I'm 5 years out from residency. I'm far enough out that I don't have the jitters when I'm in the OR like I did when I first started out. I was terrified to do laparoscopies.
Now scopes are my bread and butter. Do several a week. Rarely decide to convert from scope to open.
Vag hysts were evil. I hated them, they took a couple of hours and I would struggle. Now, I do several per month. I still hate them, for technical reasons - visualization, access to structures I need. I now whine if they take more than 45 minutes. But I'm now good at them...and I'm now the only GYN in town who does them on a regular basis - everyone else does total laparoscopic hysts pretty much exclusively.
I think surgically, I'm at the top of my game now. I've learned little tricks and tips on my own - even told my old GYN-Onc mentor a trick I figured out.
In terms of practice style, I'm close enough to residency to be up-to-date yet have experienced enough to have evolved the begininng of the "Gut feeling."
Experience. Experience. Experience. And that is why we practice.