Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Office for Student Affairs, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Mil Med. 2023 May 18;188(Suppl 2):43-49. doi: 10.1093/milmed/usac205.
The field of medicine is experiencing a crisis as high levels of physician and trainee burnout threaten the pipeline of future physicians. Grit, or passion and perseverance for long-term goals, has been studied in high-performing and elite military units and found to be predictive of successful completion of training in adverse conditions. The Uniformed Services University of the Health Sciences (USU) graduates military medical leaders who make up a significant portion of the Military Health System physician workforce. Taken together, an improved understanding of the relationships between burnout, well-being, grit, and retention among USU graduates is critical to the success of the Military Health System.
The current study was approved by the Institutional Review Board at USU and explored these relations among 519 medical students across three graduating classes. These students participated in two surveys approximately one year apart from October 2018 until November 2019. Participants completed measures on grit, burnout, and likelihood of leaving the military. These data were then merged with demographic and academic data (e.g., Medical College Admission Test scores) from the USU Long Term Career Outcome Study. These variables were then analyzed simultaneously using structural equation modeling to examine the relationships among variables in a single model.
Results reaffirmed the 2-factor model of grit as both passion and perseverance (or interest consistency). No significant relationships emerged between burnout and other study variables. Sustained and focused interest was predictive of less likelihood of staying in the military.
This study offers important insights into the relationship among well-being factors, grit, and long-term career planning in the military. The limitations of using a single-item measure of burnout and measuring behavioral intentions in a short time frame during undergraduate medical education highlight the importance of future longitudinal studies that can examine actual behaviors across a career lifespan. However, this study offers some key insights into potential impacts on the retention of military physicians. The findings suggest that military physicians who are most likely to stay in the military tend to embrace a more fluid and flexible medical specialty path. This is critical in expectation setting for the military to train and retain military physicians across a wide range of critical wartime specialties.
医学领域正面临一场危机，因为医生和学员的高度倦怠威胁着未来医生的供应。毅力，即对长期目标的热情和毅力，已在表现出色和精英军事单位中进行了研究，并发现它可以预测在恶劣条件下完成培训。美国卫生科学统一服务大学（USU）培养的军事医疗领导人构成了军事卫生系统医师劳动力的重要组成部分。总的来说，更好地了解 USU 毕业生的倦怠、幸福感、毅力和保留率之间的关系，对于军事卫生系统的成功至关重要。
本研究得到了 USU 机构审查委员会的批准，探讨了这三个毕业班的 519 名医学生之间的这些关系。这些学生在 2018 年 10 月至 2019 年 11 月期间大约相隔一年参加了两次调查。参与者完成了关于毅力、倦怠和离开军队的可能性的测量。然后，将这些数据与 USU 长期职业结果研究的人口统计学和学术数据（例如，医学院入学考试成绩）合并。然后，使用结构方程模型同时分析这些变量，以在单个模型中检查变量之间的关系。
结果再次证实了毅力的 2 因素模型，即热情和毅力（或兴趣一致性）。倦怠与其他研究变量之间没有显着关系。持续和专注的兴趣与留在军队的可能性较小相关。
这项研究提供了有关军人中幸福感因素、毅力和长期职业规划之间关系的重要见解。在本科医学教育中使用单一倦怠测量和在短时间内测量行为意向的局限性突出了未来的纵向研究的重要性，这些研究可以在整个职业寿命内检查实际行为。然而，这项研究提供了一些关于对军事医生保留率的潜在影响的关键见解。研究结果表明，最有可能留在军队的军队医生往往更倾向于接受更灵活和灵活的医疗专业路径。这对于军队培训和保留各种关键战时专业的军队医生至关重要。
