranking designed to resist influence. Both impulses were his, and the second has served a great many people well.
Examinations also make standards public. A syllabus and a marking scheme tell everyone what is expected and allow the expectation to be checked. They oblige a student to finish, which is a skill of its own, and a fair copy is a courtesy to its reader. In my own field the case is plainer still. Patients are entitled to know that someone, somewhere, tested whether their physician knows what a physician must know. I would not want to practise in a profession that had abolished examinations in a fit of sympathy for those who find them hard.
The difficulty lies in what happens to a measurement once decisions are hung on it. The social scientist Donald Campbell put the problem in a form that has become known as Campbell’s law: the more a quantitative indicator is used to make social decisions, the more it comes under pressure to be corrupted, and the more it distorts the very process it was meant to monitor. Campbell applied this explicitly to schooling. Achievement tests, he granted, can be valuable indicators of general school achievement. When the scores become the goal of teaching, they lose that value and bend the education around themselves.
The roll number, which Gradgrind turned into an erasure, has a better life in the examination hall. On the answer books of Indian board examinations, candidates write a number, not a name, so that the examiner who marks the script does not know whose it is. There the number is not a refusal to see the child. It is a deliberate blindness on the child’s behalf, a way of ensuring that the work is read without regard to family, school or favour. The same device that diminishes a pupil in one room protects him in another, and the difference lies entirely in the purpose it serves.
So the defence of the examination and the criticism of it are not opposed. An examination is a good instrument and a poor verdict. It can say, fairly and usefully, how a student performed on a set of questions on a given day. It cannot say how intelligent that student is in every sense that matters, what kind of person he is, what he is worth, or what his school years meant. The overreach is not in the measuring. It is in the reading.
Attendance #
Attendance was recorded as a fraction, but what it recorded had more depth than the arithmetic suggests: that for so many days a person had been one among others. In many Indian schools a child was known on the register by a roll number, and the daily calling of numbers was a small ritual of belonging, unglamorous and repeated until nobody heard it any more.
Gradgrind’s “girl number twenty” shows the other face of that ritual. A number can mark a place in a community, the child’s seat in a shared enterprise, or it can replace a name. The difference lies not in the number but in whether anyone still uses the name as well. A register that calls a roll number and then looks up at a face is doing something quite different from a schoolmaster who tells a girl that her name is not a name.
A school seats children, for years at a time, beside people they did not choose and need nothing from. Before adult life sorts everyone into colleagues, contacts, clients and referrals, the classroom simply leaves them to one another. A classmate is not a useful contact. That sentence sounds obvious until one has spent a few decades in professional life, where almost every introduction arrives with a purpose attached. The years before medicine had no such requirement. A friendship did not need to justify itself, and a difficult question did not need to prove its relevance to a career.
There is a second thing attendance records without meaning to: shared time. A school year imposes the same calendar on everyone in it, the same examinations in the same weeks, the same holidays, the same heat in the same classrooms. Adult life rarely gives a group of people a common clock. Professions run on shifts and schedules that scatter their members; even friends must negotiate a time to meet. For a few years, a school gives children the experience of living on the same timetable as a whole roomful of others, and that experience is part of what makes a cohort a cohort, long after its members have dispersed.
What the fraction cannot record is the quality of presence. A child can be marked present and be elsewhere in every sense that matters; another can miss days and be more fully part of the class than anyone. Attendance is a good measure of whether a body was in a room. It is a crude measure of whether a person was. Adult life narrows without announcing that it has done so, and the years of compulsory company remain one of the few standing objections to the narrowing.
Rough Copy, Fair Copy #
Indian schoolchildren of that generation will recognise two notebooks. There was the rough copy, where sums were attempted, abandoned and crossed out, and there was the fair copy, into which the finished work was transcribed in one’s best hand to be handed in. The ordinary word for an exercise book in Punjabi is ਕਾਪੀ, kāpī, borrowed from the English “copy,” and the pairing of rough and fair belongs to the English of the Indian classroom.
