Episode Transcript
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0:09
Hello. And welcome back to doctor informed.
0:11
You're listening to DI two episode
0:13
seven. This is a podcast brought to you
0:16
by the BMJ and sponsored by Medical
0:18
Protection. Doctor informed
0:20
is primarily for those doctors working in hospitals,
0:23
taking you beyond medical knowledge and
0:25
talking about all those things that you need know
0:27
be a doctor, but which don't involve
0:29
medicine. I'm Clara
0:31
Munro, a general surgical registrar in
0:34
the northeast of England, and I work as a freelance
0:36
clinical editor at the BMJ. In
0:39
our new season of doctor informed, we will
0:41
be discussing topics relevant to hospital
0:43
dot Those often not covered formally
0:46
in teaching, which can and
0:48
today I hope will inspire some debate
0:50
amongst doctors. Today,
0:52
we will be talking about grit, what
0:54
it is, how it relates to medicine,
0:57
and whether we should be considering using
0:59
grit score worrying when recruiting doctors,
1:01
either to medical school or to specialty.
1:04
The definition of grit was developed by Angela
1:06
Duckworth, an and psychologists and
1:08
researcher. Grit refers to
1:11
the combination of passion and perseverance
1:13
for long term and meaningful goals. It
1:16
is the ability to persist at something you
1:18
feel passionate about even when
1:20
doing so can seem hard. Both
1:22
in the UK and right around the world right
1:24
now. Many doctors are choosing to leave the profession.
1:27
In the wake of the pandemic, we are seeing more
1:29
and more reports of poor well-being amongst
1:31
healthcare professionals with burnout high.
1:34
What can grit tell us about this? Do
1:36
we all just need more grit? Or even
1:38
the grittiest people limited when faced with a
1:40
pandemic? Waiting lists or failing health
1:43
systems. Can understanding grit
1:45
help support clinicians better? I'm
1:53
thrilled today to be joined by our panel
1:55
and our ex but joining us
1:57
is Simone
1:58
Batching, a neurosurgeon working
2:00
in Brooklyn, New York, who has researched
2:02
extensively on this subject. Thank
2:05
you, Clara. I've been here
2:07
for about sixteen years now.
2:09
And as a female neurosurgeon,
2:12
I am in great minority
2:14
here in the United States where about seven
2:17
percent of neurosurgeons at
2:19
this point are female. I
2:22
had the distinct pleasure many years
2:25
ago now to seeing Angela Duckworth
2:27
talk about grit in person.
2:30
And at that point, Afterwards,
2:32
I was thinking what
2:35
I had been through through my
2:37
training as a medical
2:40
student and then as a resident in
2:42
neurosurgery, and even
2:44
as an attending as years went on. And
2:47
then what all of us as
2:49
physicians have to go through to get to where
2:51
we are and started to think about
2:53
the question of grit and medicine, my
2:57
focus was also looking at written
2:59
gender. And so I called
3:01
up Professor Duckworth and I
3:03
said, you know, what do you think?
3:05
And she had never been able to
3:07
find a difference really meaningfully between
3:10
men and women in even the most difficult
3:12
fields, but sent me on my and has
3:14
given me great advice and
3:17
had a lot of meaningful conversations with
3:19
her about grit and medicine since then.
3:22
So I did publish a paper several
3:25
years ago now looking at written surgeons.
3:27
The punch line really being that there
3:29
was no difference in gender between
3:33
men and women's surgeons. This is amongst
3:36
about eleven hundred surveys.
3:39
The interesting point and I think we can probably
3:41
dig into it a little more later of what
3:43
we did see was that While
3:46
there was a correlation with burnout, and
3:48
think that's something that's been documented and
3:50
discussed in the past, interestingly, women
3:54
had the same grit
3:56
scores as men, but higher burnout
3:59
rates. And so I think when you're thinking
4:01
about medicine and burnout as you talk about
4:03
in the introduction. It's interesting
4:06
to think about, you know, it's not
4:08
grid alone, but what else could it be
4:11
And, you know, we had our own hypotheses
4:13
of what those things might be that were also
4:15
protective or predictive
4:18
of a burnout that we can dig into
4:20
later. Well, I can't
4:22
wait to talk about this. And I'm
4:24
really pleased to be joined by the rest of our
4:26
panel today. We have some familiar
4:28
faces. We're joined again by
4:30
DeKlin. DeKlin, would you like to remind
4:33
our listeners about yourself?
