This special issue consists entirely of clinical cases for exploring the challenges to professionalism that confront internal medicine residents and fellows in internal medicine sub-specialty programs. The cases cover areas that pose challenges common to residents and fellows. In each case, the reader is presented with several alternative courses. Selecting an option will link the reader to an explanation of whether that option is preferred, acceptable, or to be avoided. These determinations are grounded in the AMA Code of Medical Ethics, a starting point for physician understanding of appropriate professional conduct.