Surgeons, as a group, adhere to a curious egalitarianism. They believe in practice, not talent. People often assume that you have to have great hands to become a surgeon, but it's not true. When I interviewed to get into surgery programs, no one made me sew or take a dexterity test or checked if my hands were steady. You do not even need all ten fingers to be accepted. To be sure, talent helps. Professors say every two or three years they'll see someone truly gifted come through a program -- someone who picks up complex manual skills unusally quickly, sees the operative field as a whole, notices trouble before it happens. Nonetheless, attending surgeons say that what's most important to them is finding people who are conscientious, industrious, and boneheaded enough to stick at practicing this one difficult thing day and night for years on end. As one professor of surgery put it to me, given a choice betwen a Ph. D. who had painstakingly cloned a gene and a talented sculptor, he'd pick the Ph. D. every time. Sure, he said, he'd bet on the sculptor being more physically talented; but he'd bet on the Ph. D. being less "flaky." And in the end that matters more. Skill, surgeons believe, can be taught; tenacity cannot. It's an odd approach to recruitment, but it continues all the way up the ranks, even in top surgery departments. They take minions with no experience in surgery, spend years training them, and then take most of their faculty from these same homegrown ranks.
And it works. There have now been many studies of elite performers -- international violinists, chess grand masters, professional ice-skaters, mathematicians, and so forth -- and the biggest difference researchers find between them and lesser performers is the cumulative amount of deliberate practice they've had. Indeed, the most important talent may be the talent for practice itself. K. Anders Ericsson, a cognitive psychologist and expert on performance, notes that the most important way in which innate factors play a role may be in one's willingness to engage in sustained training. He's found, for example, that top performers dislike practicing just as much as others do. (That's why, for example, athletes and musicians usually quit practicing when they retire.) But more than others, they have the will to keep at it anyway.