1. Introduction Orthopaedic surgery occupies a distinctive position in the medical profession because of its technical complexity, reliance on procedural competence, and requirement for sustained, supervised, experiential learning. The cultivation of operative judgment, manual dexterity, and intraoperative decision-making historically took place within the traditional “firm” structure of the National Health Service (NHS), where continuity of supervision, stable mentor–mentee relationships, and a progressive entrustment of responsibility provided the backbone of surgical socialisation (Collins, 2010). This apprenticeship approach, embedded in daily clinical practice, relied heavily on repeated exposure to operations, longitudinal feedback loops, and a hierarchical model of professional identity formation. From the late twentieth century into the early twenty-first century, UK training systems underwent significant reconfiguration. The introduction of competency-based curricula, summative assessments, the expansion of quality assurance mechanisms, and regulatory interventions such as the European Working Time Directive (EWTD) altered the temporal rhythms, supervisory patterns, and overall ecology of surgical training (Temple, 2010; Greenaway, 2013). These reforms pursued aims of standardisation, safety, and equity, but also carried unintended consequences: reduced continuity with a supervising consultant, fragmentation of teams through shift systems, pressures from service delivery models, and tighter time budgets for education and operating lists. Multiple reviews and surveys subsequently documented concerns about operative exposure, protected training time, and quality of supervision across surgical specialties, including trauma and orthopaedics (GMC, 2014; Royal College of Surgeons of England, 2014, 2015). It is within this shifting landscape that the article “Dissatisfaction with Orthopaedic Training in the United Kingdom” surfaced. The study sought to capture the extent and nature of dissatisfaction among British Orthopaedic Association (BOA) members, representing different career stages. Its findings—high levels of discontent with supervision, organisational structure, operative experience, and duration—anticipated difficulties that were later amplified or reshaped by Modernising Medical Careers (MMC) and changes in workforce planning, service design, and assessment regimes (Fitzgerald et al., 2012; GMC, 2014). In this sense, the article served as an early barometer of trainee sentiment, and it remains a useful artefact for understanding the trajectory of UK orthopaedic training. Yet, for all its value as an early warning, the study lacked an explicit theoretical framework to interpret why dissatisfaction clustered around certain domains or how organisational mechanisms might produce such outcomes. To address that gap, this critique adopts the Gerry Rose Model as a structure for appraising the article’s conceptual, methodological, and analytical choices. In parallel, it mobilises Herzberg’s Two-Factor Theory—a foundational theory of motivation and job satisfaction—to distinguish between “hygiene” conditions (e.g., supervision, organisational policies, working conditions) that prevent dissatisfaction and “motivator” conditions (e.g., autonomy, recognition, mastery) that foster satisfaction. Complementary lenses from Self-Determination Theory (Deci & Ryan, 2000) and Expectancy Theory (Vroom, 1964) further illuminate how structural constraints can thwart essential psychological needs and degrade motivation. Proceeding sequentially through the Rose Model—Introduction, Theory, Theoretical Proposition, Operationalisation, Field Work, and Result—this essay critically evaluates the study’s strengths and limitations, proposes a theoretically informed redesign, and outlines implications for policy and practice. The central argument is that robust theory and rigorous methodology are mutually reinforcing: the former clarifies what should be measured and why; the latter secures credible inferences that can drive coherent reform.