Ann R Coll Surg Engl 2008; 90: 286-290 286The ability to assess one's own performance critically in surgery is a valuable trait for surgeons throughout training and independent practice. Unfortunately, this remains an underdeveloped skill in surgical training and receives little attention from surgical educators. For trainees, it allows identification of their strengths and, more importantly, weaknesses in their ability, to build upon previous performance and take the necessary remedial action. For surgeons in independent practice, the introduction of new surgical techniques necessitates focused self-assessment.Evidence for self-assessment in surgery is poor, compared self, peer and supervisor ratings with scores on the American Board of Surgery InTraining Examination (ABSITE). The results showed significant correlation between ratings by peers and supervisors (r = 0.92; P < 0.001). The average of peer and supervisor ratings showed a moderate correlation with ABSITE scores (r = 0.58; P < 0.01). Multivariate analysis suggested that supervisors were influenced mainly by the interpersonal skill of the resident and secondarily by their ability. Self-assessment was influenced mainly by the residents' perceptions of their own ability, followed by interpersonal skills and effort.