The authors believe that surgical expertise can be taught and acquired through perseverance, ambition and industry, according to Ericsson’s principles of DP. However, the psychological drive, commitment and motivation needed to effectively engage DP to this end are probably innate or incidentally acquired through independent environmental factors. A minimal level of cognitive capacity based on biological inheritance or diversity is also needed as a platform on which expertise can be built.
Surgical expertise is therefore an acquired characteristics, but surgical experts are born with a superior ability to acquire expert status.