The report card rewarded the fair copy. The qualities I have learned to value since mostly live in the rough one. A corrected answer contains two kinds of information. It shows what the student can now do, and, if the abandoned work remains visible, it shows what had to change. The second kind is easily lost when the finished page becomes the only record worth keeping.
Consider a simple hypothetical. Suppose one student arrives at the right number by repeating a procedure without understanding why it applies, and another arrives at the wrong number after choosing a sound approach and slipping in the arithmetic. A marks column may need to distinguish their results. A teacher needs to distinguish their needs, and the same correction will not help both. The first student needs to be asked why; the second needs only to check a sum. Nothing in the fair copy reveals which is which. The rough copy does, because it preserves the route, including the turn that did not work. It can show whether a question was misunderstood, a concept remained unsettled, or an answer was revised for a reason the student could explain. The crossed-out line is not automatically evidence of confusion. Sometimes it is the clearest evidence that thinking occurred.
Punjabi schooling had an older instrument that took the opposite view of permanence. The ਫੱਟੀ, phaṭṭī, is a wooden writing board on which children practised letters with a reed pen and ink, and which was coated with a wash of clay so that the day’s writing could be covered and the board used again. It is still used in some places to teach Punjabi handwriting. I do not know whether it had any place at Spring Dale, and I make no claim that it did. I mention it because its whole pedagogy assumes something the fair copy forgets: that most of a child’s writing is practice, that the hand and the mind are being trained rather than a record kept, and that the surface should welcome another attempt tomorrow. A board made to be recoated cannot shame anyone for a mistake. It simply waits for the next line.
None of this makes a finished answer unimportant. Learning requires the ability to complete something as well as to explore it, and I have already conceded the fair copy’s courtesy to its reader. But completion should not erase the process so thoroughly that the learner comes to regard uncertainty as a defect to conceal. A school can require care in the fair copy while allowing honesty in the rough one. A child needs both permissions: to make work intelligible to someone else, and to leave enough of the attempt visible that someone else can actually help.
I notice, again, the urge to add that this is how a clinician ought to think, with his reasoning visible and his crossed-out possibilities preserved. It may be true. I will leave it unsaid. The rough copy needs no clinical sequel to be worth defending.
Conduct #
Conduct was the column that rewarded stillness, neatness and quiet. These are virtues of a kind, and convenient ones for anyone responsible for a full classroom. They are also easily confused with others. Quietness, cooperation, confidence and understanding are four different things, and a single word in a single column must stand for all of them. A quiet child may be absorbed or lost; a confident one may be right or merely fluent; a cooperative one may have understood everything or nothing and decided that compliance was the safer course. Speaking readily and understanding deeply are different accomplishments, and quietness is proof of neither confusion nor insight.
Punjabi has a phrase for the student who has mastered the performance without the substance. He learns ਤੋਤੇ ਵਾਂਗ, tote vāṅg, like a parrot. The idiom faults the parrot for reciting. Tagore’s parable faulted the education for making the parrot stop singing. Between them they name the two characteristic failures of schooling: to suppress what a child already has because it cannot be recited, and to accept recitation as proof that something has been learned. Bitzer, of course, would have received excellent marks for conduct. Montaigne, in the same essay on education, put the distinction in a short sentence that every examiner might keep above his desk: savoir par cœur n’est pas savoir, to know by heart is not to know. What is held by heart, he goes on, is only what one has given one’s memory to keep, and a person can hold a great deal in trust without owning any of it.
A teacher has to see past the performance in both directions: past the composure of the child who has learned how to look attentive, and past the restlessness of the one whose mind is moving faster than the lesson. A student has to discover, more slowly, that his own performance is not the whole of him. Some of us go on submitting fair copies well into middle age, and go on believing that a composed surface is the same thing as a settled mind.
Remarks #
The narrowest space on the page was the most human one. Nearly everything else was a number. Here, someone who had watched a child for a year wrote a sentence by hand.
