This book was written to help every senior medical student, every intern, every resident, and every fellow across the country learn how to navigate the treacherous waters of residency training. It will help bridge the communication gap between residents and faculty. It will help mentally prime medical students for their next stage of medical training. In preparing to write this book, I interviewed over 100 Program Directors across the country in seven specialties, including Family Medicine, Internal Medicine, Obstetrics and Gynecology, Surgery, and Orthopedic Surgery. I asked them a standard set of questions in the hopes of collecting, organizing, and sharing that wisdom to current and would-be residents. I asked them about the obstacles they overcame, the setbacks they endured, the lessons they learned, and the lessons they taught. The singular goal was to create a compendium to guide current and future residents during their final stage of training. The chapters that follow are a compilation of wisdom from over 500 combined years of medical training experience. My focus was not only on the residents who struggled the most but also on the residents who were striving. Just as much wisdom could be gleaned from the strongest residents. Every program had them, and every faculty knew who they were. These were the residents who were so far ahead of their peers that they needed very little, if any, supervision. These were the residents who were so self-sufficient that they allowed us to spend the extra time with those who needed it. These were the residents who were routinely selected or elected for Chief Resident positions. These were the residents who allowed us to sleep better at night, knowing that patient care was in good hands. These were the residents to whom we would trust the care of our family members. Every June, faculty across the country would swell with pride as these strong residents accepted their training certificates on Graduation Day. As I reflected on those who have graduated from my program, I found myself feeling the same sense of pride for the residents who completed remediation. Despite the sleepless nights thinking about the struggling resident, there is always a unique sense of satisfaction from helping a resident who adrift found his way. There are very few things more rewarding than watching a resident who appears to be on the brink of failure dig herself out of a hole and successfully graduate from residency. There is something special about the lost sheep who is returned to the flock. During my interview with a surgery Program Director, he stated, "Perhaps the question we should be asking is ''Why was the sheep lost in the first place?''" I emphatically agreed with him, and I found myself even more determined to write this book. After all, as an intern, I was one of those lost sheep. Residency training is a privilege and an honor. For every medical student who enters residency, there are many more who apply and are not accepted. Residency is not a roadblock in your journey; it is the journey. We must never forget why we entered medicine in the first place. This book should be used by senior medical students to help them mentally prepare for the extraordinary challenge ahead. This book should also be used as a guide for all residents - not just those who are struggling, but those who want to excel in residency and beyond. Finally, this book should be a compass for all Program Directors and faculty, to help them recognize early warning signs in the residents who are veering off path or have lost their way. After collecting notes from some of the most intelligent and wisest physicians in the country, I feel confident in saying that no matter who you are, where you are from, or how successful you have been, you can benefit from the combined wisdom of those who have succeeded before you. After all, the lives of your patients depend on it.