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Why Do Surgeons Have Such Big Egos?

Aaronsingh72x721_4Aaron Singh -- Last week I went to hospital. (pause for collective gasps!) I know, I know, I study in a university famous for being strictly traditional and hence not allowing pre-clinical medics anywhere near patients for the first three years. How then, you ask, did I get into a hospital? Did I, in a moment of sheer desperation, dress up as a nurse? Did I slip on some scrubs and do my best J.D. impersonation? Or did I, completely fed up of mindlessly stuffing obscure biochemical details into my brain, walk into the middle of the street, get hit by a car and get sent to A&E (the British version of the ER)?

I wish I could say that I did (it’d certainly increase the hit count on this page), but nope, the answer is much more mundane. In an attempt to pacify clinical-exposure-hungry and whiny students like me, the University has introduced a Preparing for Patients component of the course, which allows us to go interview patients in hospital once a year. It’s to improve our communications skills, and seeing how fantastically excellent I am at communicating my feelings without launching into a full-blown rant, it seems like a very good idea to prevent deprived students from beating up (or more likely getting beaten up by) patients in their 4th year.

So it was that at an insanely early hour, we were sipping coffee in the hospital cafeteria, waiting for our consultant to show up, and being given a rare opportunity to just sit back and observe how a hospital operates. There we were, so ridiculously well-dressed that any half-starved idiot sauntering by could’ve told that we were medical students. (I mean seriously, how many doctors do you see walking around hospitals wearing suits?) It was then that I noticed you could actually tell what sort of doctor the person walking by was, simply by the way they looked at you. Some of them walked past and smiled when we caught their gaze. Some of them were staring off into the distance, lost in thought, and didn’t even notice the crowd of curious well-dressed medics gawking in the cafeteria.

And then there were the surgeons.

These were the ones who walked past you with a sense of purpose, with an expression that sent lesser medical personnel scurrying out of their paths in terror, and with eyes whose gaze could physically melt medical students if you weren’t careful. Several walked past us, instantly recognizable, and those who bothered to look at us did so with a disdainful expression, dismissing our existence as being too trivial to bother their exalted minds. They were Lords of their Domain; entire operating theatres were built as shrines to their greatness. Why shouldn’t they walk around as if they owned the place?

I’ve always wondered why surgeons seem to be more affected by the famous God complex that seems so prevalent in the medical profession. Recently, my cousin brother underwent surgery, as I talked about in my previous post, and the surgeon who operated on him, whilst perfectly competent, also demonstrated this uppity demeanour. She strode into the OT (fashionably late) without seeing him pre-op, and didn’t even check on him post-op. During the surgery she didn’t bother to reassure him; it was the nurses who did this.

Now don’t get me wrong, I’m not slagging surgeons. I know many fantastic surgeons, and hope to be one myself someday. I just think they could tone down their ego sometimes. Not all ego is bad; I’m a Donald Trump fan and he’s known for espousing the belief that a healthy ego leads to a higher quality of work. And this is true as long as it drives surgeons (and indeed any other worker) to perform better, but it’s completely unnecessary when it causes them to ignore patients, shout at nurses and look down on doctors from non-surgical specialties. And abuse medical patients. ESPECIALLY when they abuse medical patients. But that’s an embarrassing story best saved for another day…

January 26, 2007 | Permalink


The intellectual gifts and volumes of integrated knowledge that a doctor must possess should be implemented with humility and and a heart to serve people with your abilities. Someday those uber-arrogant surgeons may find themselves in a state of sickness or physical disrepair, and the perspective will come around. Doctors bleed, breathe ,and are subject to time and illness just like everyone else. It's all well and good to take pride in your work and accomplishments, but to serve all patients with humility and compassion reveals a sterling character.

Posted by: MicahMan | Jan 29, 2007 9:51:09 AM

The first comment just exemplifies the lack of social intelligence some people have. Surgeons are not immune to this. I believe that most highly motivated, intelligent, and type A personality people also have low social IQ and most of them display it as arrogance or mostly just inability to accept other people. There are surgeons however who are very easy going and fun to be around.

I myself am a surgical resident.

And by the way, everyone should be doing EBM searches, not just medicine based doctors.

Posted by: Interesting Post | Jan 30, 2007 5:41:11 PM

the insulting comment above micahman must be from a surgical resident, as they are the only ones even after coming to this point in their life are capable of dishing out such vulrgar terms. Way 2 communicate(whoever u are). I agree with aaron and disagree with him on some points. Wouldn't it be healthy to point out why u disagree than to leave vulgar comments......oh wait that would require a thought process, not achieved by physical means--u're right this is the limit of ur capacities. This is why surgeons are surgeons. I know very few who think and work, and are compassionate at the same time. Goodluck aaron and hope u become one of them and GREAT post.