Education research has something to say about what such sentences can do, and it is more interesting than either the defenders or the critics of grading usually allow. In a 1987 study, the Israeli psychologist Ruth Butler gave two hundred fifth- and sixth-grade pupils a series of thinking tasks and, after each session, returned either written comments, numerical grades, standard praise, or nothing. The pupils who received comments showed the most interest and the best performance by the end, and were most likely to put their results down to effort and to the task itself. Those who received grades or praise were more likely to explain their results in terms of how they compared with others. In a later study, Butler added a condition in which pupils received grades and comments together, and the advantage of the comments largely disappeared, as though the number drew all the attention and the words beside it went unread.
That later finding is widely repeated as a slogan against grades, and the assessment scholar Thomas Guskey has pointed out, in a 2019 essay in Education Week, how much the slogan leaves out. The grades in Butler’s study were deliberately comparative, assigned by a pupil’s standing in the class and spread to fit a normal curve. The benefit of comments-only feedback appeared chiefly among the lowest-achieving pupils; the highest achievers stayed interested whatever they received. The study did not test grades that described mastery of a task, or comments that ranked a child against others. What mattered, Guskey argues, is less the form of the feedback than its substance: whether it tells a pupil where he stands relative to others, or what he can do next.
There is a further difference between Butler’s comments and a report card’s remark, and it concerns the addressee. Butler’s comments were written to the pupil, about a task the pupil had just done, in time for the next one. A report card’s remark is written at the end of a term, after the work is over, and it is addressed, in practice, to the parents. It is a letter between adults about a child, carried home by the child, who is its subject but not its recipient. That arrangement has its reasons: parents need to know, and a school must answer to them. But it means that the one sentence in the document written in words rather than numbers is usually not written to the person who might have used it. A remark to a parent tends toward verdict. A remark to a child would have to tend toward advice, because there would be no point in writing it otherwise.
That distinction is exactly the one the remarks line was positioned to make, and too narrow to make well. A remark could be task-shaped: specific about what was attempted, what was achieved, what to try next. Or it could be a number wearing words: Good. Can do better. The pressure of a full class and a small box pushes toward the second. It is not a failure of teachers that so many remarks came out generic. It is a failure of the space to admit what a year of attention actually contains.
Gratitude is most honest when it is precise, which makes a public page an awkward place for it. The people who taught at Spring Dale in those years have their own lives and did not ask to appear in mine, so I will not name anyone or attribute to anyone a lesson I cannot document. What I can say with confidence is general. Much of what a teacher gives turns out to be a manner rather than a fact: the permission to ask again, the example of an adult taking an ordinary question seriously. Gifts of that kind are usually noticed late, long after the lesson in which they were given has been forgotten, and they would never have fitted in the box.
Bulleh Shah, the Sufi poet of Kasur who died in 1757, has a kafi whose refrain every Punjabi schoolchild ought to meet at least once: Ilmoṅ bas karīṅ o yār, ikko alif tere darkār. In my rendering: enough of learning, friend; one alif is all you need. Alif is the first letter of the Perso-Arabic alphabet, and in Sufi poetry it stands for the One, the single stroke from which everything else follows. The kafi is not against reading. It is against learning that piles up books and titles and confuses the pile with what the books were for. I do not want to flatten a mystical poem into a lesson about report cards, and its alif points well beyond any classroom. But I find in it a shape for what the remarks line could have been: a single stroke, set beneath all the columns, where the one thing that mattered about a year might have been written.
Not Finished #
If I were allowed to fill in that last space myself, for the boy at Spring Dale, from this distance, I would write nothing about medicine. I would not mention the profession he entered, the countries he lived in, or the marks that made any of it possible. Those belong to other documents. The remark should be about the child who was there, in the year that was being reported, and it should say what the columns could not.
A report card is, after all, a photograph of a moving subject. It records a child as he appeared on one date, to a few observers, under particular conditions, and it is filed as though the subject had stopped moving when the shutter closed. Every child described on such a card could have become a number of different adults, and most of those possibilities were not visible in the columns, because they had not yet been chosen or foreclosed. Reading an old report in the light of how its subject turned out flattens the photograph into a portrait of the adult. It is the same backward reading I distrust in biographies, performed on a smaller document. The honest way to read a school report is as a record of a child who did not yet know any of what we know about him.
