• Hakeem J Shakir, Justin M Cappuzzo, Hussain Shallwani, Amanda Kwasnicki, Carli Bullis, Jiefei Wang, Ryan M Hess, and Elad I Levy.
• Department of Neurosurgery, Jacobs School of Medicine at the University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
• World Neurosurg. 2020 Feb 1; 134: e224-e236.

IntroductionStudies have begun investigating grit (continued fortitude in the face of hardship) and resilience (ability to recover from a setback) and their relationship to burnout (emotional exhaustion [EE] caused by prolonged stress or frustration) within medicine. We investigated the prevalence of burnout among neurosurgery residents and aimed to determine the relationship among burnout, grit, and resilience.MethodsWe surveyed U.S. neurosurgical residents to perform a discretional analysis of prevalence of burnout. Multivariate analysis was performed to determine which variables were associated with higher and lower levels of EE, depersonalization (DP), personal accomplishment (PA), burnout, grit, and resilience.ResultsOf 1385 U.S. neurosurgery residents, 427 (30.8%) responded to our survey. Burnout prevalence was 33.0% (95% confidence interval, 28.6%-37.7%). High grit was associated with U.S. graduates (P = 0.006), married residents (P = 0.025), and fewer social/personal stressors (P = 0.003). Lower resilience was associated with female sex (P = 0.006), whereas higher resilience was associated with international medical graduates (P = 0.017) and fewer social/personal stressors (P = 0.005). High burnout was associated with greater social/personal stressors (P = 0.002), clinical rotations (P = 0.001), and lack of children (P = 0.016). There were positive correlations between EE and DP and among PA, grit, and resilience. There were negative correlations for EE and DP with PA, grit, and resilience and between grit/resilience and burnout.ConclusionsThere is an inverse relationship between grit/resilience and burnout. Increased social/personal stressors are associated with increased levels of burnout and decreased grit and resilience. Grit and resilience are higher when social and personal stressors are decreased, indicating that these characteristics may fluctuate over time.Copyright © 2019 Elsevier Inc. All rights reserved.

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