Dr. Cushing, a student of Halstead, once wrote "the physician requires a special combination of head and heart; the surgeon of head, heart and hand- a rarer combination which comes partly by gift and partly by training."

Head
The best surgeons are those who make the best decisions. Excellence in surgery begins with disciplined thinking and sound clinical judgment. These are rooted in a thorough understanding of pathophysiology, and a deep knowledge of the basic sciences. Familiarity with scientific research is important because surgeons must understand how to interpret scientific data in order to inform their clinical decisions.

Heart
For the surgeon, the heart is separated into three separate but equally important components.

Compassion

• Compassion is what causes a surgeon to make patient care his or her first priority, regardless of personal convenience. Compassion is the impetus behind long house on the wards or in the laboratory. Compassion is what inspires surgeons to donate their services when patients cannot afford to pay.

Resiliency

• A surgeon's heart must be resilient so that he or she can persist in the face of setbacks.

Courage

• And a surgeon's heart must be courageous, to allow him or her to carry out procedures that entail significant risk.

Hand
Cushing envisioned technical excellence involving a solitary surgeon laboring to perfect specific manual tasks. Surgical outcomes depend on making an entire process smooth, from patient transport and room turnover, to having the proper surgical instruments in the operating room. This is accomplished through teamwork. Thus, the hands of the team, working toward a common goal, are more important than those of an individual.