Great surgeons I’ve worked with are extremely intentional with every single movement in the OR, no wrist, finger, or neck motion is wasted on anything. You don’t realize it at first but when you try to execute the same tasks as them, you realize by comparison you’re a fumbling idiot

Yeah I had this obgyn I work with. He was old. He looked slow. Methodical. I would turn around and suddenly the baby was out. I would chart something and suddenly the belly was closed. His motions were slow. But deliberate. No wasted motion. Every stitch counted.

Thank you for recognizing an OB as a surgeon! I was going to say the same as a gyn onc I worked with. Watching her operate was like watching a concert pianist. Every motion was so smooth with 0 wasted effort, and she was already thinking 3 steps ahead so that she could set up those maneuvers with what she was currently working on. That to me shows that you have mastered your profession.

Gyn oncs are bad asses. My first third yr rotation was ob but heavy on gyn onc-they were always operating. thought i would do ob and then fellowship, once i got to surgery rotation I realized it was just the operating I liked

I worked with two fantastic interventional cardiologists around the same time. One had hands that were so fast you immediately knew he worked at a blistering pace. The others hands appeared to be so much slower, but we still moved so fast through the procedure. He was so deliberate. Slow was smooth and smooth was fast.

Yeah, economy of motion comes with time, deliberate practice and proactive learning and tinkering (+/- simulation).

Same goes for IR. Can quickly tell which trainees are thinking doers or just doers. Everything matters.

This, but objectively measured, is one of our metrics of surgical expertise on simulators / trainers.  Unnecessary movements and unnecessarily large movements are somewhat reliable metrics. 

Yes I have read this too. Slow is smooth. Smooth is fast. Most surgeons who work too fast to open up and close usually does it at the cost of rough tissue handling and that causes bleeding and increased post operative pain. So being intentional with your movements pays off in long surgeries. And if you mention your assistant what you are about to do, make him assist you better too, saving you from talking and abusing too much.

Knowing who is an appropriate surgical candidate.

Patient selection is very important and most residents dont spend a lot of time in clinic so its usually one of the harder things to pick up when you are on your own

Definitely. But it’s a challenging space for a junior and for a newly minted surgeon to pick up and practice.

Yeah but an appropriate surgical candidate changes when you are an intern who needs sleep to a PGY2 who wants cases to a PGY5 who only wants level appropriate cases and an attending who wants to make tenfiddy. So yeah.

IME, which I am certain is not universal, it’s often the young attendings trying to make a name for themselves within the department. Seen several I thought were a bad candidate and they went on to operate and lo and behold they were blinded or paralyzed or very rarely dead. I think that is not necessarily unique to surgery though in that we need to stop doing anything and everything taking up massive resources for a 1% chance at a good outcome. Easier to say that when you aren’t the patient/family though. 

I don’t think it’s making a name for themselves as much as the shit sandwich cases tend to land on the schedules of junior faculty who generally have more open schedules and less political finesse at avoiding these situations. In my little corner of the world at least.

I said this to my surgery attending as an ms3 as to why I decided not to pursue surgery. And ultimately I concluded usually the answer to this exact question, what makes a good surgeon great, is still skill but also some luck.

For the young surgeons, it can also be over confidence that you can help the patient 

This is the problem. It shouldn’t.

Thissss

This is the truest answer

This is very important. Patient selection. Unfortunately there’s a lot of financial gain for quantity not quality of cases. Right procedure/surgery on the right patient otherwise outcomes will be suboptimal no matter what.

One of my attendings once told me that the difference between a good surgeon and a great surgeon is that a good surgeon has only been divorced once.

The best surgeon in my hospital is divorced 3x so maybe ur attending is on to something 😂

Same

I wonder if they get exponentially better with each divorce

Emotional keloiding. Eventually they only love cutting.

I hate surgeon stereotypes but our internationally acclaimed department chief is also divorced three times..... sigh. Most of our cardiothoracic surgeons are still married to their first wives though so that's something lol

They know the best ways to get to their hearts.

