The State of Medicine

There is a particular kind of exhaustion familiar to anyone reading this in scrubs. It does not come from overwork alone. It comes from doing a job while quietly suspecting that the system preparing you for it has stopped caring whether you are actually prepared. CURACO X exists because that suspicion is now demonstrable, and because the language used to describe it, burnout, resilience, wellbeing, has done more to obscure the problem than to address it.

This issue is not about technology. It is about the profession itself. About the covenant Osler articulated and the policies that quietly unwrote it. About the difference between fatigue and betrayal. About joy as a measurable systems variable, not a personality trait. About the institutional pathologies that produce imposter wounds, moral injury, and a generation of doctors who feel less prepared than the one before them.

The sixteen articles gathered here apply the same CURACO framework you may know from our AI edition, Clinical Safety, Understanding, Research-Informed, Authentic First Principles, Conscientious Ethics, Optimised Technology, to the human side of clinical work. The argument is not that the system is irreparable. The argument is the opposite: the evidence, the models, and the frameworks to rebuild it already exist. What is missing is the willingness to use them.

If you are a resident doctor among the 74% considering leaving, a consultant who has watched bedside teaching evaporate, a nurse or PA navigating a scope no one has formally defined, or simply a clinician who reads, this is for you. We assume you are intelligent, time-poor, and tired of being patronised. We will write accordingly.

Dr Ismail Sooltan & Dr Sudantha Bulugahapitiya
Editors-in-Chief, CURACO X, Issue 01