ln the second half of the eighteenth century, mcdical doctors faced heavy competition. They competed for patients and for institutional positions and sought a variety of means to enhance their reputations. Among rank-and­file physicians, some strove to respond to the high expectations and rationalistic discourse fueled by Enlightenment philosophy. They aimed to build a new medi­cine on rational and empirical principals. Concentrating on the rich correspon­dence left by young physicians born in Geneva, thîs article maps out the social and moral dilemrnas encountered by ambitious young physicians in the second half of the eighteenth century, who, like many thousands of others, flocked to Edinburgh, "the first medical school" in Europe. Conscious that they forrned but one group among a scries of possible practitioners, they pondered over cultural codes, chilitics and economic realities as they strove to promote the figure of a knowledgeable, experienced, gentlemanlike physician.