Nobody is as falsely confident as a senior resident.

Chief year feels like fluency. The techs don't need to look over my shoulder. The attending often breaks leaves me to close. I quote the classification, the screw length, the angle of correction from memory. The intern watches me the way I used to watch my chiefs. Some quiet part of my brain files that look away as evidence.

Here's the uncomfortable part: fluency is not true mastery. Knowing every step of the case is not the same as knowing where the case goes wrong. In 1999, two psychologists put a name to the gap between how good we are and how good we think we are. The people who performed worst rated themselves highest — not out of arrogance, but because the skills they lacked were the very skills required to notice the lack.

Plot confidence against experience, and residency looks like this:

Why does the summit sit at chief year? Because I finally have enough repetitions to feel fluent — and nowhere near enough to have met the rare disaster. My case log is deep in cases that went fine.

The attending's edge was never the thousand cases that went well. It's the thirty that didn't — the iatrogenic tibial shaft fracture, the simple mass excision that ended up not having enough tissue to close primarily, the fixation that looked perfect on the table but was an airball at the first post-op visit. Those cases build the one thing the summit lacks: an accurate map of what can go wrong. So far, I've mostly watched the experience that comes from veteran attending's scars.

The training system removes the guardrails exactly at the peak. Supervision tapers as confidence crests. Autonomy arrives right on schedule; calibration does not.

Senioritis is mistaking the false peak for the top of the mountain. You stop reading. You coast the last year on accumulated fluency, and you graduate at maximum confidence and maximum blind spot — simultaneously. The valley on the far side does not care how the summit felt.

1. Board-run every case like it's your first. The day you stop rehearsing is the day the case starts rehearsing you.
2. Keep a complications log — and read it more often than your CV.
3. Say "I don't know" out loud. On rounds. In front of the students. It isn't a confession; it's a demonstration.
4. Ask your attendings why, not just what. The steps are in the textbook. The judgment is the inheritance.
5. Teach the interns. Nothing exposes borrowed fluency faster than trying to hand it to someone else.
6. Read one thing a week that disagrees with how you were trained. Curiosity that's never contradicted isn't curiosity — it's indoctrination.