New medical graduates and pre-clinical doctors face a dilemma when confronted with in-flight medical emergencies. Intervening could raise ethical, legal, and practical concerns, while staying quiet may violate the moral obligation to provide care. This reflective essay discusses the challenges, including lack of standard protocols, racism, and sexism experienced by doctors in-flight. It also highlights the importance of reciprocity and proposes solutions like standardising medical kits. In conclusion, pre-clinical doctors can play a crucial role in in-flight emergencies, and should respond confidently to an emergency call. A nuanced discussion is necessary to determine their role.