BOOK REVIEW - SKILL: 40 Principals That Surgeons, Athletes, and Other Elite Performers Use to Achieve Mystery

Author: Dr. Christopher S. Ahmad

Book Reviewer: Amy Lu

In SKILL, Dr. Christopher Ahmad delivers an insightful contribution to the literature of surgical education and performance science. Known as the head team physician for the New York Yankees and Chief of Sports Medicine at Columbia University, Dr. Ahmad brings a unique perspective as both an elite orthopedic surgeon and a trusted confidante to world-class athletes. With SKILL, he turns his attention to the process behind the outcome: how mastery is built, one principle at a time.

The book is structured around 40 concise principles grouped into six overarching sections: Preparation, Deliberate Practice, Mental Skills, Failure and Growth, Leadership, and Sustained Performance. Dr. Ahmad opens the book with reflections on his own early years in medicine and sports. He recalls practicing suture techniques on oranges and chicken thighs as a resident, trying to mimic the hand speed and precision of his mentors. But he also shares his early struggles with confidence, including the imposter syndrome he felt even after reaching the highest echelons of sports medicine. His willingness to revisit these formative moments adds authenticity and relatability to the book. 

One particularly memorable story appears in the chapter titled “Train for Pressure.” Here, Ahmad recounts the intense pressure of operating on Yankees players during playoff season. The stakes are immense not just for the player’s career, but for the fans, the team, and the surgeon’s own reputation. To prepare for these moments, he advocates for “game-speed” training: running mock procedures under pressure, rehearsing complex surgical steps with time constraints, and even visualizing worst-case scenarios. This approach, he argues, conditions surgeons to stay focused and composed in the OR when stress is at its peak.

A central pillar of SKILL is the principle of deliberate practice, a concept Ahmad revisits frequently and expands upon with real-life examples. In the chapter “Practice to the Edge of Ability,” he explains that true improvement only happens when we operate just outside our comfort zone, where mistakes are possible but growth is maximized. He draws on sports psychology, particularly the work of Anders Ericsson, to highlight how elite athletes fine-tune micro-movements through repeated, focused effort.

For surgeons, Ahmad translates this to the operating room. He suggests that technical refinement should involve not just doing procedures, but critically analyzing every step. He introduces the idea of the “feedback loop”: recording surgeries, reviewing them frame-by-frame, and asking for structured peer feedback. These tools, he argues, should be normalized in surgical training, just as they are in sports.

Chapters like “Visualize Success” and “Confidence is a Skill” emphasize the often-overlooked role of mental preparation. Ahmad doesn’t shy away from discussing the cognitive demands of surgery. He shares how he uses visualization techniques before complex procedures, mentally rehearsing every step, every anatomical structure, every possible complication. He notes that many of the athletes he works with, including MLB pitchers and Olympic gymnasts, use the same methods to prepare for their performances.

Ahmad also reflects on the emotional toll of surgery, especially the fear of failure. In “Learn to Love Failure,” he shares how a surgical complication early in his career haunted him for months. Rather than burying the experience, he dissected it, shared it with mentors, and incorporated it into his teaching. For readers, especially medical trainees, this chapter serves as a powerful reminder that vulnerability and reflection are essential to growth.

In the second half of the book, Ahmad transitions from the internal work of skill-building to the interpersonal and systemic. He explores how mastery isn’t just about technical ability, but also about communication, leadership, and creating psychological safety within surgical teams. In “Lead with Empathy,” he recounts a time he was too focused on the procedure and failed to recognize a junior resident’s distress. It became a turning point in how he approached teaching and leading in the OR.

The final section of SKILL addresses a question that many high achievers struggle with: how do you maintain performance over the long haul without burnout? Ahmad shares his own journey through mental fatigue, time management, and rediscovering joy in surgery. He emphasizes routines, physical health, and maintaining outside interests.

For medical students, surgical residents, athletes, and professionals across disciplines, SKILL offers not just motivation but actionable strategies. It encourages humility, intentionality, and resilience. Above all, it redefines what it means to be “skilled,” not simply as a matter of talent or repetition, but as the result of a deliberate, lifelong commitment to growth.

Author: Dr. Christopher Ahmad

Dr. Christopher S. Ahmad is an internationally recognized orthopedic surgeon, sports medicine specialist, and thought leader in surgical performance. He serves as Chief of Sports Medicine at Columbia University Irving Medical Center and Head Team Physician for the New York Yankees, where he has provided care to some of the most elite athletes in professional sports. He is also the Head Team Physician for the New York City Football Club and a trusted consultant to numerous collegiate and high school teams.

Dr. Ahmad earned his medical degree from New York University School of Medicine and completed his orthopedic surgery residency at New York-Presbyterian/Columbia University Medical Center, followed by a fellowship in sports medicine at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. He is a Professor of Orthopedic Surgery at Columbia University and Director of the Center for Pediatric and Adolescent Sports Medicine.

Beyond his clinical expertise in complex shoulder, elbow, and knee conditions (especially Tommy John surgery for UCL injuries), Dr. Ahmad is a prolific researcher and educator. He has authored over 200 peer-reviewed articles and several textbooks, and he is the author of SKILL: 40 Principles That Surgeons, Athletes, and Other Elite Performers Use to Achieve Mastery, where he distills insights from decades of experience into practical strategies for achieving excellence.

A champion of surgical education, athlete safety, and team-based care, Dr. Ahmad continues to shape the future of sports medicine through innovation, mentorship, and a commitment to performance excellence.

Book Reviewer: Amy Lu

Amy Lu is a fourth-year medical student at Weill Cornell Medicine who will be starting orthopedic surgery residency at the Hospital for Special Surgery this summer. Born to Chinese immigrants in Ottawa, Ontario, and later immigrating to a suburb outside of Dallas, Texas, Amy draws on her multicultural background to inform her commitment to equitable, patient-centered care. She graduated from Johns Hopkins University with a double major in Biology and Spanish and a minor in Visual Arts. Before medical school, she spent a year conducting orthopedic surgery research at Massachusetts General Hospital through Harvard Medical School.

Amy has served on the Association of Women Surgeons (AWS) National Medical Student Committee since 2023 and currently contributes as the Social Media and Marketing Coordinator. Outside of the hospital, she is an avid long-distance runner, painter, and reader, integrating creativity and reflection into her approach to anatomy, surgery, and healing.