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Huo B, Dow T, Wallace AM, French DG. Grit and Thoracic Surgery Interest Among Medical Students. JOURNAL OF SURGICAL EDUCATION 2024:S1931-7204(24)00236-8. [PMID: 38806309 DOI: 10.1016/j.jsurg.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/11/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study evaluated the relationship between medical student Grit and thoracic surgery career interest. DESIGN An online questionnaire was designed to measure self-reported ratings of Grit among medical student using the Short-Grit scale, as well as thoracic surgery career interest. SETTING Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. PARTICIPANTS From 2019 to 2021, 192/367 (52.3%) participants in their first or second year of medical school. The cohort was comprised of 109 (56.8%) females while 115 (59.9%) were <24 years of age. RESULTS Mean Grit was high (M = 4.159 +/- 0.450) among medical students. There were 80 (41.2%) students interested in thoracic surgery. There was a significant difference in Grit between students with a career interest in thoracic surgery (4.256 +/- 0.442) and those uninterested in thoracic surgery (4.089 +/- 0.444); t(190) = 2.572, p = 0.011; Cohen's D = 0.442. Career interest in thoracic surgery was not influenced by career factor interest. CONCLUSIONS Grittier students have a career interest in thoracic surgery. Recruitment teams in thoracic surgery residency programs with high rates of burnout and poor psychological wellbeing among trainees may take interest in these findings.
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Affiliation(s)
- Bright Huo
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario.
| | - Todd Dow
- Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
| | - Alison M Wallace
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia; Department of Pathology, Dalhousie University, Halifax, Nova Scotia
| | - Daniel G French
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
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2
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Di Vincenzo M, Arsenio E, Della Rocca B, Rosa A, Tretola L, Toricco R, Boiano A, Catapano P, Cavaliere S, Volpicelli A, Sampogna G, Fiorillo A. Is There a Burnout Epidemic among Medical Students? Results from a Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:575. [PMID: 38674221 PMCID: PMC11052230 DOI: 10.3390/medicina60040575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Medical students represent the ideal target group for promoting mental health and mental wellbeing, being exposed to specific risk factors, such as the content of medical training, the exposure to sickness and death, and a stressful academic routine. Medical students report high levels of cynicism and emotional exhaustion, which represent two of the essential features of burnout syndrome. In this systematic review, studies assessing the levels of burnout among medical students through validated tools worldwide were analyzed. Materials and Methods: A systematic review has been performed in order to identify studies: (1) focusing on samples of medical students; (2) evaluating burnout syndrome using validated tools; (3) providing prevalence data on burnout; and (4) written in English. Results: Out of the 5547 papers initially obtained, 64 were finally included in the analysis. The sample sizes ranged from 51 to 2682 participants. Almost all studies had a cross-sectional design; the Maslach Burnout Inventory and its related versions were the most frequently used assessment tools. The prevalence of burnout, which was stratified based on gender and academic stage, ranged from 5.6 to 88%. Burnout was mostly predicted by thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation. Conclusions: The prevalence of burnout syndrome in medical students is quite heterogeneous, reaching a peak of 88% in some countries. However, several predictors have been identified, including negative life events or poor motivation. These findings highlight the need to develop preventive interventions targeting the future generation of medical doctors, in order to improve their coping strategies and resilience styles.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Gaia Sampogna
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy (S.C.)
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Li H, Upreti T, Do V, Dance E, Lewis M, Jacobson R, Goldberg A. Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints. MEDICAL TEACHER 2024; 46:82-101. [PMID: 37405740 DOI: 10.1080/0142159x.2023.2231625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
PURPOSE Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary. METHODS Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed. RESULTS 221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once. CONCLUSIONS Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.
