Surgical fellows demonstrate significant stringency in self-assessment of their technical skills compared to faculty evaluations, which has implications for surgical training and professional development.

• Fellows rated their entrustment levels at 2.98, while faculty rated them at 3.28 (p < 0.001), indicating fellows are generally more critical of their own performance.
• Accuracy of self-assessment improved with increasing case load and experience over time.

Surgeons should consider implementing targeted interventions for fellows who may struggle with accurately assessing their competencies based on these findings.