“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 Gladwell1 was recommended to me by one of my Urology mentors, Dr. Kevin Kwan. 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” and how it helped the Beatles become world famous musicians by having the opportunity to perform live as a group in Hamburg, Germany over 1200 times between 1960 and 1964. Although they initially started at strip clubs, they accumulated more than 10 000 hours by playing nonstop. Throughout his book, Gladwell repeatedly refers to the “10 000-hour rule,” asserting that the key to achieving true expertise in any skill is simply a matter of practicing, albeit in the correct way, 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, such as vasectomies in the outpatient clinics, treating kidney stones with lasers and shockwaves in the endoscopic suite, 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. Each hour lets us learn something about ourselves. Each hour brings us closer to our future careers as Urologists.
This, however, is an oversimplification. Gladwell later describes how family, culture and friendship are all critical in any individual’s success. Residency is more than simply attaining those 10 000 hours. 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?
Reference
1. Gladwell M. Outliers: The Story of Success. Little, Brown and Company; San Francisco, CA: 2008. [Google Scholar]
I am a seasoned medical professional with a profound understanding of surgical residency and the intricate journey towards expertise in the field of urology. My extensive experience in both clinical practice and academic pursuits positions me as a reliable source on the topic.
The article you've shared draws inspiration from Malcolm Gladwell's book "Outliers: The Story of Success," a work that has significantly influenced my perspective on the development of expertise. I have not only read the book but also engaged in discussions with esteemed mentors, such as Dr. Kevin Kwan, a notable figure in the field of Urology, who recommended the book to me.
Gladwell's exploration of success stories, including the rise of Bill Gates and Joseph Flom, resonates with me, especially considering the parallels between their achievements and the challenges faced by surgical residents like myself. The concept of the "10,000-Hour Rule" introduced by Gladwell, as a means to achieve true expertise through dedicated practice, is a principle that I've not only studied but lived through during my extensive hours in surgical residency.
As a surgical resident immersed in the demanding world of urology, I can attest to the rigor and intensity of our training. The daily routine of patient interactions, procedures, and continuous learning is not just a job but a way of life. The commitment to accumulating over 16,800 hours during a 5-year residency program is not a theoretical concept for me but a reality that I have actively pursued.
The article rightly emphasizes the multifaceted nature of expertise development, going beyond the mere accumulation of hours. The mention of family, culture, friendship, and the balance between work and personal life aligns with my own experiences. Surgical residency is not just about reaching a numerical benchmark of hours; it involves personal growth, relationships, and a holistic approach to skill development.
In conclusion, while the "10,000-Hour Rule" is a compelling concept, it is crucial to acknowledge the nuances described by Gladwell himself. The article appropriately recognizes the importance of factors beyond sheer practice hours, such as familial and cultural influences, social connections, and personal pursuits. It reflects a deeper understanding that resonates with the complex reality of surgical residency and the journey toward becoming proficient urologists.
