01 · The app · 25 min
Obsidian
Install it, point it at one teaching vault, and turn on four switches. Theme shopping is how the weekend disappears.
What you are setting up
Obsidian is a folder of markdown files with a fast editor on top. That is the feature. The graph view is not the system. A colleague should be able to open one note in ten seconds and find the decision.
Use it for teaching notes, talk outlines, video scripts, and prompts. Do not use the first vault as a second electronic record. If a note would embarrass you on a projector, it does not belong in the vault you will sync or show to a model.
Install and make the first vault
- 01 Download Obsidian from the official site
obsidian.md. Install the desktop app on the computer where you actually write. Add the phone later, only for the teaching vault.
- 02 Create a new vault, not “Open folder from somewhere cloudy”
Name it something dull like Teaching. Put it in a directory you chose, on this machine. Not the hospital shared drive.
- 03 Refuse the tour that wants you to start theming
Close the graph. You will make folders in the next chapter. Today the win is one vault that opens.
Settings that change the work
Leave everything else alone. These are the ones that prevent a mess.
- Files and links → Default location for new notes: in the folder 00 Inbox. Captures land in one place instead of beside a random file.
- Automatically update internal links: on. Renaming a note should not break the desk.
- New link format: shortest path when possible. Wikilinks: on.
- Attachment folder path: assets. Images stop scattering.
- Deleted files: move to system trash. You will mis-click.
- Editor → Readable line length: on. Live Preview. Strict line breaks: off. Fold heading: on.
- Appearance: keep the default, or any light theme you can read at 10pm. The test is whether you write, not whether it looks like a product.
Plugins: the short list
Core plugins are enough for the first month. Turn these on: Templates (folder: Templates), File recovery (snapshot about every 5 minutes), Outline, Backlinks, Page preview, Slash commands, Command palette, Canvas, Word count.
Turn Daily notes off unless you will truly use them. A neglected daily note becomes a guilt streak. An inbox folder does the same job without pretending you journal.
- Community plugins on day one: none.
- After a month, Excalidraw is worth it if you sketch a field or a flap.
- Dataview is worth it when you have a real question, like “every draft video note for this procedure.” Not before.
- An AI plugin inside the vault is optional. Many surgeons are better off keeping the model outside the notes and pasting only text that is already clean. A plugin that can read the whole vault will read whatever you forgot to strip.
- A web clipper is for papers. Never the record.
A habit that survives call
- Between cases, capture a sentence into 00 Inbox. Dictate if typing is the reason you won't do it.
- Once or twice a week, turn those sentences into a real note or delete them.
- When a case taught you something, write the decision the same day, from memory, chart closed.
- When a talk or a clip is finished, link it to the technique note and stop reorganizing.
Phone app: yes, for the teaching vault inbox. No, for photographing a whiteboard that still has a name on it. The graph is still not the point on a small screen.
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Questions in this chapter
Do I need Obsidian, or are my current notes enough?
Short answer
You need a place that stays plain text and never holds an identifier you might show a model. Obsidian is the assumption here. If you already have that, don't migrate for the aesthetic.
- If notes are trapped in someone else's database and you want to point an agent at files later, Obsidian is worth the afternoon.
- If your group is fluent in another tool and the notes are clean, keep it and steal the folder habits.
- Don't run both as permanent homes. Pick the teaching vault and stick to it.
Where should the vault live on my computer?
Short answer
On the machine where you write, in a folder you chose, not on a hospital shared drive and not inside a cloud folder until you have decided the vault is clean.
- Create the teaching vault locally first.
- Sync only after a week of notes you would project.
- Obsidian Sync is the least surprising sync. iCloud and Dropbox work until they don't, and they are still someone else's cloud.
- A second, unsynced vault stays on the hospital machine for anything not yet rewritten.
Which plugins should I install on day one?
Short answer
No community plugins. Turn on Templates, File recovery, Outline, Backlinks, and Canvas. Learn the quick switcher.
- Set the template folder to Templates.
- Leave Daily notes off unless you will really use them.
- Add Excalidraw later if you sketch. Add Dataview only when you have a question it can answer.
- An in-vault AI plugin can read notes you forgot to clean. Prefer a model outside the vault at the start.
How do I stop making a new Untitled note every day?
Short answer
Send every new note to 00 Inbox, and name it the way you would say it before you close the laptop.
- Settings → Files and links → new notes go to 00 Inbox.
- If you can't name it, it isn't a note yet. It is a line in an inbox capture.
- Twice a week, file or delete. An inbox that never empties is a second graveyard.
Can I use Obsidian on my phone between cases?
Short answer
Yes, for a sentence in the teaching-vault inbox. No, for photos of boards, badges, or screens.
- Sync only the teaching vault to the phone.
- Dictate a single sentence. Clean it later on a real screen.
- The graph on a phone is still not the system.