This book looks at medical professionalisation from a new perspective, one of failure rather than success. It questions the existing picture of broad and rising medical prosperity across the nineteenth century to consider the men who did not keep up with professionalising trends. It unpicks the life stories of men who could not make ends meet or who could not sustain a professional persona of disinterested expertise, either because they could not overcome public accusations of misconduct or because they struggled privately with stress. In doing so it uncovers the trials of the medical marketplace and the pressures of medical masculinity. All professionalising groups risked falling short of rising expectations, but for doctors these expectations were inflected in some occupationally specific ways.