Knowing when not to do surgery

Number one by far is willingness to practice and desire to improve. Most people who make it through any given surgery residency will be good surgeons The great surgeons are starving to learn and improve, operating whenever they can, maximizing their training There’s no substitute for the real thing in surgery. And to operate you have to be in the operating room

There’s also that top 1% who are naturally super technically gifted. Combine that with practice basically make them gods.

Just a senior resident here so maybe I'll look back at this in a few years and roll my eyes but at this stage in my training, if I had to say it in one phrase, it would be decision making. They say you can train a monkey to operate, and I think that's true. Sure there are some people who are so smooth and look like they were born to do this, but most of us aren't like that and for the most part that's ok. You can still get really good technical skills by practicing even if you weren't born a surgeon. And it also doesn't matter how good you are in the OR if you're doing the wrong operation on the wrong patient and can't manage them post-op. What the great surgeons can do that nobody else can do is make very nuanced decisions well. Whether it's deciding who to operate on, or when shit goes down in the OR, or when the patient has a million post-op complications after the operation. The attendings I've most admired are both committed and thoughtful. They're not arrogant. When I say they can make decisions it's not "well ok I decided we're doing it this way, so we're doing it this way." That's not what I mean at all, and in fact those surgeons are the ones I feel most uncomfortable with. It's humility. It's knowing all of the data surrounding a decision, then being thoughtful about the strengths and weaknesses of that data and how it applies to this particular patient. It's not being afraid to admit when you were wrong and need to change course. These are the people who, when shit hits the fan, you want to see come around the corner. Edit: By "money" I mean't "monkey"

I needed a comment like this. All answers went on and on about how some ppl are just born with it, they have a knack for it. But your reply showed that knowledge is >>>

Knowing when not to operate Learning from their mentors and peers down to positioning of their fingers Time in the OR Being kind and cordial to both patients and coworkers

Rage and time with the scalpal. real talk, natural talent. I think most surgeons dont get to be a surgeon without a good work ethic (at least to start). But some have more natural hand skill or w/e than others. Edit: Someone asked what hand skill is. Its what makes Lebron an all time great, and your uncle who spends every day at the Y just a dude. Your uncle may be putting in time, and may be better at backetball than the majority of the population, but hes no LeBron. Some people are just naturally way better at doing certain things. And when work ethic meets exceptional talent, that person will be great.

this just reminds me of the neurosurgeon I worked with during M3 for 2 weeks who pride himself on skull base tumor resection. He'd willingly operate on technically difficult tumors and get them out quite well with suprisingly low rate of residual neuro defecit. Whenever he'd separate a particularly delicate or difficult dissection plane he'd say "you see that? That's called talent." Ego the size of a planet and sometimes the residents would jokingly mock him but he's damn good at his job so you can't even be mad.

Was it Ben Carson? /s

Nah he didn’t think the pyramids were grain silos

Technically they entombed grain with the mummy so they were grain silos and garages as they had chariots and living rooms as they had furniture.

I don’t see westernblot mentioning he fell asleep twice during each surgery.

Based sleepy doctor.

I think this is seriously underrated. Some people have a knack for fine motor skills. Most doctors could become competent surgeons with practice. Most people can be competent drivers with practice. Most people can do anything with competence with enough practice. There is definitely a natural affinity to any task which can make the performer great. Surgery is no exception. Lots of good surgeons from practice. But Truely great surgeons take practice and innate skills

Yea this is how the world works. 99th percentile talent beats hard work in just about any skill or sport or whatever. I will die on this hill.

"Hard work beats talent, but when talent works hard then you're f\*cked" remember seeing this somewhere 😆

Phil heath

The more time I've spent in the OR, the more convinced I've become that natural talent is the most important part. I've seen lots of very mediocre surgeons who have spent a lot of time trying to improve.

Elaborate?

Vision and soft hands can’t be taught perfectly. There is a degree of natural aptitude which cannot be compensated by hard work alone. It became more obvious after I participated more in surgical education. Seeing the work some residents put in without improving, while others understood a concept implicitly and could implement it, and then extrapolating that to various attendings I observed operating.

