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 between 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.

Skill, surgeons believe, can be taught; tenacity cannot.

"There is a saying about surgeons, meant as a reproof: "Sometimes wrong; never in doubt." But this seemed to me their strength. Each day surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one's knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off - or even alive. Standing at the table my first time, I wondered how the surgeon knew that he would do this patient good, that all the steps would go as planned, that the bleeding would be controlled and infection would not take hold and organs would not be injured. He didn't, of course. But still he cut."

It’s insulting to call a professional talented. She’s skilled, first and foremost. Many people have talent, but only a few care enough to show up fully, to earn their skill. Skill is rarer than talent. Skill is earned. Skill is available to anyone who cares enough.

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.

There is a difference between skill and talent. Master the skill to allow the talent out.

At one time I thought the most important thing was talent. I think now that — the young man or the young woman must possess or teach himself, train himself, in infinite patience, which is to try and to try and to try until it comes right. He must train himself in ruthless intolerance. That is, to throw away anything that is false no matter how much he might love that page or that paragraph. The most important thing is insight, that is ... curiosity to wonder, to mull, and to muse why it is that man does what he does. And if you have that, then I don't think the talent makes much difference, whether you've got that or not.

[<i>Press conference, University of Virginia, May 20, 1957</i>]

They who lack talent expect things to happen without effort. They ascribe failure to a lack of inspiration or ability, or to misfortune, rather than to insufficient application. At the core of every true talent there is an awareness of the difficulties inherent in any achievement, and the confidence that persistence and patience something worthwhile will be realized. Thus talent is a species of vigor. (Eric Hoffer 1902-1983)

Even worse than losing self-confidence, though, is reacting defensively. There are surgeons who will see faults everywhere except in themselves. They have no questions and no fears about their abilities. As a result, they learn nothing from their mistakes and know nothing of their limitations. As one surgeon told me, it is a rare but alarming thing to meet a surgeon without fear. “If you’re not a little afraid when you operate,” he said, “you’re bound to do a patient a grave disservice.

If you are good enough to get in, you obviously have enough talent to do well, regardless

Achievement is talent plus preparation. The problem with this view is that the closer psychologists look at the careers of the gifted, the smaller the role innate talent seems to play and the bigger the role preparation seems to play.

we need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon.

Do not talk about giftedness, inborn talents! One can name great men of all kinds who were very little gifted. They acquired greatness, became 'geniuses' (as we put it), through qualities the lack of which no one who knew what they were would boast of: they all pos­sessed that seriousness of the efficient workman which first learns to con­struct the parts properly before it ventures to fashion a great whole; they allowed themselves time for it, because they took more pleasure in making the little, secondary things well than in the effect of a dazzling whole

Talent is a wonderful thing, but it won't carry a quitter.