Sleep deprivation in high-risk professions is associated with high personal and economic burden to the workforce through impaired cognitive performance, decreased productivity, poor worker health and loss of civilian life. Minimum rest is mandated in other high-risk professions, such as aviation; however, there is a perception among surgeons and trainees that physical wellbeing is less important for surgical excellence. The expectation that sleep deprivation is necessary to achieve surgical excellence is pervasive in the surgical profession and is not supported by the evidence. For instance, lack of sleep is directly associated with prolonged operation time, more errors, increased stress and reduced manual dexterity (1). Sleep deprivation and long working hours are also associated with a significantly higher prevalence of burnout, depression and work and home conflicts among surgeons. Most frameworks of surgical excellence, including the RACS core competencies, feature teamwork, collaboration, communication and decision-making as key prerequisites for surgical excellence, and sleep deprivation is clearly an impediment to attaining these in practice. The wellbeing of the surgeon is therefore necessary for the wellbeing of the patient and should not be sacrificed as the cost of excellence, but rather lay the foundation to achieving it. With the support of institutions, policy-makers, colleagues and families, the culture of the surgical profession can be shaped to encourage both surgical excellence, and the surgeons practicing it, to thrive. References 1. Whelehan DF, McCarrick CA, Ridgway PF. A systematic review of sleep deprivation and technical skill in surgery. The Surgeon. 2020 Dec 1;18(6):375-84.