The 10,000 hour rule for Surgical Residents

“Practice isn’t the thing you do once you’re good. It’s the thing you do that makes you good.” The book “Outliers: The Story of Success” by Malcolm Gladwell was recommended to me by one of my Urology mentors. The book explores factors that contributed to the high levels of success of some individuals. It dissects the steps of how Bill Gates created the world’s largest PC software company, Microsoft, as well as how Joseph Flom transformed Skadden, Arps, Slate, Meagher & Flom LLP and Affiliates into one of the most powerful law firms in the world.

In the second chapter, Gladwell introduces the concept of the “10,000-Hour Rule”. He describes how it helped The Beatles become world famous after they performed live as a group in Hamburg, Germany over 1,200 times between the years 1960 and 1964, accumulating over 10,000 hours overall. Gladwell repeatedly refers to the “10,000-Hour Rule” throughout the book, asserting that the key to achieving true expertise involves practicing the skill for at least 10,000 hours.

As surgical residents, we spend roughly 70+ hours a week working, learning and breathing Urology. A typical day is spent seeing patients in the clinic or inpatient wards, performing minor procedures, or performing open, laparoscopic or robotic surgeries in the main operating rooms. At the end of the day, if not on call, we go home to read journal articles, brainstorm research ideas, or study from our 3753 page bible, Campbell’s Urology. With a 5-year residency program that runs 48 weeks a year, we will each accumulate 16,800 hours of experience – more than the 10,000 hours “necessary” to achieve true expertise. Each of these hours presents us with a new opportunity and lets us learn something about ourselves. Each hour brings us closer to our future careers as Urologists.

This, however, is an oversimplification of achieving success. Gladwell later describes how family, culture and friendship are all critical in any individual’s success. As residents, we take time out of our scheduled lives to be with family and friends. We balance our work lives with various sports and artistic activities that cultivate our determination and creativity. The supportive relationships we build and who we are outside of residency define the future surgeons we will become. These things help us to not only survive those 10,000+ hours of surgical residency, but to also flourish in it.

So, is 10,000 hours really enough?

This summary was adapted from an original article published in the Canadian Journal of Urology (Wong, N. The 10,000-hour rule. CUAJ 2015 Oct; 9(9-10): 299.).