“…FRCS performance alone takes no account of covert confounding variables including operative ability, academic reach, hospital rota intensity, and other hidden curriculum factors such as burnout, sleep deprivation, dignity at work, geographical deprivation and inequality, and trainer variation. Many other factors have been reported to influence examination performance, including demographics, earlier education, and organizational skills 4 . Interpreting SEB-related examination performance as a surrogate marker of training quality assurance must therefore be made with caution.…”