It has been proposed that chronic and overwhelming stress, in the absence of adequate coping skills, promotes burnout and associated distress symptoms. It has also been posited that performance deficits, from surgical errors to poor professionalism, derive from stress effects on cognition. Very few studies have examined the effects of burnout on performance among surgeons and surgical trainees, nor have any focused on mediating psychological characteristics in this population. Moreover, while recent studies have described environmental assets that may reduce the risk of burnout and distress, there is very little work testing individual-based interventions among surgeons and no work to date focusing on mindfulness in this population. Interestingly, our cross-sectional national survey of general surgery residents examined psychological characteristics that mediate stress and found that dispositional mindfulness reduces the risk of burnout, perceived stress, alcohol misuse and abuse, moderate to severe depression and suicidal ideation.