4:35
Yes. Hi. And Dechlema
4:37
Murphy, a current academic ophthalmology
4:39
training up in the north
4:41
of England. Find this topic
4:43
absolutely fascinating. And I think particularly around,
4:45
you know, the the concerns with
4:47
the NHS and the the workforce problems as
4:50
well that we're having So
4:52
I'm really really interested and really excited
4:54
to have a discussion about
4:55
it. And after a bit of a break,
4:57
I am thrilled Ayesha is back with us
4:59
on the podcast. Ayesha for days
5:01
of our listeners who have not been with us
5:03
from the
5:04
beginning, shocking. Would you like
5:06
to reintroduce yourself? Yeah.
5:08
Sure. Thanks, Clara, and thanks for having me again.
5:10
So, hi, everyone. My name is Ayesha Ashmore.
5:13
I am an awesome guy in New Jersey in the East
5:15
Midlands. And super
5:17
interested in this topic as well. It's caused
5:20
lots of contentious
5:22
arguments in my household. So I'm
5:25
I'm interested to where this discussion
5:27
takes us. Excellent.
5:34
Those who have listened to the first few
5:36
episodes of our next series. We'll know
5:38
that we like to get ourselves warmed up
5:41
by discussing what people are talking
5:43
about on the wards or what has been in the
5:45
news recently. I can't take
5:47
credit for this one, but one of our other panelists
5:49
drew my attention to this story of Daymar
5:52
Hamlin, a defensive back
5:54
who plays for the NFL American
5:56
football team Buffalo Bills. In
5:59
a high profile match up against the Cincinnati
6:01
Bangers, the young player
6:03
born in nineteen ninety eight, makes
6:06
you feel very old. Collapse on the
6:08
pitch whilst playing having had a
6:10
cardiac
6:10
arrest. Did anyone else see
6:12
this story? Does anyone else read about this?
6:15
Yeah. I saw it. And III
6:18
don't It was it was interesting to
6:20
see all of the kind of coverage around
6:22
it because you know, there was this
6:24
whole thing about heart attacks and cardiac arrest
6:26
again. And there's so much
6:28
like misinformation even on reputable
6:31
news sites. I think something even
6:33
I think on the BBC, I think I saw something
6:36
which was factually incorrect and
6:39
it just and it brought back all of the
6:41
stuff about, you know, footballers in
6:44
in the in the last few years. What what was his name
6:46
again? Christian Erickson, and
6:48
all of all of what happened
6:50
with him and it was just fascinating to
6:52
see that actually there's still
6:55
no learning from from
6:57
a kind of generalistic perspective about medical
6:59
conditions and diseases. Do you think
7:01
that has a big impact on
7:04
public perception? I think so
7:06
because especially how
7:10
people perceive what
7:12
these kind of medical conditions are and what
7:14
may relate to them. So I think we were talking
7:16
about anti vaxes and
7:19
how they think that this might be related to
7:21
the COVID vaccine. And that's why we're seeing so
7:23
many young professionals
7:25
and athletes collapsing everywhere.
7:29
So nothing has changed. Yeah.
7:32
I thought it was really interesting as well. Like,
7:35
you know, I'm looking at the the
7:37
tweet, so one in the Georgia
7:39
congresswomen Marjorie Taylor Green
7:41
tweeted. Before the COVID
7:44
vaccines, we didn't see athletes dropping dead on
7:46
the playing field like we do now at time to investigate
7:48
the COVID vaccines. That tweet
7:50
has been viewed around, well,
7:53
over a million times a day for the
7:55
last three days since it went up,
7:58
which shocks me that people were, you know,
8:00
we're still getting this level of of misinformation.
8:03
Decking you're a football fan. What do you think
8:05
about this?
8:06
First of all, I'm not a football fan. What? I'm
8:10
an I'm an American football
8:11
fan. It's every
8:12
time Hey. So this is an American football fan. It was
8:14
am however a a basketball fan
8:16
even though I'm about five seven. So
8:19
I have some interest in the spot. Yes.
8:21
And I think it's really interesting. think there's
8:23
there's couple of things. I think, firstly,
8:25
if you know, the classic discrepancy
8:28
between cardiac arrest and and
8:30
heart attack. You know, that's been going on
8:32
forever. And clearly, we're not doing something well
8:34
enough to inform public. I've always
8:36
of the opinion that, you know, the general public aren't
8:38
stupid. We're perhaps
8:40
just not com communicating that well enough
8:42
to them. So I think the last part
8:44
of the thing, we're actually we as, like, you know,
8:46
medical professional have to take some responsibility, as
8:49
well as the journalists also have to
8:52
in terms of how they actually are communicating
8:55
with the public because it's a very basic
8:57
concept and refuse to
8:59
believe that the public aren't able to understand
9:01
that. So I think, yeah, that's one interesting
9:04
thing. And then you have the other
9:06
side of thing, the misinformation. Where,
9:09
you know, clearly, there are groups who
9:12
are knowingly, you know, attributing
9:14
these things to COVID,
9:17
for example, And then you have the public
9:19
who, again, I feel aren't
9:22
stupid, but perhaps
9:24
haven't been kind of
9:26
educated in how to critically
9:28
appraise information. And again, I think in
9:30
in some ways that's kind of our responsibility
9:33
as medical professionals always just educated as
9:35
full stop. So it's really interesting
9:37
and these things pop up every single time. There's
9:39
something, you know, in the news about a health
9:41
relate a health related thing to any celebrity
9:44
I think Rod Gilbert is in is in
9:46
the news at the moment with his prostate cancer and
9:49
there's a lot of kind of
9:51
lack of understanding about that as well. So
9:54
Yeah. I mean, I just kinda looked at it and I was like, well,
9:56
we really need to start educating people better
9:58
and the medias that we use to educate
10:00
people need to be aligned with
10:03
what, you know, helps people to understand things.
