Generational Differences in Grit, Self-Control, and Conscientiousness Among Orthopaedic Surgeons: From Millennials to Baby Boomers.BACKGROUND
 The training process and practice of orthopaedic surgery is demanding and arduous.  Accordingly, grit, self-control, and conscientiousness are desirable qualities in orthopaedic surgeons.  Some established orthopaedists have expressed concern that the future generation of surgeons may not possess the same level of grit as their predecessors.  The purpose of this study was to evaluate levels of grit among attending orthopaedic surgeons, identify predictors of grit in orthopaedic surgeons, and compare grit scores between attending surgeons and orthopaedic residency applicants.  We hypothesized that applicants would demonstrate lower grit and self-control scores but greater conscientiousness scores than attending surgeons.


 A total of 2,342 attending orthopaedic surgeons and 895 orthopaedic residency applicants from the 2016-2017 National Resident Matching Program (NRMP) were given surveys that quantified their grit, self-control, and conscientiousness.  Demographic and career information also was collected.


 Assessments were completed by 655 (28%) of 2,342 practicing orthopaedic surgeons and 455 (50.8%) of 895 orthopaedic residency applicants.  The residency applicants demonstrated higher mean grit scores (4.12 of 5.0) than the attending orthopaedic surgeons (4.03) (p < 0.01).  These average scores placed applicants and attending surgeons at the 70th and 65th percentile, respectively, when compared with the general population.  There were no differences in self-control (p = 0.68) or conscientiousness (p = 0.93) between the 2 groups.  Attending surgeons with more publications had increased grit (p < 0.01), self-control (p = 0.04), and conscientiousness (p = 0.01) scores.  Attending surgeons who had been inducted into the Alpha Omega Alpha honor society as medical students demonstrated greater conscientiousness scores than those who were not members (p = 0.04).


 CONCLUSIONS
 Orthopaedic residency applicants were at least as gritty, consistent in their interest, persevering in their efforts, and ambitious as currently practicing orthopaedic surgeons.  Although these results may be encouraging and diverge from some preconceived perceptions of "millennials," it is unclear if they will be predictive of career success in the next generation of orthopaedists.
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