What if the biggest threat to your success in medical training has nothing to do with how much you study? Vance Lehman, professor of neuroradiology and chief of neuroradiology education at the Mayo Clinic, spent over two years researching why capable trainees stumble despite strong clinical knowledge. In this episode, based on his KevinMD article "The hidden curriculum: What medical school does not teach you," he explains how unspoken expectations, invisible social dynamics, and stealth influences shape evaluations and career trajectories far more than most trainees realize. You will learn why making a strong first impression on a new rotation triggers a powerful psychological feedback loop, how generational biases from attendings quietly distort trainee evaluations, and why years of excelling at test scores can actually leave you blind to the skills that matter most in clinical settings. Lehman also shares practical steps any medical student or resident can take tomorrow to stop leaving their reputation to chance. If you are in medical training or teach those who are, this episode reveals the forces you feel every day but have never had a name for.

Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation.

For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol.

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