Objective ‘Grit’ can be defined as the passion and perseverance for long term goals, and it can be measured using a validated 12 item scale.Grit has been shown to correlate with seniority amongst ENT surgeons in the UK.Emergency Medicine trainees consistently report high levels of burnout, and amongst UK trainees, doctors working in Emergency Medicine posts are more likely to rate the intensity of their work in these posts as ‘very heavy’ than other medical training posts.As is the case with ENT surgeons, it might be expected that grit is necessary to progress through training.This study aimed to examine the relationship between grit and progression through training years in Emergency Medicine, and the relationship between grit, burnout, anxiety and depression.

Design This was a prospective, survey based study, using four validated tools: the Short Grit Scale; the Oldenburg Burnout Inventory, the Generalised Anxiety Disorder Assessment (GAD7), and the Patient Health Questionnaire (PHQ-9).

Setting UK based trainees in Emergency Medicine, working as part of a nationally recruited training programme leading to the award of a CCT in Emergency Medicine.

Participants A total of 432 trainees completed the study, split across 6 years of training from ST1 to ST6, the normal end-point of UK Emergency Medicine training.Progression through training by grade is associated with increased grit scores (r=0.49, p<0.05).Burnout scores were high in all stages of training with no respondent scoring low risk of burnout, and all grades averaged ‘high or very high’ risk of burnout.Trainees who undertook additional locum work alongside training had significantly lower burnout scores than those who didn’t (p<0.05), but no significant difference in grit scores.There was no significant correlation between grit and PHQ9 or GAD7 scores, nor between burnout and PHQ9 or GAD7 scores.

Conclusion Grit is an important feature in progression through training in Emergency Medicine.Burnout in Emergency Medicine is so prevalent that the inventory used to detect it may no longer discriminate effectively in this cohort.