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Affiliation(s)
- Henry Li
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Tushar Upreti
- Max Rady College of Medicine, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
| | - Victor Do
- Department of Pediatrics, Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
| | - Erica Dance
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Melanie Lewis
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Ryan Jacobson
- Office of Advocacy and Wellbeing, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Aviva Goldberg
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
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Miyawaki Y, Sada KE, Shidahara K, Nawachi S, Asano Y, Katayama Y, Hayashi K, Katsuyama E, Katsuyama T, Takano-Narazaki M, Matsumoto Y, Oguro N, Yajima N, Ishikawa Y, Sakurai N, Hidekawa C, Yoshimi R, Ichikawa T, Kishida D, Shimojima Y, Wada J, Kurita N. The Association of Grit With Burnout Components (Professional Efficacy, Exhaustion, and Cynicism) Among Academic Rheumatologists: The TRUMP 2 -SLE Study. J Clin Rheumatol 2023; 29:268-274. [PMID: 37226300 DOI: 10.1097/rhu.0000000000001989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES There is a high prevalence of burnout among rheumatologists. Grit, which is defined as possessing perseverance and a passion to achieve long-term goals, is predictive of success in many professions; however, whether grit is associated with burnout remains unclear, especially among academic rheumatologists, who have multiple simultaneous responsibilities. Thus, the purpose of this study was to examine the associations between grit and self-reported burnout components-professional efficacy, exhaustion, and cynicism-in academic rheumatologists. METHODS This cross-sectional study involved 51 rheumatologists from 5 university hospitals. The exposure was grit, measured using mean scores for the 8-item Short Grit Scale (range, 1-5 [5 = extremely high grit]). The outcome measures were mean scores for 3 burnout domains (exhaustion, professional efficacy, and cynicism; range, 1-6; measured using the 16-item Maslach Burnout Inventory-General Survey). General linear models were fitted with covariates (age, sex, job title [assistant professor or higher vs lower], marital status, and having children). RESULTS Overall, 51 physicians (median age, 45 years; interquartile range, 36-57; 76% men) were included. Burnout positivity was found in 68.6% of participants (n = 35/51; 95% confidence interval [CI], 54.1, 80.9). Higher grit was associated with higher professional efficacy (per 1-point increase; 0.51 point; 95% CI, 0.18, 0.84) but not with exhaustion or cynicism. Being male and having children were associated with lower exhaustion (-0.69; 95% CI, -1.28, -0.10; p = 0.02; and -0.85; 95% CI, -1.46, -0.24; p = 0.006). Lower job title (fellow or part-time lecturer) was associated with higher cynicism (0.90; 95% CI, 0.04, 1.75; p = 0.04). CONCLUSIONS Grit is associated with higher professional efficacy among academic rheumatologists. To prevent burnout among staff, supervisors who manage academic rheumatologists should assess their staff's individual grit.
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Affiliation(s)
| | | | - Kenta Shidahara
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Shoichi Nawachi
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Yosuke Asano
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Yu Katayama
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Keigo Hayashi
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Eri Katsuyama
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Takayuki Katsuyama
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Mariko Takano-Narazaki
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Yoshinori Matsumoto
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Nao Oguro
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo
| | | | - Yuichi Ishikawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu
| | - Natsuki Sakurai
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Chiharu Hidekawa
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama
| | - Takanori Ichikawa
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Dai Kishida
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Yasuhiro Shimojima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto
| | - Jun Wada
- From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Lee DH, Reasoner K, Lee D. Grit: what is it and why does it matter in medicine? Postgrad Med J 2023; 99:535-541. [PMID: 37319151 DOI: 10.1136/postgradmedj-2021-140806] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/05/2021] [Indexed: 11/03/2022]
Abstract
Grit refers to the combination of passion and perseverance for long-term goals. Grit has emerged as a recent topic of interest within the medical community. With ever-increasing rates of burnout and psychological distress, increasing attention has been directed towards modulatory or protective factors for these deleterious outcomes. Grit has been studied in regard to a variety of outcomes and variables in medicine. This article reviews the current literature on grit in medicine and summarises the current research on grit and performance metrics, personality characteristics, longitudinal progression, psychological well-being, diversity, equity and inclusion, burnout and residency attrition. While there is inconclusive evidence on the influence of grit on performance metrics in medicine, research consistently demonstrates a positive correlation between grit and psychological well-being and a negative correlation between grit and burnout. After discussing some of the inherent limitations of this type of research, this article suggests some possible implications and future areas for research and their potential role in cultivating psychologically healthy physicians and promoting successful careers in medicine.
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Affiliation(s)
- Donald H Lee
- Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kaitlyn Reasoner
- Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Diane Lee
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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2022 Central Surgical Association presidential address: Grit and resilience in surgery. Surgery 2023; 173:562-566. [PMID: 36572619 DOI: 10.1016/j.surg.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/25/2022]
Abstract
Grit is a personality trait that is defined as passion and perseverance for a long-term goal. Resilience is defined as the ability to recover or adjust to misfortune or change. The 2 concepts are inexorably intertwined. Surgery residents demonstrate higher average grit scores than the general population. Increased levels of grit predict success in many areas of life and are positively correlated with satisfaction in surgery residency. Decreased levels of grit correlate with burnout, attrition, and suicidality in resident surgeons. Personal grittiness can be increased by a focused interest in an area, deliberate goal-directed practice, finding a calling in life, and cultivating hope and resilience. Resilience, like grit, can be nurtured over time with deliberate steps. Grit and resilience are important in residency training, and training programs can be tailored to promote a wise environment, with demanding, yet supportive, departments. Organizational grit can be boosted by seeking to maximize successful attributes of dynamic organizations.