My remark would begin by granting him the present tense, which is the one thing a backward reading takes away. It would refuse to treat his interests as a preview of a career, because a child’s interests are not previews. It would decline to predict, because a child is not a forecast. And it would end where every honest school report should end, with a word that the form never quite permits: unfinished, not as a criticism but as a description of what childhood is.
Already a whole person, with a world sufficient to occupy him. Has not yet decided what he will become, and does not need to. Promising. Not finished.
Evidence and Editorial Note #
Documented findings. The essay relies on the author’s public biography: attendance at Spring Dale School in Amritsar, and Punjabi as his first language alongside Hindi, Urdu and English. Tagore’s The Parrot’s Training (Tota Kahini, Bengali, 1918; English in the Modern Review, 1918) and the quoted sentences: the English text as archived by the Internet Archive, and the Lehigh University digital archive Literature of Colonial South Asia for dates. Tagore’s founding of the Santiniketan school in 1901: standard biographical knowledge. Macaulay’s Minute of 2 February 1835 and the quoted phrases: text as quoted in Scroll.in’s history of the Anglicist–Orientalist debate; Macaulay’s statement that he had no knowledge of Sanskrit or Arabic: the Minute’s text, as widely reproduced. Macaulay’s later support for open competition in the Indian Civil Service: The Historical Journal (Cambridge), “The abolition of patronage in the Indian Civil Service and the closure of Haileybury College.” Dickens, Hard Times (1854), Book I, Chapters 1–2, including the quoted lines and Bitzer’s definition: Standard Ebooks text. Montaigne, “Of the education of children” (Essays, Book I): the phrases are given in the original French, with the author’s renderings. The use of roll numbers rather than names on Indian board-examination answer books is described from general knowledge of those examinations. Campbell’s law and Campbell’s remarks on achievement tests: Donald T. Campbell, “Assessing the impact of planned social change,” as summarised in standard reference sources. Butler (1987), Journal of Educational Psychology 79(4): 474–482: Hebrew University research record of the paper. Butler’s 1988 study and Guskey’s caveats: Thomas Guskey, “Grades versus comments: what does the research really tell us?”, Education Week, June 2019. The phaṭṭī as a Punjabi wooden writing board still used to teach handwriting: SBS Punjabi report on community Punjabi classes in Albury-Wodonga; clay-coated wooden slates written with reed pens: The Pen (Pakistan) on takhti writing. Bulleh Shah’s refrain is given in transliteration with the author’s own rendering. The use of roll numbers, “rough copy” and “fair copy,” the Punjabi ਕਾਪੀ (kāpī) and the idiom ਤੋਤੇ ਵਾਂਗ (tote vāṅg) are offered as general knowledge of schooling and speech in Punjab, not as descriptions of Spring Dale’s practices. Vendor representations. None.
Recollection and tradition. That the author attended Spring Dale School is part of his published biography. No teacher, classmate, subject, mark, report, school event, notebook or classroom is described or named; the categories of classmates are general types, not people. The two students in the section on rough and fair copies are explicitly hypothetical. Whether the phaṭṭī was used at Spring Dale is not asserted. The closing remark is written by the author in the present, not quoted from any school document.
Analysis and forecast. The reading of the report card’s columns as an argument, the readings of Tagore, Macaulay, Dickens and Bulleh Shah, the distinction between an examination as instrument and as verdict, and the claim that school years deserve value apart from a later career are the author’s interpretation as of November 6, 2026. Independence. This essay is not sponsored by any institution, company, health system or technology developer.
About the Author #
Kanwar Partap Singh Gill, MD, traces his family roots to Khadur Sahib in Punjab’s Majha region and grew up in Amritsar. He attended Spring Dale School and completed pre-medical studies at Khalsa College in 1994–1996. He earned his MBBS from Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar in 2002.
He completed PGY-1 at the University of Arkansas for Medical Sciences in Little Rock in 2007–2008, and PGY-2 and PGY-3 with UCSF Fresno at Community Regional Medical Center from 2008 through 2010. He has practiced medicine in California since 2010.
His career has crossed four distinct information eras: predominantly paper-based medicine, early and fragmented electronic records, the integrated-EHR era, and the emerging age of generative and agentic artificial intelligence.