Purpose <p>Academic faculty generally accept that confidence is an essential quality in successful surgeons, but there is little understanding of how residents view confidence or gauge success. This study assessed resident attitudes on the role of confidence in surgical careers and identified the qualities residents associate with successful surgeons.</p> Methods <p>A mixed methods exploratory study was done, starting with a focus group of 20 residents at a tertiary academic medical center. Themes that emerged from the focus group were used to develop questions for an anonymous online survey that was sent to all surgical residents. Residents frequently reported confidence as a requirement for success in surgery, which led to a secondary aim of the study: defining the qualities of a successful surgeon. Survey questions therefore asked residents to evaluate several features of confidence using a 5-point Likert scale, and then list the five most important qualities of successful surgeons.</p> Results <p>41 survey responses were collected from the 55 residents. 59% of residents strongly agreed that confidence is important for a surgeon’s career, and 37% strongly disagreed that competence and confidence were equivalent. Similarly, 52% of residents felt that confidence is equal parts situational and absolute. The list of 58 total qualities of successful surgeons revealed 10 major themes. The categories of most reported characteristics were ranked by order of importance based on frequency of reporting: Interpersonal Skills (69%), Conduct/Demeanor (55.2%), Work Ethic (43.1%), Medical Knowledge (34.5%), Personal Integrity (32.8%), Critical Thinking (27.6%), Operative Skills (25.9%), Professional Excellence (19%), Communication (10.3%), and Wellness (1.7%).</p> Conclusions <p>Residents overwhelmingly agreed that confidence is important to a surgeon’s career, and most felt that confidence was more learned than intrinsic. Residents valued characteristics that demonstrate non-technical skills in surgery as the most important qualities of successful surgeons, which somewhat deviates from the prevailing wisdom of surgical educators and historic societal leadership, suggesting an evolution in the definition of success in surgery. This data on resident attitudes surrounding success in surgery sets the stage for a deeper analysis of the development, evaluation, and measurement of confidence in surgery residents.</p>