10:06
But, yeah, the whole misinformation side of
10:08
thing as well is just I I don't
10:10
know how I don't know how it's a a
10:11
problem, sadly. I think there's quite a
10:14
lot to do with us as medical professionals. There's
10:16
been like this massive push to go
10:18
jargon free. But there hasn't been
10:20
like a kind of quality control for the
10:22
jargon free language that we use. So
10:24
I think because there isn't this kind of standard,
10:27
on how to use nonmedical language. We
10:29
ourselves as medics may be getting
10:31
it wrong when we're describing
10:33
things, not using medical
10:35
language. And then that's being propagated. Yeah.
10:38
And I think similarly with kind of like
10:40
the explosion of Twitter, I think people are also
10:42
using medical language, but inappropriately. So,
10:45
you know, don't have not the qualifications, but
10:47
haven't been educated in that field and are
10:49
thrown about these terms, which, you know, very
10:51
much sounds like they haven't lived in there. Understanding,
10:54
but but really don't. So it's very difficult
10:56
for the general public to be able to, you know, decide,
10:58
you know, what
11:00
what, you know, what what the truth is. If
11:03
people start using sports terms, I would have
11:05
no idea if they were accurate or not. I'm gonna
11:07
be completely honest. Interestingly,
11:10
this is a sort of a side, but stemming
11:12
from what you've said, Dachen, when
11:15
you guys write letters to patients
11:17
after clinics, do you write it to the patient,
11:19
or do you write it to their general
11:22
practitioner, their family doctor, with
11:24
the patient copied
11:25
in. It
11:26
depends on the consultant you're working for.
11:28
Doesn't it? That's how I don't know.
11:31
I I always wrote to the patient. Yeah.
11:33
I mean, I didn't really care what who the consultant
11:35
was. And I To
11:37
be to be honest, Adam, it's such a rebel.
11:40
But yeah, I think it's There
11:43
was a time when I was about fourteen and
11:45
I remember, girl, my dad had an 0GD.
11:47
This is very off topic. So I don't
11:50
I'm an ophthalmologist now. I can't remember what's a sulfur
11:52
electrode it, you know.
11:54
I don't know if they DI a a thing down the throat.
11:56
It anyway. You know this girl.
11:58
I can't attest of the Golar. Okay.
12:00
Yeah. Exactly that. And
12:02
it was just when Nikita
12:04
explained his result. It was
12:07
so terribly explained to him
12:09
that he had absolutely no idea. And
12:11
maybe I was a bit older. Maybe I was like seventeen
12:13
and eighteen. might have just started school, but I remember,
12:16
like, being like, can you please explain that again? Because
12:18
that makes absolutely no sense. think that's
12:20
always stuck in the back of my mind of, like,
12:22
you actually have to be able to communicate
12:24
what the hell is and honor these people. So
12:27
even if the consultant wanted XYZ
12:29
put
12:29
in, I would also add on, you know, this
12:31
is what it means in real terms. Yeah. But
12:34
I
12:34
think may maybe that's just me where, you
12:36
know, I do try to be patient focused there, can
12:38
be.
12:39
No. I was I actually found out the other day that is
12:41
the NHS standard now to write
12:43
your letter. We should all be writing
12:45
the letters to the patients in
12:47
jargon free way to summarize the exportation,
12:50
which I've always tried to DI but
12:52
a bit like Eurasia. Sometimes my boss is
12:54
like, why are you doing that? Write it to their GP, you
12:56
know. Is there a standard someone in
12:58
the US? Do DI write letters
13:00
to patients or do you write it to the family doctor?
13:03
So with the electronic medical record,
13:06
it's a little bit of a pre populated
13:08
situation, which I'm sure is similar. And
13:11
our letter is do go to the primary to
13:13
the referring doctors. Mhmm.
13:16
And they
13:18
are available on the portal. For
13:22
the patients to log in to.