Posted by: | Jan 30, 2007 5:47:04 PM

Per the previous reply, I see the gutter segment has reached even medical discourse. Sad to say it may well have been an educated surgeon expounding with his/her monosyllabic verbiage. Oh, and good insight into the underbelly of medicine and the disfunctionality of givers of healthcare. Good Luck in your endeavors!

Posted by: | Jan 30, 2007 5:48:04 PM

I think surgeons need to have ego. They have huge repsonsiblity and need to "know" that they know what they are doing. At the same time, being a jerk with an ego is not desirable in any way shape or form, esp for the staff who have to work with them or the patient, who is the source of their paycheck. I agree with the previous post,balancing the ego with humility and compassion. As in all fields of medicine, transporters to Neurosurgeons, could be you in the wheelchair or on that OR table. Helps to keep it all in perspective.

Posted by: AB | Jan 30, 2007 5:50:27 PM

I agree with you Aaron and MicahMan, there is an awful and unecessary attitude from some Surgeons. I suppose the reason for their Prima Donna type outlook, might be their misery on no longer having much to strive for, save the ability to not kill anyone under their care. They often don't do any research, don't write papers, just go to the NHS facility to operate a.m. then off to the BUPA in the afternoon, followed by the Club Prive for supper. It's a terrible life for a surgeon! Great blog Aaron, keep up the great work, (and let's try to moderate the criminally insane, such as sucka Dick Bitch, as I'm sure 'our friend' of apt name does frequently, along with the Rectals and EBM's).

Posted by: Andrew | Jan 30, 2007 5:53:26 PM

The thought that seems to be missing here is that there is a big difference between arrogance and confidence and that the latter can most definitely be achieved without the former.

Posted by: K | Jan 30, 2007 6:02:33 PM


I am unsure what country you're posting from, but at least at U.S. academic centers surgeons do far more than operate and eat dinner. I would direct you to any one of the dozens of surgical journals in print today, not to mention the high level basic science research done by surgeons around the country in areas such as transplantation immunology, pancreatic cancer, and colon cancer (to name but a few).

Medicine takes all types. Some personalities are well suited to life in an outpatient clinic, others primarily to the laboratory, and others still to the high stress environment of the operating room. Your characterization of surgeons as a group as having "awful and unnecessary attitude" is hardly more defensible than the supposed attitude of surgeons themselves.

Nobody's condoning behavior harmful to patients. At the same time, people need to realize that different fields require different skill sets- and that different skill sets bring with them different personalities. Say what you will, but surgeons are hardly a group without "much to strive for" as you put it.

-An MD/PhD student and surgeon-to-be

Posted by: SurgeonScientist | Jan 30, 2007 6:23:56 PM

Lest we all forget the history of the surgeon? What once was a barber is now one of the most revered in the medical profession. I think a good lesson in history would add humility to a surgeon's personality. For more historical perspective on surgery, read "The Scalpel's Edge."

At the same time, let me agree with some of the other posts in that, at least the surgeons I know at academic hospitals do WAY MORE than just surgery and dinner. They teach courses, manage fellows and residents, conduct research, and do much more than you think.

The OR is a stressful place and in the words of a friend of mine who is a cardiothoracic surgeon, "You have someone's life in your hands each time you lift the scalpel and the ability to save it as well. That demands a bit of ego."

-Future Surgeon

Posted by: AP | Jan 30, 2007 6:33:00 PM

Surgeons have no need to be arrogant - they are (as a whole) great physicians. However, there are many other outstanding doctors. They work hard and go through hell to get where they are. But that is a choice that they all made, and wearing the abuse they experienced as a badge of courage is actually sort of sad. It's as if they can't find anything else to be proud of, so they pride themselves on their ability to take punishment. And in some way, they feel it is ok, in turn, to dole out that same punishment. Often times, it seems that their hard exterior facade is a defense mechanism to cover up some inner lack of confidence or other short coming - if they are mean enough, no one will ever question them or find out that underneath it all, they really are human...I think...

Posted by: RDM | Jan 30, 2007 6:44:51 PM

I think surgeons need to have ego. They have huge repsonsiblity and need to "know" that they know what they are doing. At the same time, being a jerk with an ego is not desirable in any way shape or form, esp for the staff who have to work with them or the patient, who is the source of their paycheck. I agree with the previous post,balancing the ego with humility and compassion. As in all fields of medicine, transporters to Neurosurgeons, could be you in the wheelchair or on that OR table. Helps to keep it all in perspective.