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Vaysburg DM, Delman AM, Sisak S, Turner KM, Ammann AM, Cortez AR, Shah SA, Quillin III RC. Biophysiological stress and sleep deprivation among abdominal transplant surgery fellows: A prospective multi-institutional study using a wearable device. Am J Surg 2022; 225:962-966. [DOI: 10.1016/j.amjsurg.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/20/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022]
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Huo B, Dow T, Helyer L. The Relation of Grit and Surgical Specialty Interest Among Medical Students. JOURNAL OF SURGICAL EDUCATION 2022; 79:1159-1165. [PMID: 35660308 DOI: 10.1016/j.jsurg.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/14/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The assessment of Grit among medical students applying to surgical residency programs may be useful, but the relationship between student Grit and surgical specialty interest is not clear. This study investigated whether medical student Grit differs based on interest in direct-entry surgical specialties. DESIGN A literature search informed the development of a cross-sectional study assessing medical student ratings of the validated 6-item Short-Grit scale. Medical students also indicated their career preferences. SETTING Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; a tertiary medical center. PARTICIPANTS Surgical specialty interest and Grittiness were assessed among 297 (50.4%) pre-clerkship medical students in their first or second year of training. Data was collected from program applicants over 4 years. RESULTS Medical students had high levels of Grit (M = 4.029, SD = 0.517). There was a significant difference in Grit level between medical students interested in cardiac surgery ([M = 4.197, SD = 0.471 vs M = 3.919, 0.518]; t(295) = 4.674, p < 0.001; Cohen's D = 0.556), general surgery ([M = 4.178, SD = 0.466 vs M = 3.916, 0.527]; t(295) = 4.434, p < 0.001; Cohen's D = 0.520), neurosurgery ([M = 4.238, SD = 0.457 vs M = 3.950, 0.518]; t(295) = 4.412, p < 0.001; Cohen's D = 0.575), plastic surgery ([M = 4.138, SD = 0.497 vs M = 3.967, 0.520]; t(295) = 2.747, p = 0.006; Cohen's D = 0.333), and vascular surgery (M = 4.248, SD = 0.368 vs M = 3.948, 0.541); t(295) = 4.570, p < 0.001; Cohen's D = 0.501). CONCLUSIONS Medical students with a career interest in "poor lifestyle" surgical specialties have higher Grit than their peers. These findings may be noteworthy for surgical residency programs with high rates of attrition and burnout.
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Affiliation(s)
- Bright Huo
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Todd Dow
- Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lucy Helyer
- Division of General Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Zambare WV, Dechert TA, Sanchez SE, Brahmbhatt TS. Changes in Medical Student Perceptions of Surgery Are Sustainable Through Focused Preclinical Surgical Exposure. JOURNAL OF SURGICAL EDUCATION 2021; 78:1583-1592. [PMID: 33771474 DOI: 10.1016/j.jsurg.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/16/2021] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Many medical students hold negative perceptions about the surgical field that deter them from pursuing surgical training. We hypothesize that these perceptions can be sustainably changed with preclinical surgical education. DESIGN Students were administered a 10-question survey before the educational experience, immediately after completing the experience, and 1-3 years later. Survey questions focused on perceptions about surgery. Changes in responses over time were measured and analyzed. SETTING The study was performed in the setting of a voluntary preclinical surgical education experience. PARTICIPANTS Surveys were administered to 217 first-year medical students who all participated in the preclinical surgical education experience from 2017 to 2019. Follow-up surveys were administered to all cohorts simultaneously and anonymously via email. RESULTS Nine of the ten questions demonstrated statistically significant changes in perceptions from pre-experience to immediately post-experience (p < 0.048). Though attenuation was seen over time, changes in perception regarding the workload and time investment of surgical training, the role of women in surgery, and the relationships between surgeons and their patients were sustained over time (p < 0.044). CONCLUSIONS The results indicated that our model of surgical education could effect long-term changes in negative perceptions about the surgical field. Many of these negative perceptions are highly concerning to medical students. As such, success in changing perceptions about length and difficulty of training, gender inclusivity, and patient-centered care in surgery is important in increasing student interest in the surgical field. This becomes relevant in the current climate of a nationwide shortage of surgeons and the need to better attract students to this profession.
