PS6-02: EXPLORING THE RELATIONSHIP BETWEEN BURNOUT AND GRIT DURING GENERAL SURGERY RESIDENCY
Alexander R Cortez, MD, Leah K Winer, MD, Al-Faraaz Kassam, MD, Joshua W Kuethe, MD, Jeffrey J Sussman, MD, R. Cutler Quillin III, MD; University of Cincinnati

Introduction: With increasing emphasis on resident wellbeing, efforts to identify those at-risk and mitigate burnout have become a predominant focus in residency education. Grit, a measure of perseverance, has been associated with improved wellbeing and decreased  risk of attrition. Our objective was to evaluate the longitudinal relationship between burnout and grit during surgical residency training.

Methods: During the 2015 to 2018 academic years, surgical residents completed the Maslach Burnout Inventory and Grit Scale. Residents were grouped by level of training. Burnout was defined as having 2 of the following 3 criteria: high emotional exhaustion (EE; ≥ 27), high depersonalization (DP; ≥ 13), or low personal achievement (PA; < 31). Grit was measured 1 to 5, with 5 being high. A p-value <0.05 was considered statistically significant.

Results: Fifty-five general surgery residents completed a median of 2 surveys (range 1-3) over the consecutive three-year period for a total of 103 unique entries. The mean grit score was 3.96 ± 0.42, which did not differ by training level (p=0.31). Overall, residents had low EE (16 ± 9), moderate DP (9 ± 5), and high PA (37 ± 8); however , there was significant variability in burnout associated with resident training level (p=0.03) (FIGURE). There were also significant differences in EE (p=0.03), DP (p=0.03), and PA (p=0.02) among the groups and post-hoc analysis suggests that DP peaked at the junior resident level (p=0.04), while EE was highest at the senior resident level (p=0.02). Overall, residents with burnout were found to have lower grit scores compared with those without burnout (3.71 ± 0.42 vs 4.02 ± 0.42, p=0.01). Moreover, there was a linear relationship between increasing grit and decreasing EE, decreasing DP, and increasing PA (all p<0.05). On multivariate analysis, higher grit conferred a protective effect against burnout (OR=0.21, CI 0.1-0.8, p=0.02).

Conclusions: High rates of burnout have been reported among surgical residents. We found that burnout fluctuates during surgical residency depending on training level, and that grit is an important individual-level characteristic that may identify those at risk for burnout.