True Grit: The Tale of American Integrated Plastic Surgery Residency Applicants

J Surg Educ. 2024 Dec 30;82(2):103371. doi: 10.1016/j.jsurg.2024.103371. Online ahead of print.

Abstract

Introduction: Selecting candidates for plastic and reconstructive surgery (PRS) residency is complex, involving academic metrics and intrinsic personal qualities. "Grit"-perseverance and passion for long-term goals may be one of these valued qualities. This study investigates how grit scores relate to securing a PRS residency, hypothesizing that higher grit correlates with greater matching success.

Methods: After match day, an email survey was distributed to all the applicants of Rush University Medical Center's integrated PRS program during the academic years 2021-2022 and 2022-2023. This survey included items regarding match results and a validated grit questionnaire. We calculated baseline differences among the study participants. Correlation between grit score, academic achievements, and match was performed with univariate analyses using the Spearman correlation for continuous variables and the Wilcoxon rank sum test.

Results: The program received 616 applications, of which 132 (21%) responded to the grit survey. Among the responders, 97 (74%) reported matching into PRS, versus 35 (27%) who did not. After adjusting for multiple confounders, higher grit score was found to be associated with significantly lower odds of matching into PRS residency (OR 0.13, p-value 0.03). Higher Step 1 and 2 CK scores, number of publications, and female gender were associated with greater odds of matching.

Conclusion: Our study did not identify any association between higher grit and matching successfully in PRS. After adjusting for confounders, we observed significantly higher grit scores among applicants who did not match into PRS, which may be related to the psychological phenomenon of increased perseverance as people reflect on their perceived failures.

Level of evidence: IV (Cross-sectional study).

Keywords: academia; grit; medical students, plastic surgery, professionalism; residency applicants.