title: Survival of the Grittiest? Consultant Surgeons Are Significantly Grittier Than Their Junior Trainees.
abstract: OBJECTIVE
  "Grit" can be defined as the passion and perseverance for long-term goals, and it can be measured by a validated scale. It has been associated with success in diverse fields such as basic military training and spelling tests. Surgical training is arduous with large number of trainees reporting burnout, and it could be expected that grit is a fundamental requirement to complete training. This study aimed to examine the relationship of grit in surgical training, whether grit varies by grade of surgeon, and the association of grit with burnout.
  
  
  METHODS
  This was a prospective survey-based study, using the validated tools Short Grit Scale and Oldenburg Burnout Inventory.
  
  
  METHODS
  UK-based ear, nose, and throat doctors based in secondary care were invited to participate.
  
  
  METHODS
  Ear, nose, and throat surgeons were used as the sample population, with subgroups of core trainees (core surgical trainees), specialist registrars (higher surgical training), and consultants.
  
  
  RESULTS
  A total of 102 participants completed the study (33 core surgical trainees, 49 mid-career trainees in higher surgical training, and 22 consultants). Consultants were significantly grittier than trainees (p < 0.05). Grit had a significant inverse relationship with burnout (r = -0.54, p < 0.05). There was a nonsignificant trend of reduced burnout in consultants. Age and sex were not associated with grit or burnout.
  
  
  CONCLUSIONS
  These findings reinforce the concept that grit is fundamentally important to completion of surgical training. In addition, grittier individuals are more likely to resist burnout than their less gritty counterparts. These findings carry implications for retention and recruitment of trainee surgeons, and further study is required to investigate whether surgical training influences grit levels or selects out the grittiest trainees to survive to completion.
authors.affiliation: Department of ENT Surgery, St George's Hospital, London, United Kingdom. Electronic address: abiwalker@doctors.org.uk.
authors.forename: Abigail
authors.initials: A
authors.lastname: Walker
authors.affiliation: London Specialty School for Surgery, Health Education South London, London, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Hines
authors.affiliation: London Specialty School for Surgery, Health Education South London, London, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Brecknell
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000523:psychology; D002983:Clinical Competence; D005260:Female; D006040:Goals; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D010036:Otolaryngology / Q000193:education*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000523:psychology; D066231:Surgeons / Q000523:psychology*; D006113:United Kingdom
keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; burnout; grit; surgeon