13:24
And then they the patients will get a separate
13:27
patient summary at the time. That's
13:29
written more that skips a
13:31
lot of the details and is more
13:33
of an action plan diagnosis
13:35
focus. That they
13:38
would get at the time
13:40
of a visit. That's how
13:42
I quite like that. I think that's quite a good model
13:44
because yeah, the criticism from
13:47
consultants, maybe this is what they said to you, A.
13:49
Show us, I've been referred this patient,
13:51
so I'm going to write to the doctor. You
13:53
know, in doctor language that,
13:56
you know, to the person that's referred them. But sometimes,
13:58
I think when these patients get copied in and there's
14:00
all these, you know, declan as doctor
14:02
and he does even know what DI
14:04
means. So How can we How
14:07
can we expect people to get a number?
14:09
I'm just in awe of this
14:11
online portal and here I am with my little
14:13
dictaphone. Recording
14:15
tape.
14:17
We are about thirty years behind, I think.
14:20
Well, it's a
14:21
diff it's a difficult thing to do though, isn't it,
14:23
I think? And it's also hard because
14:25
you you do need to use specific
14:27
terms to communicate to other
14:29
physicians.
14:32
And, I mean, simplifying some of them
14:35
succinctly is is not it's not easy. I
14:37
mean, I remember doing a couple of things for the BMJ
14:39
and trying to write for, you know, even from, like, an
14:41
ophthalmology perspective, trying
14:43
to write for a general doctor is
14:45
is difficult. So it's pretty
14:47
challenging with the time constraints and stuff that you have
14:50
as well. It's not to to actually be able to do that.
14:52
And in medical school, we're not told how to
14:54
write when, you know, and
14:57
it's a skill that really does take training.
15:00
So, yeah, to tangy one. Well,
15:02
interesting stuff. Now
15:04
we are all warmed up in our discussion. I
15:07
am keen that move on to the nitty
15:09
gritty of our
15:10
topic. Sorry, dad, Jake, that.
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future. Okay. Back
16:09
to the show. Simone our
16:11
experts say, I want to start with you.
16:13
Could you tell us a little bit more about
16:15
what is grit and what grit
16:18
isn't?
16:19
I think great use summarized great in
16:21
your introduction. It is the passion
16:24
and perseverance really for
16:26
long periods of time and often without
16:29
you know, the positive reinforcement or
16:31
feedback that we might seek
16:34
as individuals when pursuing
16:36
something
16:36
difficult. You know, so
16:38
it really has nothing to do with the
16:40
talent or with
16:42
luck or with our
16:44
intentions or our wishes.
16:47
It's more of, you know, our
16:50
ability to continue on
16:52
a goal and a path making progress
16:54
over
16:55
time. And is
16:57
this something that you I mean, you mentioned
16:59
how you got into talking
17:02
or thinking about grit and
17:05
that you went to see one of Professor
17:07
Angela Duckworth lectures. Is
17:10
grit something that you now
17:12
use when you think about yourself
17:15
or you think about your trainees or that your colleagues
17:17
that you work
17:18
with. It's So honestly,
17:20
I think more about it with my children a
17:22
lot of the time. And
17:25
how I can instill, you know,
17:27
grit in them I think one
17:30
of the things when we think about grid is we
17:32
automatically think it's just a part of
17:34
us or not, but like many things in
17:36
our personality, it is mutable. And
17:39
there is a lot of evidence that grit changes
17:42
over time. We know that older people
17:44
have more grit than younger people, for instance,
17:46
that's you know, been well documented over
17:48
the years. So I think
17:50
about it when you think about
17:53
studying it and who the proper compares
17:55
person is. Right? So, you know, you talk
17:57
about your trainees and your colleagues and you
17:59
think about grit. And is your comparison,
18:02
your store neighbor who isn't in medicine,
18:04
or is your comparison, your other colleagues,
18:06
or earn medicine, are the
18:08
other people within your own specialty?
18:11
So I think about it like that. And
18:13
I think about it when it relates to burnout,
18:16
but I certainly don't think about it
18:18
as far as screening
18:20
for people for any type of positions.
18:24
Mhmm. think that's interesting that
18:26
you mentioned that grit is something
18:28
that you know, you have or you haven't got
18:30
grit. Because my I think my immediate assumption
18:33
was this is testing for something that is,
18:35
you know, part of your personality, but But
18:37
what I'm I'm hearing from you is that actually
18:39
grit is something that you can almost train
18:42
into
18:42
people. Is that is that what you think?
18:44
I do think it is something that people can
18:47
get better at. And I think you also have to think
18:49
of when it's time to quit something.
