What makes a bad surgeon. Beyond training, being able to read into every mistake and figure out what went wrong and reflect to honestly think of what could you have done better is the only way to grow and get better. But that doesn't mean that all of the inadequate surgeons we see around us are not doing so. I think at one point after much reflection one will reach a point where he has to confess that he reached his ceiling. If a trauma surgeon struggles with supraceliac control 10 years into his carrier despite reflecting every time on what went wrong then that is it, he is just an inadequate one. What are those supposed to do? If you are faced with the fact that your best will never be enough. I see them either try to limit their practice (refuse to do an indicated gallbladder because it is gonna be a horrible one), Assign blame (always cussing and complaining and trying to find mistakes in others to use as counter attack for when they are criticized) or call for help for everything ( Calling vascular on a trauma before even going to the OR to get px and distal control).  So is that it for those surgeons? and is there really a technical ceiling for people or is it that they are not learning from their experiences the right way?. Is there a way to know while in training if you are gonna be one of them? how can you for sure know that you are not gonna be a mediocre surgeon? You have fantastic surgeons coming from mediocre residencies and the other way around so obviously training is not everything, there is an X factor, I just don't know what it is..