© 2015, Otology & Neurotology, Inc. Objective Microscopic techniques are an essential part of otolaryngologic practice. These procedures demand advanced psychomotor and visuospatial skills, and trainees possess these abilities to varying degrees. No method currently exists to predict who will possess an aptitude for microscopic surgery. Our goal was to determine whether performance can be predicted by background experiences or skills. Study Design Retrospective cohort study. Setting Tertiary academic hospital. Subjects Students with no previous surgical experience. Interventions Subjects were surveyed on a wide range characteristics thought to affect surgical aptitude, with a primary focus on video gaming and musical training. Main Outcome Measure Subjects performed a microsurgical task using a novel simulator and their performance was assessed by blinded investigators. Results Forty-six students were assessed. There was no correlation between video gaming and improved microsurgical performance. Rather, video gamers obtained worse scores, although this difference did not reach significance. The majority of students played a musical instrument. Within this group, musicians who began playing at younger ages obtained higher scores, with the highest scores obtained by musicians who began playing before age 6. However, musicians did not obtain higher scores than non-musicians, regardless of their age of initiation. Conclusions No improvement in microsurgical aptitude was seen in subjects who had a history of video gaming or musical instrument playing.