18:51
Right? I mean, if you're pursuing a
18:53
goal and you know, we're
18:55
all successful doctors here,
18:57
but there was a point where we gave
18:59
something up something else up
19:02
in our lives so that we could make
19:04
that decision to go into medicine. Right?
19:06
So whether it was
19:08
sports or another academic career that
19:10
you may have been interested in and
19:12
working towards, we all do have
19:15
to know when to pull back and
19:17
to change course. Yeah.
19:20
Grid is absolutely something that
19:22
can change over time. Angela's
19:25
book, she talks about how
19:27
she makes her kids do one hard
19:30
thing every day. And
19:33
that's how she thought about instilling
19:36
grit in someone. I think
19:39
there's a lot of connections obviously between
19:41
grid and things like Carol
19:44
Dwight's, you know, growth mindset, that
19:47
she and others have talked about
19:49
at length and, you know, instilling in children
19:52
in school. And they're very
19:54
similar. Right? With these social science
19:57
abstract DI. And
20:00
I do think that they're changeable, and I do
20:02
think we can do things to fortify
20:05
our grit or
20:06
to, you know, try to modify it.
20:09
I saw Asia and Daclyn
20:11
nodding along when he said that
20:14
you know, having grit is what we say about knowing
20:16
when to give up. And I
20:19
do wanna come back to that because I think that that's such
20:21
an important point especially at the moment and
20:23
in the context that we're talking about this.
20:25
But just going really into the basics,
20:27
we're talking about grit here as a sort of an abstract
20:30
ep7. Is there a measure of grit? Can we measure
20:32
grit in people? And if so, how do we
20:34
do that?
20:35
So there was a, you know, professor earth
20:38
is really well known for having developed
20:40
the grid scale that takes
20:42
about three minutes and it's available online.
20:44
Anyone take it and you can get
20:46
your instant score as a feedback. Of
20:49
course, as with any of these
20:51
social science scales, you
20:54
have to understand the
20:56
drawbacks of them. The grid scale
20:58
was really developed for research. It wasn't
21:00
developed as a screening tool. You
21:03
know, the feeling is, of course, you know, we're
21:05
all science based. If you can't measure
21:07
it, it's very, very hard to talk about it.
21:10
We'd like to put numbers and values on
21:12
things, and this is another way we can
21:14
put a number or a value to
21:17
a a personality trader, an idea
21:19
but you can think about it. We're
21:22
more as people than what a piece of paper tells
21:24
us. Right? And it's great
21:26
for self reflection. It's great for research.
21:29
It may even be great for screening people
21:32
who might be predisposed to burn
21:34
out or, you know, think
21:36
about how we can make people DI as
21:38
a way to protect them from burnout,
21:41
but it's very hard to
21:43
use one of these subjective measurements
21:45
to screen people for job
21:48
applications or trainees into
21:50
medicine or anything else because
21:53
it is subjective. And
21:55
also, I think because it's
21:58
pretty easy for many people
22:00
to give dishonest
22:02
answers. Right? You know, you have to really
22:05
be willing to be honest with yourself to measure
22:07
lot of these traits. So when
22:09
it's that easy to fake, you shouldn't
22:11
be using it to screen people
22:13
for a job position or
22:15
a career
22:16
goal. So we can't use
22:18
the score to tease the grittiest people,
22:20
but does give us an idea when
22:23
we're researching or targeting people
22:25
for help. Understood. Ayesha,
22:28
I saw you nodding when Simone
22:30
mentioned about grit or
22:33
saving about. When to give ep7? You
22:35
had to give up on something in the
22:37
past because of medicine.
22:39
God, where where do we start with that crushing
22:42
flower? Have
22:44
you ever done something really hard? And just had
22:46
to think, do you know what Ayesha can't
22:48
do this? Just gonna have to pop this in the bin.
22:51
Well, it's funny that you mentioned that because
22:54
I did my great school today. DI think
22:56
my husband's doing my grits his grit
22:58
score. And we both did it
23:00
without, like, knowing about grit,
23:03
and then we compared our results. And your
23:05
husband is a general surgeon? Vascular
23:07
surgeon. Vascular surgeon apologies. And
23:09
my score was higher than
23:11
his,
23:11
which
23:12
is called main this is what's
23:14
called the tension in our household today.
23:16
We're gonna have a divorce on our hands. Well,
23:18
maybe. Yeah. Because
23:22
he says that actually, like
23:25
like he said someone, you can fake it, aren't
23:27
you? And I think that my personal
23:30
kind of life and grade school is
23:32
very different to my medical life and grade school.