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Affiliation(s)
- Wini V Zambare
- Boston University School of Medicine, Boston, Massachusetts
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Harolds JA. Quality and Safety in Healthcare, Part LXVI: Contributing Causes of Poor Well-being in Medical Students. Clin Nucl Med 2021; 46:133-135. [PMID: 32108702 DOI: 10.1097/rlu.0000000000002969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Problems in the learning environment are the main contributing factors to medical student burnout. These issues include stresses from mistreatment, poor support, cynical supervisors, pressure to get good grades and learn a huge amount of information quickly, fatigue, lack of control, and so on. Personal risk factors include having been seriously ill recently, having a low grit score, being in debt, and having a job.
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Affiliation(s)
- Jay A Harolds
- From the Advanced Radiology Services and the Division of Radiology and Biomedical Imaging, College of Human Medicine, Michigan State University, Grand Rapids, MI
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Kassam AF, Cortez AR, Winer LK, Conzen KD, El-Hinnawi A, Jones CM, Matsuoka L, Watkins AC, Collins KM, Bhati C, Selzner M, Sonnenday CJ, Englesbe MJ, Diwan TS, Dick AAS, Quillin RC. Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows. Am J Transplant 2021; 21:307-313. [PMID: 32463950 DOI: 10.1111/ajt.16075] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 01/25/2023]
Abstract
Burnout among surgeons has been attributed to increased workload and decreased autonomy. Although prior studies have examined burnout among transplant surgeons, no studies have evaluated burnout in abdominal transplant surgery fellows. The objective of our study was to identify predictors of burnout and understand its impact on personal and patient care during fellowship. A survey was sent to all abdominal transplant surgery fellows in an American Society of Transplant Surgeons-accredited fellowship. The response rate was 59.2% (n = 77) and 22.7% (n = 17) of fellows met criteria for burnout. Fellows with lower grit scores were more likely to exhibit burnout compared with fellows with higher scores (3.6 vs 4.0, P = .026). Those with burnout were more likely to work >100 hours per week (58.8% vs 27.6%, P = .023), have severe work-related stress (58.8% vs 22.4%, P = .010), consider quitting fellowship (94.1% vs 20.7%, P < .001), or make a medical error (35.3% vs 5.2%, P = .003). This national analysis of abdominal transplant fellows found that burnout rates are relatively low, but few fellows engage in self-care. Personal and program-related factors attribute to burnout and it has unacceptable effects on patient care. Transplant societies and fellowship programs should develop interventions to give fellows tools to prevent and combat burnout.
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Affiliation(s)
- Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Cincinnati, Ohio, USA.,Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Cincinnati, Ohio, USA.,Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Leah K Winer
- Cincinnati Research on Education in Surgical Training (CREST), Cincinnati, Ohio, USA.,Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kendra D Conzen
- Department of Surgery, University of Colorado, Aurora, Colorado, USA
| | - Ashraf El-Hinnawi
- Department of Surgery, The Ohio State University, Columbus, Ohio, USA
| | | | - Lea Matsuoka
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Anthony C Watkins
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA
| | - Kelly M Collins
- Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Chandra Bhati
- Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Markus Selzner
- Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada
| | | | | | - Tayyab S Diwan
- Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - André A S Dick
- Department of Surgery, University of Washington, Seattle, Washington, USA.,Seattle Children's Hospital, Seattle, Washington, USA
| | - Ralph C Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Cincinnati, Ohio, USA.,Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
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Jumat MR, Chow PKH, Allen JC, Lai SH, Hwang NC, Iqbal J, Mok MUS, Rapisarda A, Velkey JM, Engle DL, Compton S. Grit protects medical students from burnout: a longitudinal study. BMC MEDICAL EDUCATION 2020; 20:266. [PMID: 32787919 PMCID: PMC7425562 DOI: 10.1186/s12909-020-02187-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/04/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Burnout is a serious issue plaguing the medical profession with potential negative consequences on patient care. Burnout symptoms are observed as early as medical school. Based on a Job Demands-Resources model, this study aims to assess associations between specific job resources measured at the beginning of the first year of medical school with burnout symptoms occurring later in the first year. METHODS The specific job resources of grit, tolerance for ambiguity, social support and gender were measured in Duke-NUS Medical School students at the start of Year 1. Students were then surveyed for burnout symptoms at approximately quarterly intervals throughout the year. Using high ratings of cynicism and exhaustion as the definition of burnout, we investigated the associations of the occurrence of burnout with student job resources using multivariable logistic regression analysis. RESULTS Out of 59 students, 19 (32.2%) indicated evidence of burnout at some point across the first year of medical school. Stepwise multivariable logistic regression analysis identified grit as having a significant protective effect against experiencing burnout (Odds Ratio, 0.84; 95%CI 0.74 to 0.96). Using grit as a single predictor of burnout, area under the ROC curve was 0.76 (95%CI: 0.62 to 0.89). CONCLUSIONS Grit was identified as a protective factor against later burnout, suggesting that less gritty students are more susceptible to burnout. The results indicate that grit is a robust character trait which can prognosticate burnout in medical students. These students would potentially benefit from enhanced efforts to develop grit as a personal job resource.
