When you start out in any branch of medicine there are so many unknown unknowns that it makes sense to follow the well trodden path of those that have gone before you. It makes sense to use checklists and flowcharts to make sure you are not missing something. It makes sense to look at resources like DFTB. But then what? Not all patients fit into neat little boxes, presenting with classical signs and symptoms. Then what do you do? Paediatrician, Robyn Brady, explores how we can learn to think beyond the algorithm.