In 1839 he became surgeon to the Royal Infirmary, and Fellow of the Royal Society of Edinburgh, and already shared the highest surgical practice with Syme. In fact there was hardly room for two such men in Edinburgh. Liston had betaken himself to London. In 1840 Fergusson followed his example, accepting an invitation to King’s College, which was now establishing its hospital. At a farewell presentation, Lizars said that he had seen no one, not even Liston himself, surpass Fergusson in the most trying and critical operations. The man of whom this could be said at the age of thirty-two had every chance of success in London, even though he came thither with scarcely any personal friends to back him. Professor Partridge, his old friend, gave him a cordial introduction, and he established himself in Dover Street, Piccadilly, only to find that his first year’s private practice did not exceed £100. Yet it cannot be denied that Fergusson came to London at a fortunate period. Within a few years death or retirement withdrew from practice many of the most capable operators, such as Liston, Aston Key, and Astley Cooper. Thus his success was really rapid, for his third year brought him £1000, and in 1847 he removed to a large house in George Street, Hanover Square. His style of operating soon attracted general attention both among students and practitioners, and King’s College operating theatre became the resort of all the medical students and practitioners who could cram into it. As an operator Fergusson was most peculiarly skilled, and he appears to have had a natural manipulative dexterity, which he assiduously cultivated. Like Sir Charles Bell and other eminent surgeons, he was a splendid fly-fisher; and his manipulation served him in good stead in acquiring skill on that most difficult of instruments, the violin. Carpentering and metal-working came easily to him, and gave him great readiness in improvising splints or other apparatus desirable for his patients’ special circumstances. Yet having such power and dexterity, he did not choose to display it on all possible occasions, but rather was conspicuous for his frequent abstinence from operative interference, counting it a greater glory to save a limb than to cut one off, and taking endless trouble to preserve a portion when amputation would have been much easier.