These amazingly creative cupcakes were made by the aunt of a young tonsillectomy patient for the surgical ward and theatre team. It meant a great deal to the staff. Dr Ruj Roplekar, who was one of the recipients, said, ‘I was delighted that someone had shown that degree of appreciation for all those involved in the care of someone she loved.’ When Ruj posted this image on Facebook, it was interesting to see that one of her fellow medics urged her to save the photo as evidence for the ARCP of the ISCP (that’s Annual Review of Competence Progression for the Intercollegiate Surgical Curricular Programme). Indeed, thank you cards and other ‘evidence’ of patients’ appreciation are considered when competency is being reviewed. All the more reason to say ‘thank you’ creatively when good care has been received.