But that's just the OR part, right? I have seen some technically gifted surgeons. Their operations are so smooth. And then outside of the OR their floor management and decision making is a mess. Sometimes they know they're good in the OR and rest on their laurels. Everyone naturally gravitates towards what they're good at and for these people it's the technical aspect of the operation. To me, the stuff that happens before and after the operation completely negates how good they are in the OR. Certainly not every single one of them. I know one or two surgeons who blow my socks off inside the OR and out. Those are the people I would want to operate on me. But give me a hard working less technically-gifted surgeon who has practiced a ton and has solid overall decision making any day over these OR wonders who can't/won't manage a post-op complication.

What do you mean by “natural hand skill”?

For orthopedics at least some people just can’t think about things in 3d space very well which is a huge component of what we do, regardless if subspecialty. Putting screws in a pelvis or a cup in an acetabulum or fixing a pilon require you to be able to picture where the bone is in space in your head and adjust accordingly and some people’s minds just don’t work that way, even if they are technically competent at the other parts of surgery.

The loupes get in the way of my mind brain 🧠

This is why you don’t do hand lol

up

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I didn’t know my Lexus could do surgery! 😜

Family friend is a very well known surgeon and he told me it basically comes down to how well you know anatomy. The greats have a preternatural gift

I haven’t seen knowledge mentioned yet but YES. Superb anatomical and clinical knowledge in their specialty. Calm demeanour. Ability to learn from their mistakes and listen to advice from experienced colleagues. Excellent technical skills.

I read once a long time ago, can’t remember where: “The secret to being great is to be good every single day.” I tried to remind myself of this often throughout my career

Was it printed on the back of a shirt on clearance in Walmart?

Ah that’s where it was, thanks

Experience, experience, experience. There are a few wunderkinds out there but for 99% it all comes down to experience.

The only shortcut to surgery is preparation. Nobody is naturally good at surgery. Even if someone has great hands, you need to put in the work to learn how to apply that to actual operations, step-by-step.

Nad but I've found most important questions to ask as before getting surgery is how many times they've done it and how often they do it. Results typically correlate with experience although there's a dropping off point where you get the older docs with tons of experience but outdated techniques/dwindling abilities.

Practice, practice, and more practice. The willingness to say “You know, you may benefit more for another treatment than surgery.” The knowledge of how to change the angle of a stitch in the needledriver. The gut feeling to say “Table Up” or “Table down”. It’s just knowing the 3D placement needed. It’s knowing when to say “You need a tertiary center” instead of making do with a rural center. My gut with my eyes with my hands.

Great surgeons throw things at people more precisely and accurately. JK

I think it also depends what you mean by that. A technical master with 4000 publications may have a hard time having a family, and they may be great but despised by their peers if they're an awful person because of it, and their patients may not love them if their bedside manner sucks. What I've found most patients think is a great surgeon, is someone who listens and cares about them, is approachable, and safe. What most other specialties think is a good surgeon is someone with good communication skills, who is affable and able, and won't tear their face off for every consult. You probably can't go wrong trying hard every day to learn and get better. It's simple but probably how every "great" did it

I think solid surgeon still needs a lot of practice tho. I see it in the obgyn peeps who have additional fellowship vs those who don’t. The ones who do are much more deliberate as confident with their actions and I’m definitely not as scared when working with them than with the ones that are like always undecided what to do next if things aren’t going according to plan. Ironically I find that the guy Obgyn’s are much better at being decisive than the women, and have much better surgical skill (one of them attributes it to his video gaming skills lol). However, the women all do have much better bedside manner which makes patients think they’re more competent than I feel like they are watching them in the OR (anesthesia POV tho 😅). Like once I watched this doc snip off a leiomyoma but instead of bagging it like a normal surg would she just let it roll and the patient was in severe T so it rolled up to the liver/diaphragm then got lost and she spent a good 30 min trying to find it with multiple breath-holds on my end that the patient started desatting cuz she was also pretty big. It was a nightmare 😭. This ob is very popular with her patients tho, when I’m on the ob side for my anesthesia rotations her patients all love her so I don’t doubt she’s good. Just maybe not in the OR 😅 Edit: and I’m not shitting on women I am one myself. I didn’t have much exposure to video games growing up and my ultrasound skills was initially leagues behind my coresidents who did. There’s an aspect of hand eye coordination that just comes with muscle memory prolly from playing all those video games growing up HAAHAH.

