On May 30, as the graduates sat in Providence's First Unitarian Church waiting to recite the Physician's Oath and receive their diplomas, Dean Edward J. Wing rattled off some of the ways their future has changed.

Because tomorrow's doctors will be employed by larger health-care systems, he said, they won't have to spend so much of their time on the business of medicine. This should free them to focus more on doctoring. They'll work in teams, and their decision-making will be informed by access to electronic medical records as well as by advances in genetics, pharmacology, and other research fields.

On the other hand, Wing said, "You'll make less money." And have less autonomy: "Electronic records will keep track of your patients," he observed, and will hold doctors more accountable for their mistakes.

But, he said, "You and your patients will have more time together," which is a privilege: "You will be the recipients of all your patients' emotions."

Graduation speaker T.R. Reid, best known for his lighthearted reports on National Public Radio, struck a less sentimental note when he stepped up to the pulpit. "You're about to face a tremendous drop in stature," he said, warning students that, the moment they walk into the hospital as residents, "You will be the newest, greenest, lowliest, most poorly paid, and frankly the most ignorant doctor in the place.

"You'll be freshmen again."