Lessons learned in the pursuit of a dream.

Context The author describes a career in which he combined clinical surgery with the formal study of medical education. In the 1980s, when the author embarked on this career track, it was an uncommon pathway. Over the last 30 years there has been an exponential increase in the number of individuals who have made medical education their principal academic focus. This paper provides examples from the author's personal story and lessons derived from that experience. Process The author outlines his experience of attaining formal training in education and concludes that this training was a foundational element in his pursuit of a career in health education research. The author describes his involvement in the transition from paper and pencil-based tests to performance-based testing in high-stakes examinations. He describes the development of a research centre in health professions education and the establishment of a simulation centre. The author's experiences in the development of an examination intended to measure technical skills, in the adoption of surgical safety checklists and in the elaboration of a programme in competency-based education are discussed. Discussion The author describes several of the lessons learned in the course of his career in medical education. He argues that successful enterprises in scholarship in medicine are almost invariably the product of interdisciplinarity. He describes the power of a joint venture between a university and an academic hospital. He argues that the geographical footprint of an emerging centre is critical. He discusses the importance of graduate studentship in an emerging discipline and enterprise. [ABSTRACT FROM AUTHOR]