Today’s medical students and residents are from the first generation of digital natives: those who grew up with cell phones, text messaging, and the Internet. They are comfortable with e-innovation,1 are increasingly disengaged from traditional teaching methods within medical schools and residency programs, and are quick to embrace new teaching technologies. Students instead stream lectures from home, use electronic devices to access medical journals online, and use “smart” phone applications during rounds. Adapting teaching methods within medical schools and residencies to connect with this generation of e-learners is challenging. Text messaging (short message service) offers a method of bridging the gap between traditional teaching styles and the educational styles of millennial learners because of its ease, familiarity, and asynchronous nature. Among adults aged 18 to 29 years, 94% own a cell phone, and of those, 97% send and receive text messages.2 Some residency programs even provide trainees with smart phones.3 The prevalence, acceptance, and low cost of text messaging make it particularly inviting as a potentially high-yield learning tool in medical education. Texting has already become a well-accepted way to communicate with and engage students in high school and undergraduate settings, with a variety of platforms available for teachers.4–6 Teachers may use text messages to remind students about assignments, to deliver rapid-fire surveys or quizzes during class, or to conduct course-wide discussions (either within or outside the standard classroom period).7 Texting platforms are unique in that they allow participants to ask questions or discuss topics via the comfort of anonymity, which may promote participation and enhance learning.8 This form of feedback direct from one’s mobile phone is popular. Texting that occurs directly between learner and teacher, although it may not afford anonymity to the student from the teacher, … Address correspondence to Matthew A. Broom, MD, Department of Pediatrics, Saint Louis University School of Medicine at SSM Cardinal Glennon Children’s Medical Center, 1465 S Grand Blvd, St Louis, MO 63104. E-mail: broomma{at}slu.edu