23:34
So in my personal life, I can't have
23:36
a hobby for more than one second. Whereas
23:39
in a professional life, I will
23:41
spend three years trying to get a paper published
23:43
if if that's what what's needed. So
23:45
and it's so funny because in one in
23:48
one aspect of my personality, I'll just give
23:50
up DI. And
23:52
in another way, won't. And and so my husband
23:54
was was raging at the
23:56
fact that he's gone through this difficult process
24:00
of getting a vascular surgery number. And
24:02
has persevered for, like, his entire life
24:04
to get there, and I've gone to my Rick's school.
24:06
We DI
24:09
you think he has a higher grade score in his personal
24:12
life?
24:13
Yeah. Definitely. That's interesting. That's
24:15
really interesting, isn't it? How about you, Dachshund? I'm
24:17
assuming you haven't done your grade score? It's
24:19
alright. I didn't DI either. I She's just
24:21
now made it kind of standard as a framework
24:23
for this podcast. Yeah.
24:25
I I did have about a five second
24:27
brief look at what the grit score was. But
24:30
no, I haven't done that. I
24:32
feel like you can you can have grit score
24:34
to an extent, but there's many, many other
24:36
factors which are also contrarian.
24:39
So I'm probably going to be leaving medicine
24:41
pretty soon. And, you know,
24:43
I haven't done my great skill, but I'd argue it's
24:46
pretty damn high. Yeah. And, you
24:48
know, tend to persevere, whatever. But,
24:51
yeah, it's it's a it's a difficult one
24:53
because, yeah, I think it's it's also
24:55
knowing I think it's recognized
24:57
in, you know, your own your
25:00
own mental health and stuff as well and
25:02
and whether whether it's with with
25:04
it in the the broad context of your
25:06
life, really. Also, I guess, I didn't
25:08
quite understand when you're saying you,
25:10
you know, you can use your grip score to know
25:13
when to quit. Am I interpreting that right?
25:15
As in, you know, some of the high grit score
25:17
can persevere
25:19
through challenges and achieve you
25:22
know, highly kind of alongside
25:25
those challenges. But I guess, where where does it
25:27
come into play when you're then thinking about
25:29
using it to
25:30
quick? Simone, if you don't mind me asking.
25:33
Of course. I I don't think you can use it like
25:35
that. I think that, like, any personality
25:37
trait, some of your greatest strengths can also
25:40
be your greatest misses. Right? So if you dig in
25:42
your heels and you're going for something that's
25:45
just not working out, you you still need to
25:47
have the self recognition of when to quit.
25:49
I don't think Grit score has anything to do with that.
25:51
I just think that there
25:53
are times when grit isn't
25:56
the be all end all. For
25:58
your, you know, long term goals. And
26:01
do you perhaps think people with the highest script
26:03
scores? Do you kind of find the
26:06
find the challenge in too quick because
26:08
you can sometimes go
26:10
for too much, which just just
26:12
kind of reflecting when, you know, people get
26:14
in a kind of very competitive specialties. Which
26:17
I feel pretty much all of us are in
26:20
that sometimes it can be a lack of
26:22
the recognition of
26:24
other contributing factors and people persevere
26:26
regardless? It's
26:28
a great question, Jacquelyn. And I think
26:30
it just speaks to how there's
26:33
not one thing that we can use
26:35
to make decisions or determine who we
26:37
are as people or how we act. Yeah.
26:39
Do I think that the DI
26:42
people don't know when to quit. I I
26:44
don't think that's generally
26:45
true.
26:46
I don't know that there's ever been any evidence
26:49
to show that people with really high grit scores
26:51
don't know when to make
26:53
the decision to move on, but I
26:55
do know that all of us in life have made
26:58
that decision to give up on
27:00
things no matter how greedy we are.
27:02
Right? We've all made
27:04
choices to give
27:06
something up. And I think as Ayesha
27:09
clearly pointed out, she's really gritty in her
27:11
medical life and maybe
27:13
in her personal hobbies. You
27:15
know, she's just not as gritty. And maybe
27:18
her husband is you know, a little bit
27:20
more balanced or different has a different
27:22
approach. And I think that that's probably true for all
27:24
of us, which takes me back
27:26
to, you know, it depends what your says, you
27:28
know, what exactly are you talking about and
27:31
who are you comparing yourself against.
27:37
One of my questions, which I think you've sort
27:39
of asked that Jacklyn was, is there
27:42
such a thing as being too
27:45
gritty? Like, is it is it
27:47
something that we, you know, we see
27:49
as being good, you know, grit is good, it
27:51
helps you stick at things. But also, can
27:53
it get you stuck in a job that you
27:56
hate or a specialty that you hate because
27:58
you
27:58
think, well, I've said I'm gonna carry on doing
28:00
this, so I'm gonna dig my heels and,
28:02
you know, does it equate to stubbornness? mean,
28:05
I don't think it's the same thing as stubbornness. I
28:08
think it's different. I don't know
28:10
the there's a correlation
28:12
between stubbornness and grit. There is a correlation
28:14
between grit and success,
28:17
which is very hard to define, but
28:19
there have been attempts to study
28:22
that. And there is
28:24
a high correlation, but it's
28:26
not the only factor. There
28:28
certainly are gritty people that can end
28:30
up not being successful. Is it
28:32
because they end up too DI? And they're stubborn?
