What Surgeons Can Learn From Musicians Beyond Hand Dexterity

Albert B. Lowenfels, MD


March 02, 2018

What can surgeons learn about enhancing their performance from evidence obtained from professional musicians? The authors of a study published in Surgery identified five key areas where surgeons might learn from characteristics of outstanding musicians.[1] These include extensive training and deliberate practice; enhancing bimanual dexterity; evaluating self-performance; avoidance and management of occupational injury; and management of performance anxiety.


On the basis of the experience of high-level musicians, the authors make several suggestions:

  • Reduced training hours and extended intervals of surgical inactivity are likely to reduce desired levels of manual dexterity;

  • Video games might increase the usefulness of the nondominant hand;

  • Feedback from reviewing videos of operative performance is essential to improving surgical skills;

  • Promoting ergometric posture and prompt attention to painful symptoms will minimize occupational injury; and

  • Intention tremor can be reduced by diet, rest, and perhaps by use of agents such as propranolol.

Recommendations to Surgeons

This report provides a thoughtful review of the factors that lead to excellence in musicians and to the overlap of these factors with excellence in surgery. To be an outstanding musician, the performer must accumulate 10,000 hours of practice over a 10-year period. Moreover, musicians customarily receive critical performance feedback from teachers and peers, whereas in surgical training programs, the emphasis is focused more on intellectual standards rather than surgical dexterity.

The authors also cite reports that about 20% of musicians use beta-blockers, and one randomized trial suggests that these drugs can enhance surgical performance.[2] However, the authors and most surgeons would agree that sufficient rest, diet, and avoidance of excess stimulants such as coffee or other caffeine-containing beverages should be the initial approach to enhancing surgical performance and reducing tremor, rather than using pharmacologic agents.

Musical accomplishment of applicants to the field of surgery might well be a predictor of future success. Theodor Billroth, considered to be the founder of modern abdominal surgery, was not only a master surgeon but also a highly qualified musician and a close, respected friend of Brahms, the brilliant 19th century composer and pianist.

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