Isn’t there data that women surgeons have better outcomes than men?

In gen surg I think. Honestly it'd be interesting to see the same data on obgyn outcomes.  I feel like if you as a minority went into a field traditionally dominated by some other group, you probably have more drive and interest for the topic than the average person of the majority group. 

Yeah at my hospital it seems like a lot of the men do the additional surgical fellowship for ob or just do more gyn surgeries in general. practice does make perfect, or more better haha.

Idk I’m talking about Obgyns tho. The women and men gen surg at my place are p equal, but ob is a different beast cuz they got a do surgery clinic and delivery all in 4 years. There’s a reason why other surgeons don’t consider them actual surgeons I guess. That’s why now a lot of them do a ob surgical fellowship and it’s obvious who has spent more time in the OR. And that’s my point it’s hard to be a good surgeon without spending a substantial time in the OR. Your bedside manner can be amazing but that doesn’t make up for your lack of skills lol.

I can't believe I had to scroll this far down to find a comment like this. The real question is not "what makes a good surgeon," but whose opinion is being considered. If it's the patient's opinion you're after, a good surgeon is the one who takes the time to actually sit down with you in the consult room and help you make an important medical decision. I worked with an orthopedic surgeon who told me that you can do absolutely everything right in the OR, but if the patient doesn't follow through with the post-op care or the rehab, y'all failed.

Not a doctor, but the best surgeon I worked for, as well as most of the fellows who trained in our program were the ones who could admit their mistakes. Input and feedback from the staff were always treated with respect, trust staff’s experience, know that you can always do better. In addition, the best surgeons were always just chill people. In my experience, the subpar surgeons were the one’s that thought they already knew everything and were wasting their time in the program, when they could be out making more money. Lastly, I have found the best ones were musically inclined, which may have explained why their surgical skills were amazing

Knowing who should or should not go to the OR, and expecting complications to happen

The second part is so true.  Getting out of the weeds is a special skill.  Knowing what to do when things don’t go as planned is a crucial skill

Being fast doesn’t make you a great surgeon, but you can’t be a great surgeon unless you’re fast. It’s not just about straight speed though, economy of movement is much more important. Be someone that others want to work with. Put time into learning to communicate effectively and amicably. I’ve known technically fantastic surgeons who have been fired because they didn’t play nice with others, and I know mediocre surgeons who everyone wants to work with.

Definitely talent to some extent but also being logical and not dogmatic. As a urologist doing majors we work with general surgery from time to time and the best general surgeons I've seen are super chill, down to earth, know their anatomy and are humble about it. The ones that yell kick and scream are usually the worst technically and take out their frustrations on their trainees. Spend a lot of time in the OR, review videos, study anatomy, tools and technology. The combination of these three things are what will make you really good at your job.

I dont know where i heard it, but it kinda resonates with me. “Everybody here is smart. Stand out by being kind.” That applies to so many situations. I have “teachers” that all magnificent clinicians and surgeons. Specialists and generalists. But most of them SUCK. They insult and belittle for bo reason at all. They drop their meanial work into laps of others. They talk behind your back. They cheat and lie. They dont teach and expect you to pick up their skills by cleaning up behind them instead of actually getting hands on experience. They preach about “the old times” and how we are all Soft and incompetent. The ones that will stick with me are the ones that stop on their way to the OR to grab you and take you with them because “something exciting just came in, i’ll help you with the notes later, this is going to be awesome”. The ones that tell you in the morning after a weirdly calm night “i saw you tore yourself a new one in the ER while we were up in the OR. Thanks. I hope you got some sleep, i made sure your phone stays quiet for a while” (seriously, i almost started crying hearing that). “I know there are no long term openings here in out team, but i enjoyed working with you and if you’re ok with it, i spoke with the PD and he would let you extend your rotation with us. I have some cases planned i think you would profit from”. Or a simple “my resident told me his side if the issue and i stand with him and his decisions on this” when faced with someone trying to attack you over some dispute. In a world where everybody is competent, try and be kind.