28:34
And don't know when to quit? That's a great hypothesis
28:37
about maybe why those
28:39
that percentage of people doesn't end up,
28:41
you know, quote unquote, successful. Well,
28:45
I guess when I was thinking about this topic,
28:47
When I first saw grit, I thought, oh,
28:50
tough and stubborn. Those are the words that I equated
28:52
it to you. And then I think the more I've read about it, the
28:54
more I've understood that maybe does there's many
28:56
more facets to it. But I think
28:58
almost, you know,
29:01
I know that you're saying that grit score
29:03
in the in the sense that you've looked
29:06
at it in the past and the the score
29:08
that professor Duckworth developed
29:11
isn't for selection.
29:13
But I was thinking that actually, you know,
29:15
all the things that any of us do
29:17
to get into medical school kind
29:20
of proves the grittiness already. I mean, medical
29:22
school is already sort of a great
29:24
test in itself. It's like, can you jump through
29:26
all of these hoops? To prove
29:28
that actually you wanna stick at something when it's hard,
29:30
you know, when all of your friends are going out, getting
29:32
drunk and you were having to wake up at nine AM the next
29:34
morning to go to a lecture. Does that actually
29:37
prove that you have some perseverance or are committed
29:39
to something? So actually, you know,
29:42
are we kind of selecting for grit already?
29:45
And then those that are relatively
29:47
successful, all of these other factors
29:49
are coming into play, Oh, a
29:51
hundred percent. We're preselected in
29:53
medicine, of course. I mean, there's
29:56
no doubt that we've become a preselected
29:58
crowd, which is why studying grit and medicine
30:01
becomes challenging in and of itself because
30:03
you're taking people that already do
30:05
have very, very high levels
30:07
of grit, and you're trying to compare them to
30:09
each other. And there's such nuanced
30:11
conversations about, you know,
30:14
do different specialties have different
30:16
grid. I mean, it's really hard to compare
30:18
when you're at such a
30:20
high level at the
30:22
beginning point. And I think that, you
30:25
know, this scale was just used to try
30:27
to study it and give a
30:29
scientific measurement to
30:32
a trait that is otherwise hard
30:35
to define. So when I was
30:37
doing my background
30:39
reading about you, And I know
30:41
that you've touched on this earlier, but I noticed
30:43
that you're involved in a subject which is very close
30:45
to my heart, which is women in surgery. And
30:47
one of my first thoughts was is
30:50
grit gendered, which I know pertains
30:52
to the research that you did. One of
30:54
the things I wondered is do you men
30:56
generally have more grit than women.
30:58
And historically is this where there are more
31:00
men in sort of successful or
31:02
inverted commas high powered professions. Or
31:05
is this less about grit and more
31:07
about sort of pre existing patriarchal structures
31:09
or something else
31:10
entirely? I think a lot about female surgeons.
31:13
And I we can talk about we
31:15
could talk about female surgeons for hours.
31:18
But our study, not that it's the
31:20
end to the story, but
31:22
really demonstrated that within surgeons,
31:24
at least, and there's
31:27
been other studies that have mimicked these findings
31:29
in residents and in medical other
31:31
medical specialties, the men and
31:33
women have the same grit
31:35
scores. They're not significantly different.
31:38
I think that the point in
31:40
me doing the study was that maybe
31:44
not so much or hopefully
31:46
less so now than when went into training,
31:48
but certainly when I interviewed for
31:50
residences, I was
31:53
inappropriately asked many times
31:55
if I was enough enough to
31:57
do neurosurgery. And I think
31:59
that while tough and grit
32:02
are not exact, synonyms.
32:05
There are nuanced differences. I
32:08
do think that there is a
32:10
preconceived no in
32:14
the society here in the US
32:16
and probably globally given the numbers
32:19
are similar. For female surgeons
32:21
around the globe that
32:24
women are lacking some kind
32:27
of whether you call it
32:29
grit or toughness or ability
32:32
you know, be successful in
32:34
a surgical residency in a surgical
32:36
career. Hopefully, the data,
32:38
you know, we have shows that that's
32:40
not the case. Women are just as gritty
32:42
as men. So I don't
32:44
think it has anything to do with that.
