# Confidence Without Wisdom: The Dunning–Kruger Problem in Modern Surgery

## TL;DR

This paper explores how misplaced confidence in surgeons can risk patient safety and how professional culture contributes to this issue.

## Contribution

The paper introduces a new perspective on miscalibrated confidence in surgery as a systemic issue, not just an individual flaw.

## Key findings

- Confidence in surgery can outpace self-awareness, especially during career transitions.
- Professional cultures emphasizing decisiveness and productivity may foster miscalibrated confidence.
- Experience helps reshape surgical judgment and recalibrate confidence over time.

## Abstract

Confidence is indispensable in surgery, yet when it becomes misaligned with judgment it may place patients and professionals at risk. This editorial examines how confidence evolves across different stages of a surgical career and how miscalibration can emerge during periods of transition and increasing responsibility. Drawing on philosophical perspectives on knowledge and uncertainty alongside practical considerations of training and clinical practice, we explore how confidence may outpace reflective self-awareness and how experience gradually reshapes surgical judgment. We argue that miscalibrated confidence is not primarily an individual shortcoming but a predictable consequence of professional cultures and systems that emphasize decisiveness, productivity, and visible achievement. Understanding how confidence is acquired, reinforced, and recalibrated is essential for promoting patient safety, professional development, and ethically grounded surgical decision-making.