Published in American Urological Association News - October 2017

Reprinted with permission from AUANews, volume 22, issue 10, 2017; © American Urological Association 2017.



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The Mental Strength of Surgeons

Surgeons are a lot like high performance athletes. Not in the physical sense (although there are certainly some very athletic surgeons out there!), but in the mental sense. Successful surgeons are mentally tough. They have hardiness and fortitude, and can push through life’s disruptions.

When faced with the everyday challenges of surgical life, elite surgeons go beyond the barriers of what’s comfortable using the same mental toughness the world’s most elite athletes tap into during training and competition. There is a resilience and willingness to go beyond the point of exhaustion to secure the “win.”

For surgeons who’ve been struggling or surgeons simply looking to stay at the top of their game, understanding what it takes to be mentally tough is critical. The best definition of mental toughness that I have found comes courtesy of authors Peter Clough and Doug Strycharczyk in their book, Developing Mental Toughness. 1 They define mental toughness as “The quality which determines in large part how people deal effectively with challenge, stressors, and pressure...irrespective of prevailing circumstances.”1

Strycharczyk and Clough continue their defi nition by breaking the broader concept of mental toughness into the 4 keys of 1) challenge—viewing challenges as opportunities rather than obstacles; 2) control—believing fully in the power of self-determination; 3) commitment—an unwavering ability to see assignments through to completion; and 4) confi dence—complete confidence of self and one’s ability to succeed.

Elite surgeons have each of these 4 keys. Applied outside the operating room, they maintain thriving careers. Applied to their personal life, they achieve lifestyle-friendly and sustainable careers.

Challenge. Mentally tough surgeons don’t think they can succeed inside and outside the operating room— they know they can. Their attitude is one of maximum positivity, built to withstand the gauntlet of surgical life.

Control. Elite surgeons believe fully in their ability to control their destiny. That belief cultivates an insatiable passion for performance improvement, which naturally leads to sustained professional success.

Commitment. The best surgeons are the most committed—those unwilling to retire from the day until the job is done. Through relentless practice, these surgeons become masters of complex problem solving and time management. They learn to reduce a problem to its simplest form before attempting to solve it, allowing them to get more done with less time and effort. This helps them be more committed.

Confidence. Mentally tough surgeons inspire and influence themselves using internal rather than external rewards. Because they have an internal well of 24/7 motivation, their confidence in themselves, their abilities and their mission can’t be shaken by setback.

Ultimately, the only thing that binds elite surgeons and elite athletes more than any other is an uncanny ability to find the positive in everything.

It is not that elite surgeons and athletes never have “down” moments, as they absolutely do. However, when those down moments occur, they are confined to just that moment. When the moment passes, elite surgeons know how to bounce back. They put a positive spin on things, find a silver lining to extract, and resume their quest for professional and personal excellence.

For those surgeons reading this article who think they lack one (or more) of the 4 keys to mental toughness, don’t worry, as they are skills that can be learned over time with an investment of time, energy and (of course) practice!


1. Clough P and Strycharczyk D: Developing Mental Toughness: Improving Performance, Wellbeing and Positive Behaviour in Others. London: Kogan Page Publishers, 2012.