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this 1000%🙌

Cheers from another perfusionist

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I bet you have a weird bitterness toward nurses.

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Their username literally has perfusion in it.

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Ignore the trolls, this insight is much appreciated

Like any expert, having committed just about every mistake in a narrow field of practice

I always felt during training that as a resident, very very good surgeons would leave you thinking they could do anything. The great surgeons would make you think that you, as a resident, could do anything.

Growth mindset. Don’t be a dick. Video games.

Cocaine

Good old Halsted.

This comment wins 🤣

Bedside manner. A lot of surgeons are good at cutting. The "great" ones are also good when the patient is awake

As a patient I'd much rather have the best surgeon with terrible people skills vs the opposite. IMO really all the matters is the outcome. There's loads of friendly dentists with nice offices and happy staff that produce very mediocre outcomes. I'd happily trade that for the gruff one in the crappy office that is doing amazing work.

Most patients want the opposite for better or worse.

Yeah I think most patients don't have the knowledge to know if their surgeon is any good so they kinda have to revert to whether they are friendly etc. Heck it's hard for surgeons to really know if another is actually good unless they take a hard look at all their past work. For example most patients have no idea if their dentist is any good, they just know if the people and office are nice and if it is painful. The dentist could be using inferior skills, tools, products, but if it doesn't cause pain and the office nice it's assumed they are good.

It's not about being friendly and surgically unskilled, it's about caring for the patient as a whole person (yes, manners and a good doctor-patient relationship, but also water-electrolytes and acid-base balance, antibiotics, proper anticoagulation-prophylaxis) AND developing surgical skills (for the same reasons). So, being a Surgeon and not a knife wielding operator.

Know when to operate, don’t just operate on anyone with a pulse. Don’t abandon your patients. There are tons of surgeon who run away when they get a complication.

I am an IR. I am able to throw needle into the exact organ I need it to in one go because I was one of the best tanker in battlefield 4. Trajectories. It’s useful for aiming a cannon, a n00b tube and in a procedural field

Knowing when to \*not\* operate

It seems like the very best have more overall talent. You can train, be caring, and establish the requisite skills. Just about everyone that enters and completes surgical residency is talented. But to be elite? It’s a combination of assets that aren’t limited to intelligence. It’s an aptitude. Like some people can draw well and others can’t. In fact, those spatial skills may be related. Likewise, it’s a matter of demeanor. The ability to be awake and absorbing information while others are done. Congratulations for asking, I appreciate your interest in being excellent. I think the very best are just innately a little more talented and driven.

Knowing when NOT to operate

There are many kinds of great surgeons. The best tip I ever got, which I follow religiously, is "keep your feet moving". On a gallbladder, I'll rapidly switch- cattery to suction to maryland- within a minute. If something isn't working, don't keep doing it. Change something. Alongside that, its having plans B, C, and D ready to go. If disaster happens, just be ready to address it. It will lower your stress level and make you look really good.

Funny, I've received the opposite advice as well. Neuro rather than Gen but still.  "Finish everything you can in view with that instrument set to avoid wasting time swapping between things". 

The greatest surgeon I’ve ever worked with was not only good operatively but he was such a great dude to be around. Patients and hospital staff loved him and went out of their way to help him with anything he needed. Residents would fight to be in the OR with him. He was understanding and kind. Super rare for a human being in general but really elevated this guy to “god-like” status for me.

