The Importance of Grit in Medical Training

Medical school admissions and residency selection committees are faced with the daunting task of using limited information to predict which applicants are most likely to succeed in the medical profession. Although standardized test scores may predict academic success to an extent, an added objective measure of “grit” may be helpful in predicting career success in this demanding field.

Grit has been defined as “perseverance and passion for long-term goals.”¹ Assessed by a validated 12-item scale,¹ grit provides a better predictor of success than standardized test scores in many contexts. For example, the grit metric proved better than Scholastic Aptitude Test (SAT) scores at predicting West Point cadet dropout rates and undergraduate grade point average (GPA). Within the field of medicine, grit has been associated with decreased burnout rates and increased psychological well-being among residents.²

Some have suggested that grit should be integrated into the medical school admissions process by asking recommenders to speak to an applicant's perseverance or by inquiring about grit during the interview process.³ We echo these sentiments and wish to bring attention to another measure of grit, noting that it may also be highly useful in the resident selection process.

To understand how to apply the concept of grit to assessing medical school or residency candidates, we can apply insights from a recent study⁴ in education, which showed that novice teachers who scored higher on a measure of grit outperformed their peers and were less likely to leave the classroom midyear. No other factors predicted teacher retention or effectiveness, including previous leadership experience, college GPA, and demographic information. In this study,⁴ teachers' resumes were assigned scores based on objective determinations of the length of previous involvements and success; points were awarded for college activities or work experiences lasting at least 2 years, and additional points were awarded for achievement, such as being a club president. The sum of the 2 highest-scoring activities was the objective measure of grit.

While this scale has not yet been validated in medical education, we expect grit to be an important metric in undergraduate and graduate medical education. More research should be done in medical school and residency to define the relationship of grit to performance. As both medical school admissions committees and groups that decide on resident applicants need access to the requisite data, we suggest that the academic medical community assess objective measures of grit in their review of applicants.