Training Apart, Together

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes also both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery as an interdependent (or, colloquially, team) sport, such as soccer, in which participants collaborate toward a shared goal. Although valid for the operating room, the broader structure of surgical residency often functions more like an individual sport (eg, track or swimming), with residents training and working independently. This structure exposes residency programs to the unique dynamics observed in individual sports teams, including excessive individualism, exclusionary subgroup formation, and detrimental social hierarchy. These phenomena can undermine team building, weaken individual performance, and accelerate burnout. Evidence from the sports psychology literature suggests that program leaders can combat these trends by fostering a sense of interdependence, promoting socialization and development of a collective identity, cultivating a flexible and egalitarian culture, and developing faculty coaching skills to reframe individualism, facilitate inclusion, and model context-dependent hierarchy. Recognizing that the structure of surgical residency often mirrors that of an individual sport provides a valuable framework for understanding threats to team building and appropriate interventions in this setting. This Scholarly Perspective may allow program leaders to build more cohesive resident teams, ultimately improving trainee education, well-being, and performance.