Posted by: AB | Jan 30, 2007 7:03:36 PM

An ego can overlap with or, even, reflect arrogance or confidence and certainly for some doctors it reflects either characteristic they may have in general. It can be quite difficult to determine whether a doctor's ego reflects one more than the other and to what degree, without getting to know him or her as a person. Most patients or colleagues (particularly in the "lower" hierarchies) typically would not have an opportunity to do so. Of course, a doctor's ego can also be a defense mechanism to hide his or her professional insecurity, doubt, or fear. Being obnoxious or offending to a patient or a colleague - regardless of whether it arises from ego, arrogance, or insecurity - is, however, an unprofessional conduct that should not be tolerated and which deserves a due reprimand or penalty.

Posted by: Robert | Jan 30, 2007 7:24:22 PM

I happen to be lucky enough to have worked with some of the most highly esteemed pediatric cardiovascular and neurosurgeons in the field. They also happen to be some of the most gregarious and upfront people I know. Generalzations about any group are damaging and in this case, misses the mark. It is true some individuals, regardless of profession, like to hide their inadequacies and insecurities behind rudeness and a know-it-all attitude. I think we are all guilty of this at one point or another, because as physicians we are "supposed to know" the answers all the time. With time, hopefully, the author will have more exposure with surgeons that will prove his stereotype wrong. By the way, I am not a surgeon :).

Posted by: Shafkat Anwar, M.D. | Jan 30, 2007 7:25:11 PM

As a 3rd year medical student, I have recently been "privilaged" to experience the surgeon sterotype; stereotype is exactly what I thought it was until now. I realize there are exceptions to the stereotype and I hope to learn from them, but they are not the norm.

I was the student who stayed incredibly positive and unwavering first and second year when all of my collegues were questioning their career choice. The 1st 3 weeks of my surgery rotation I was treated as if I were taking in too much of my residents' oxygen. I was ignored, scorned, ridiculed and ignored again. This behavior came from 30+ year old women senior residents who are likely intellegent, once caring people. Although I know this behavior does not reflect anything that I did or didn't do, it was an incredibly stressful environment to endure 13 hours a day, 6 days a week.

I cannot fathom how residents can forget so quickly what it is like to be a 3rd year medical student...muchless a compassionate HUMAN BEING.

Posted by: MS-III | Jan 30, 2007 7:51:14 PM

correction to my post below:


intellegent=stressed out sleep deprived MS-III

Posted by: MS-III | Jan 30, 2007 8:00:02 PM


Your observations I clearly accurate. Surgeons typically, though not universally, have an air of confidence/arrogance about them. As others have noted, this is in part a product of the personality traits needed for the job. Slicing a hole in someone and removing things takes a level of confidence not everyone posses. Clearly this is taken too far in some. I think this is often a result of learners emulating their mentors. Surgical residency seems very much like hazing a fraternity. (As an emergency medicine resident I spent several months on surgical services. I can't say I lived it but had a good exposure to it.) You must conform or rounds and M+M are brutal.
Surgeons need to be confident and definitive. However, mastering the "It's not a surgical abdomen turf it to medicine" attitude is not. The best surgeons I have meet are confident individuals who posses good interpersonal skills. And that is something we don't teach very well in resident education. Especially, surgical resident education.

Posted by: MG | Jan 30, 2007 8:38:29 PM

I have had the fortune of being a Cardiothoracic surgery resident in Egypt, and will be an Interventional Cardiology fellow here in the US come July.

I'd have to disagree with the comment: "You have someone's life in your hands each time you lift the scalpel and the ability to save it as well. That demands a bit of ego." Does opening up a thrombosed coronary in the throes of an acute MI demand one too? - the answer is no, neither do. Confidence in your knowledge, skills, and ability to help the patient - yes.

If you're in this for egotistical reasons, you're missing the point. Medicine (the overall profession) is a privilege and a vocation - please leave egos at the door.

On a lighter note, if you haven't already read this brilliant article do yourself a favour and do so now!

Antoni Trilla et al. Phenotypic differences between male physicians, surgeons, and film stars: comparative study. BMJ 2006; 333: 1291-1293

Posted by: Ehab | Jan 30, 2007 8:41:31 PM

Whether it's a cutaeous abscess being drained or a segment of cancerous colon being resected, surgeons are among the few that live in a world where their actions directly CURE the patient. Obviously, drugs are used, but unlike the bulk of the medicine specialties they are an adjunct to real, physical, tangible hands-on intervention, day in and day out. For that reason, every surgeon I know has some degree of hypergonadism. ;)

However, none of that excuses blatant arrogance or rudeness. The surgeon that doesn't check on his/her patient before and after surgery (or have it done by a close, trusted partner to report back) is unprofessional, not overconfident. True confidence speaks for itself, period. It doesn't need showiness or condescending actions to underscore its existence.