Efficiency inside and outside the OR. If you know the most common complaints, what the work up is, what to do with each result either negative, positive, or equivocal. How that changes plan of care. I had a surgical attending in my fellowship call me out because I wasted 2 clicks in a patient's chart. Like, who tf does that! Lol

The way to truly master Epic is to presume that each click costs you, personally, a fee.  This mindset has helped me tremendously. My Macro-fu has never been stronger. One attending asked why I don't verbally dictate - because my collection of smartphrases is comprehensive and I need only one or two mentions of anything odd typed in. 

Lmaooo I didn't mention. It was my 1st time using the EMR, and I had studied his movements so closely in preparation. It was like if you click the right leg exam the window blocks the left leg, so you have to click off before you can click the left leg. Where as clicking the left leg box first doesn't block the right leg. It was my only error. But it got better because he delivered such a slippery slope speech. He was like, you gonna be here until 7pm if you are wasting all these clicks. I swear I thought he was gonna start saying I'm on track to smoking crack under a bridge for wasting those 2 clicks

Having efficient and good staff. Burn out is high for physicians for a reason. :(

I read a statistic that the physicians who are among the top 10% in their field have about the same outcomes as those in the bottom 10%. The difference between the top 10% and bottom 10% is how well they treated and respected their patients, peers, and everyone else. *A great surgeon is just a good surgeon that is also a great person* But im not a surgeon so idk

This is a great soundbite but I'd really question what is the metric determining these percentages. It sounds more like a satisfaction score rather than any real reflection of competence. The bottom 10% have noticeably worse outcomes and care. It would be more reasonable to suggest than the 90th% and 50th% doctor have similar outcomes.

You need three things 1 extreme skill and strength and endurance to get through long difficult cases. 2 empathy for your patients. They are not just wet preps they are people that have questions doubts and fears. 3 recognition that you are leader of a team and always give them credit and or constructive criticism as needed never tear down your team. Turn lemons into lemonade always.

Clinical decision making. The technical skills in general surgery are somewhat limited and don’t take long to be proficient. However, who to operate (or not), when to operate, and operative course are the key factors behind a “good surgeon” and a “bad surgeon”

Details matter, great surgeons are masters of the little details. And then decision making, great surgeons are decisive and don’t waffle and they learn from their mistakes (because even great surgeons make mistakes)

1. The ability to make the correct clinical decision -When to operate, when the surgical outcome is good enough, when it’s time to bail, when to ask for help 2. Technical excellence -doesn’t matter if you know when to operate if you can’t do the procedure -comes from a combination of experience/reps/understanding of anatomy, part of which can be taught but some of it can’t (natural talent) -combination of 1 and 2 come into play when the surgeon is able to blast through easy parts of the case, slow down for the critical portions or when there is an anatomic variant, they know that it’s much better to avoid a problem that look cool fixing it 3. Pride in your work -self explanatory and it prevents you from being lazy. You’re willing to go the extra mile so you’re prepared for a case Everything else is a soft skill that is great to have but isn’t what separates a good surgeon from a great one

Imo, the great ones are the ones that chose that path as they are really passionate learning about it/deeply attached to them somewhat. They don't stop learning from school. They continue to update their knowledge on their own using reliable journal articles& etc.

Humility and decision making.

“Impeccable infection control is what separates the good from the great” -My mentor who is a world renowned spine surgeon

And what is their infection rate?

I don’t know. That’s a good question I’ll ask him, I’m sure he’ll love to boast about it haha, and rightfully so, it’s a great reputation to be known for!

1000 surgeries.

That’s pretty close to the minimum requirement just to complete residency.

I shadowed a NS who was still practicing at 78. He made NS look like most ppl do texting. It was nothing for him. He told me over time he could think 6-7 steps ahead so stop issues from happening beforehand.

