Abstract
BACKGROUND: Grit refers to a combination of perseverance and passion, which is essential for long-term success. Grit is associated with higher education attainment and a lower likelihood of burnout. Understanding how grit evolves during internal medicine residency training is important for providing better support to residents. The primary objective of the current study was to evaluate potential changes in the level of grit throughout the training program and investigate the association between grit and stress levels, quality of life (QoL), and satisfaction of learning scores. METHODS: We conducted a prospective study involving internal medicine residents enrolled in training programs from July 2022 to July 2023, except for the second-third-year residents of dermatology and neurology programs and the third-year residents of haematology and oncology programs, which are not part of the same training regimen. Data collection was conducted using questionnaires at the beginning of the training year and every three months until the end. Collected data included age, gender, habitat, working experience, financial burden, marital status, rotations, grit scores, QoL, stress score, and satisfaction of learning score during each trimester. Changes in grit over the year were examined using repeated measures analysis of variance adjusted by training program, financial status, working experience, habitat, marital status, and age. We performed multivariable linear regression models to explore associations between grit and the following domains: QoL, ST-5, and SoLs. RESULTS: Of 122 internal medicine residents in all three years of training, one resident dropped out during training, and another declined to participate. A total of 120 residents were included. Grit did not significantly change over time. Subgroup analysis of the first-year resident group revealed that grit significantly decreased (P = 0.049). Multivariable analysis revealed that grit was positively associated with QoL (β = 0.01, P < 0.001) and satisfaction of learning score (β = 0.07, P < 0.001) but inversely associated with stress score (β = - 0.04, P < 0.001). CONCLUSIONS: Of all residents, grit did not change over a year. However, only the first-year residents reported a decrease in grit during a training year. Throughout first-year residents' internal medicine residency training, grit was positively associated with QoL and satisfaction of learning score but negatively associated with stress level. These findings suggest the need for targeted interventions to support first-year residents and enhance their resilience throughout training.