Like most people, I loved the real surgeries in the game and started getting annoyed when the rest of the game turned into "well, here's what you did before, only it's more frustrating!" Not to say that it's bad, but the believability and the repetition just pretty much removed me from the rest of the game.
Overall, I'm still thrilled with Trauma Center, but I don't think I'll be buying my own copy for a while, at least not until it hits $15 or so. Fantastic premise, insanely good controls, writing, and characters, but god, I dislike the repetition of the GUILT.
Here's hoping for a quality sequel!