Extensive research into surgeon’s decision-making and operative skills, made this month’s orthopodcaster realise that stress has a significant impact on both. Uttam Shiralkar worked as a surgeon for 15 years in the UK, India and USA. A developing interest in psycho-oncology and medical problems following a car accident, contributed to a move to the field of psychological medicine. This new strand of expertise illuminated the impact a surgeon’s psychology can have on clinical outcomes.