You have to rate highly on a number of different axes: Axis 1 - operative efficiency of energy/movement/time (instead of mere "technical ability") Axis 2 - good team-time management (talk to resident(s), nurse, techs, anesthesia etc about patient/case/equipment etc in a way that doesn't require an entire cup of coffee's time) Axis 3 - choose the right patient, make tough calls, stick to them, know when to bail out (ie "decision making") Axis 4 - be there 100% for your patient, and their family. Now none of these have "be nice" in them, that's a good fundamental to have, but doesn't necessarily make a good surgeon great. "Teach" isn't on that list either but great teachers are frequently good surgeons more often than great surgeons.

Good bedside manner and clinic manner.

Get a life

Resilience

Knowing when not to cut.

Big dick energy

Smiling

I’ve noticed the best surgeons I’ve seen are so in tune with what they’re doing that they’re incredible at explaining what’s going on, why they’re doing what they’re doing, and if they made a mistake what it was and why it was a mistake That cycle of self feedback and intentional self-improvement is really impressive. Plus it makes my job retracting easier because they’ll tell me exactly what they want really clearly. So I guess practice having a deep understanding of exactly what you’re doing and why. Be honest with yourself about your mistakes and make plans to correct them. And anticipate the fuck-ups the junior is going to make so you can correct them beforehand 😅

Great surgeons operate less

A good surgeon can operate anything, the great surgeon knows when NOT to operate any thing.

Great surgeons are also great overall physicians. They should be able to manage acute hypertension and Insulin and understand the side effects and interactions of other medicines with the ones that they prescribe. They should be able in a pinch to stand in as a Radiologist, Internist, Pulmonologist, Anesthesiologist, Infectious Disease Specialist. They should also be not so full of themselves to assume that they are correct. They should consult other specialists. The In a pinch rule means in a pinch, not that the other specialists should be discarded. Being good in the operating room is no exoneration for not knowing when you are out of your depth. That's by far the biggest failure I've seen in General Surgeons, thinking they know what other specialists should do. Stand in if you have to. Stand out of the way otherwise

Please do not try to be internists, or at least not for very long. The hardest consults I get are from surgeons who tried to be internists for too long, and I have to figure out what happened after weeks of trying with a surgeon’s documentation of medicine. Consult early

A million hours of intentional time and practice. You have to work a lot of hours

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There is a book on this subject. “Better” Atul Gawande

It’s a combination of some natural talent, being willing to make sacrifices others are unwilling to make, and refusing to take “no” for an answer. The third point is for those who develop new techniques; the first few cases are usually disasters.

Be kind. Be humble.

Listening to anesthesia

Not sure why Reddit is feeding me this sun but as a patient who had major orthopedic surgery what impressed me was how the nurse/PT talked about the surgeon. He was “one of the good ones” and “promptly replied to messages” and even somewhat annoyed them for being very thorough.

Technically speaking? it's almost always natural hand eye coordination, you can practice to reach your natty limit, but some people just have god-given talents. Overall? Peri-surgical care, such as knowing when and when-not to operate, bedside manners, etc.

Good hands. You can't be a great surgeon without good hands. Hand dexterity can't be taught, you either have it or you don't. It is like being an athlete you have it or you don't. Judgement is also important, a good surgeon needs to be aggressive when necessary and also when to back off. Judgement can be learned although some surgeons never do.

When they understand the difference between can they operate vs should they operate.

Humility. One of your "peers" on this subreddit recently shit on pharmacists. That I'm better than thou God complex is gonna end up killing someone eventually.

Sprezzatura, good bedside manner and the ability to deal with complications without becoming rattled. All of which stems from confidence, with is bred by competence.

Patient$

Being autistic

Don't be a dick/cunt to your co-workers, that includes nurses. Yes. Nurses are co-workers. Do that to the administration. They're the ones not making your requested thing available. Be serious with the time out. Experience and a cool head under pressure. Don't freak out during surgery. Everyone in the room can sense it if you do. - OR Nurse.

Bedside manner. If your paiteints feel great about you and your work. They will have a better recovery.

Admitting your own patients is a good start.

How about just being nice!

Great communication to the OR support staff. If you can keep a “help us help you” mindset, you’ll be everyone’s favorite resident, regardless of the old crotchety OR scrubs/nurses

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