The mind-set of writing a prescription for an antihypertensive and telling the patient, "Come back in 2 weeks for a follow-up" is not anywhere similar to, "I'm going to open your belly and fix your AAA before that ticking time bomb explodes and you bleed to death." It's not that surgeons are better, but they're different for good reason.

Posted by: enrico | Jan 30, 2007 8:58:46 PM

Wow- After reading this I see what all of you are saying and feeling. Why? I ask myself. As a CNA for a restorative care unit I enteract with patients after surgery and care in the hospital. I rarely hear how arrogent their surgeon was. I ALWAYS hear how well or ignored they were treated before and after. When I walk down the halls of our hospital and see the thoughts and stares we all see from ALL of us I think "Thank you God that I don't have that responsibility. Let him get good sleep tonight(the surgeon). Who knows, it could be me tomorrow.

Posted by: Jeanne | Jan 30, 2007 9:00:25 PM

I am in complete agreement with you and I do note that there are a few (and I do mean a small few) surgeons who do not fall into the category of egomaniac. I think most surgeons are so full of themselves that they are almost useless as human beings. I am in an interesting position in life (a pastor's wife at a very big church with several of this type of physician in leadership positions here) where I serve as a confidant to many people - and I have been privy to the opinions of many - and unfortunately most patients feel the same way. It is heartbreaking. I do NOT subscribe to the belief that a surgeon NEEDS to have some ridiculous God complex. That is a stupid and pathetic idea...and unfortunately a belief that I find not only in surgeons, but in many other doctors as well. My greatest hope is that this next generation of up-and-coming doctors realize the problem and make a real effort NOT to become like the ones who we (patients) are forced to be at the mercy of now. Best wishes to you, and don't lose sight of why you are doing what you're doing!!! We desperately need good, caring doctors who realize they have a gift from God, but that they are NOT God.

Posted by: Tara Tonjes | Jan 30, 2007 9:39:35 PM

I think they're arrogant because they put their hands where only God has been.

Of course, that makes their arrogance even less excusable. It should humble them to their knees!

Posted by: Talia | Jan 30, 2007 10:22:35 PM

I recently matched into a neurological surgery residency, and I must comment that after having visited more than 18 different programs over the past two months that the stereotype does these people a gross injustice. Surgeons, especially those involved in sub-specialty areas, undergo longer hours, longer residency programs, and have more expected of them on a daily basis than any medicine based residency, save perhapse a interventional cardiology fellowship..... Who still has the bonus of knowing it will be over in a couple of years. Surgeons are quite misunderstood. The majority of them are taken to be egotists because of their mannerisms and often short conversations both with other physicians as well as patients, but these adaptations exist only due to time constraints, required objectiveness, and a training background that requires them to be responsible for everyone around them. Granted there are many who could benefit from some social education, but for me I can tell you that the worst attitudes I have experienced thus far actually have been from fellowship trained internists who are soured secondary to being underpaid and over dumped upon by ER doctors unwilling to take responsibility for complicated patients. Surgeons save lives in acute settings on a daily basis. Quit complaining and thank one for putting in the hours.

Posted by: Student of life | Jan 30, 2007 11:07:05 PM

I totally agree with Shafkat Anwar. I am the last year med. student, and the best doctors I have ever seen are surgeons. If they don’t have automatic smile as many Americans do, it doesn’t mean that they are rude or arrogant.

Posted by: Shahsanam Mirishova | Jan 31, 2007 3:09:00 AM

When you are “clever” this sometimes automatically gives you an ego, and you med students are guilty of it too. You see the probability of you meeting someone out there(apart from a learning institution) who has more knowledge or can acquire knowledge at your speed will be quite rare. You have probably been always at the top of your class and have always been your parents consultant ever since you can remember, tell me if that hat isn’t an automatic ego builder.

Anyone who has gone the gauntlet in higher learning is automatically respected because they should know better and do better and ordinary folks respect that.

I would prefer to be examined by a surgeon who takes his/her work seriously and seems to be impartial to any emotional involvement because it sets the stage for the seriousness of the relationship The surgeon doesn’t have time to get to know my likes and dislikes. If the doctor's eyeing you up looks nervous or laughing how does that instill confidence.

Secondly, like yourself, there are many medical student chancers out there who think they are the next best thing and will try challenge a surgeons knowledge, I believe the surgeons are right to keep their distance and keep it professional at all times.

The only reason why you student doctors are nice to the patients now is because you want them to agree to have you in the examining room. Later when they start suing your ass for malpractice you will find keeping it professional and pleasant is the best way.

Posted by: Yvette.McNaught | Jan 31, 2007 6:43:35 AM

Let's not forget at this type of arrogant behavior is becoming very unpopular with the public. Patient's can take their surgical needs to a surgeon with social skills.

Posted by: Susan | Jan 31, 2007 8:37:06 AM

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