Key principles from the article “Excellence in Surgery: Psychological Considerations” by Judy McDonald & Terry Orlick


  • Mental Factors in Surgical Excellence: This study focuses on the psychological aspects that contribute to outstanding performance in surgery, emphasizing that mental readiness and focus are as crucial as technical skills.


  • The Wheel of Excellence: The research revolves around Orlick’s “Wheel of Excellence”, comprising seven elements crucial for success: commitment, belief, positive imagery, mental readiness, full focus, distraction control, and constructive evaluation.


  • In-Depth Interviews with Elite Surgeons: Interviews with 33 highly proficient surgeons across six specialties reveal the importance of these seven elements in achieving surgical excellence.


  • Commitment and Belief: Surgeons demonstrate an unwavering commitment to their profession and a strong belief in their skills, which are foundational for high performance.


  • Positive Imagery and Mental Readiness: The use of positive mental imagery and thorough mental preparation before surgeries helps surgeons perform complex tasks under stress.


  • Full Focus and Distraction Control: The ability to maintain focus and control distractions during surgery is critical, especially in high-risk scenarios.


  • Constructive Evaluation: Post-surgery evaluation is essential for continuous improvement and learning from each surgical experience.


  • Implications for Surgical Training: The study highlights the need for incorporating mental training in surgical education, emphasizing that technical skills and mental preparedness go hand in hand for excellence in surgery.