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A job analysis was conducted to determine what competencies are required for success as a surgeon in the 21st century. The study design consisted of in-depth interviews with board-certified surgeons followed by questionnaires distributed to a large sample of surgeons. There were 24 competencies identified (five technical skills, six cognitive abilities, and 13 personality characteristics). The three groups of competencies were all considered to be important for success as a surgeon, as well as for selection for surgical training. Further, personality characteristics were perceived to be more important than both cognitive abilities and technical skills. The study has revealed an updated definition of the competencies required of surgeons. This definition may aid in developing valid selection methods for surgical training.