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Affiliation(s)
- Muhammad Raihan Jumat
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
| | - Pierce Kah-Hoe Chow
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
- Singapore General Hospital, Singapore, Outram Road, Singapore, 169608, Singapore
| | - John Carson Allen
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
| | - Siang Hui Lai
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
- Singapore General Hospital, Singapore, Outram Road, Singapore, 169608, Singapore
| | - Nian-Chih Hwang
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
- Singapore General Hospital, Singapore, Outram Road, Singapore, 169608, Singapore
| | - Jabed Iqbal
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
- Singapore General Hospital, Singapore, Outram Road, Singapore, 169608, Singapore
| | - May Un Sam Mok
- Singapore General Hospital, Singapore, Outram Road, Singapore, 169608, Singapore
| | - Attilio Rapisarda
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore
| | - John Matthew Velkey
- Department of Psychology and Neuroscience, Duke University School of Medicine, North Carolina, 27708, Durham, USA
| | - Deborah Lynn Engle
- Department of Psychology and Neuroscience, Duke University School of Medicine, North Carolina, 27708, Durham, USA
| | - Scott Compton
- Office of Education, Duke-NUS Medical School, 8 College Rd., Level 3, Singapore, 169857, Singapore.
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Kassam AF, Cortez AR, Winer LK, Kuethe JW, Athota KP, Quillin RC. The impact of medical student interest in surgery on clerkship performance and career choice. Am J Surg 2020; 219:359-365. [DOI: 10.1016/j.amjsurg.2019.09.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/05/2019] [Accepted: 09/30/2019] [Indexed: 11/25/2022]
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Cortez AR, Winer LK, Kassam AF, Hanseman DJ, Kuethe JW, Sussman JJ, Quillin RC. Exploring the relationship between burnout and grit during general surgery residency: A longitudinal, single-institution analysis. Am J Surg 2019; 219:322-327. [PMID: 31623881 DOI: 10.1016/j.amjsurg.2019.09.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/24/2019] [Accepted: 09/30/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND How burnout changes during general surgery residency remains unknown. METHODS From 2015 to 2018, general surgery residents completed the Maslach Burnout Inventory and Grit Scale. Statistical analyses were adjusted for repeated measures and compared to the incoming intern level. RESULTS Fifty-five residents participated in this study. Burnout rates varied by program level, with an increased risk occuring in the third clinical year (OR = 11.7, p = 0.03). Emotional exhaustion (EE) peaked during the first and third clinical years, depersonalization (DP) peaked during the first and second clinical years, and personal achievement (PA) reached a nadir during the third clinical year (all p < 0.05). Residents with burnout had lower grit scores compared to those without burnout (3.71 vs 4.02, p < 0.01). Increasing grit was linearly associated with decreasing EE, decreasing DP, and increasing PA (all p < 0.05). CONCLUSIONS Burnout varies throughout surgical residency, and grit is inversely related to burnout.
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Affiliation(s)
- Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
| | - Leah K Winer
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Dennis J Hanseman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Joshua W Kuethe
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey J Sussman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - R Cutler Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
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Shelton J, Obregon M, Luo J, Feldman-Schultz O, MacDowell M. Factors Influencing a Medical Student’s Decision to Pursue Surgery as a Career. World J Surg 2019; 43:2986-2993. [DOI: 10.1007/s00268-019-05167-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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