Creativity Under Constraint: Why Surgery Needs Art-based Education

Surgical trainees train their hands, eyes, and mind.They learn to operate with precision, to see anatomy in three dimensions, and to make patient-centered decisions informed by available evidence.Creative judgment is essential to surgery because of its intricacy and shifting variables of form and proportion.1,2 Surgery is a safety-critical profession built on standardization, with protocols, checklists, and training systems designed to reduce variation and minimize harm.3 This ethos can seem incompatible with creativity, which is often associated with risk-taking.3 Yet in high-stakes, time-pressured situations, creativity is not a luxury but a necessity.This tension highlights a possible blind spot in surgical education.Surgical trainees are trained to operate in a world of black and white, where anatomy is familiar, operative steps are rehearsed, and contingencies are anticipated.In the operating room, surgeons prepare relentlessly for the optimal outcome.However, surgery inevitably presents moments that challenge preparation, such as unexpected findings or complications.Suddenly, the surgeon is pushed into a space where one must improvise with what is available, much like a painter returning to their primary colors.These moments expose a form of professional competence that is rarely made explicit in surgical training.This "forced creativity" parallels what Bourgeois-This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.