32:47
I think also that, interestingly,
32:51
what we saw and I know that the data
32:53
prove it out and many other places is is that
32:55
burnout in women in medicine
32:57
is and surgery specifically is
32:59
much higher than in
33:02
men. And if your grits the
33:04
same, but your burnout and the rates at which
33:06
you're leaving your career or higher, you
33:08
know, that becomes a much more interesting
33:11
question. Question and is it that
33:13
women are more likely to report burnout
33:16
than men, which is possible, you know,
33:18
certainly there are gender and cultural
33:20
differences about who reports, what kind of
33:22
symptoms. And then second
33:24
of all, if if grit is
33:26
the same, then what else
33:30
is protective of burnout? Because
33:32
if we can figure out how
33:34
to protect people against burnout,
33:36
then we can screen them and hopefully
33:39
change things before, you
33:42
know, burnout occurs instead of way
33:44
game for it. We kind of
33:46
hypothesized some kind of success.
33:49
However, you define that, might be protective,
33:52
but we don't have any answers. Yeah.
33:54
I'd be curious to see if anyone else has ideas
33:56
of what they think might be protective of
33:59
burnout
34:00
besides grit. As far as personality
34:02
traits. I
34:03
was gonna ask you Ayesha because you
34:06
work in Ep7 and Guinee, and
34:08
I feel like whenever people talk about women not
34:10
being tough. Somebody just has to say childbirth.
34:13
I'm I'm sure that you have tons of experience of
34:16
that. Do you have any thoughts on,
34:18
you know, if women are as girthy as
34:20
men, why is it that
34:23
women report more
34:24
burnout? Or what could we do to protect
34:27
people that report more burnout? It's
34:30
interesting because, like, Obzengai in the UK
34:32
has one of the highest attrition rates Mhmm.
34:34
-- within the special within different
34:37
specialties. And one of the
34:39
reasons for it is burnout. Normally,
34:42
secondary to like litigation and things
34:44
because there's in
34:46
obstetrics in particular particular, you
34:49
get quite a lot of incidents which
34:52
end up litigation. And
34:55
I don't know if there's any evidence
34:57
to what I was saying here, but one of the
34:59
protective factors for myself
35:02
and the people I work with within
35:04
my own training program is having
35:07
peers and and
35:09
peer support. And be
35:12
able to reflect amongst
35:15
our group that actually these
35:17
are normal things to happen within
35:19
training. And and
35:22
to be able to almost have kind of an
35:24
echo chamber and
35:26
be able to bend a bit and
35:28
but then also take take
35:30
some constructive steps as to
35:32
actually, is there anything that I could have gone better? Is
35:34
that it's true reflection really? And then
35:37
to be able to take it forward knowing that, actually,
35:39
it's not just me. And I
35:41
think it's actually helped a lot of
35:43
people get through difficult parts
35:45
of trading, particularly when things
35:47
have gone really badly wrong. And which
35:49
is the nature of Opsgenie. That
35:51
would certainly lend to your hypothesis.
35:54
Wouldn't it to mean that if you've got fewer women
35:56
in a specialty and those women
35:58
have a higher rate of burnout if
36:01
they've got less peer support or less,
36:03
you know, a gas
36:05
fist and peer support in the sense
36:07
that people that look like them or people that are
36:09
are like them, perhaps
36:11
perhaps that's that's the reason. Decathlon
36:14
is somebody who's in the process of
36:16
leaving the NHS and has had a
36:18
degree of of burnout, but
36:20
is obviously incredibly gritty.
36:24
Is there anything you think that
36:26
that might have have been a protective
36:29
factor for you? I I mean,
36:31
I think what I use this is is amazing.
36:33
I think ophthalmology and academia in itself
36:35
are both incredibly isolating. And there's
36:37
so few people who are doing the same thing
36:40
that you're doing that. It's it's very, very
36:42
challenging to actually get somebody that understands
36:45
what you're going through. You know, you can't
36:47
speak to consultants because
36:50
they're typically big big dog professors
36:52
on their own who, you know, can't quite relate
36:55
to those challenges anymore. You can't speak
36:57
to your peers because, you know,
36:59
you're basically doing two jobs and
37:01
trying to achieve the same clinically as them at the
37:03
same time. Can't speak to allied
37:05
healthcare professionals because they're just, like, reset
37:07
it to why waste your time doing that. So
37:10
I actually think that I think that's an an
37:12
absolutely huge one. No. Yeah.
37:15
So I think that probably would have helped
37:17
me. But I I mean, ultimately, it's
37:19
it's the whole system, which is the reason why I am
37:21
leaving. But but yeah, I think
37:23
what Ayesha said would probably be the key
37:26
thing that probably would have helped
37:28
me stay in a little bit
37:29
longer. I
37:31
also think there's a, like, a massive, like, mentoring
37:33
that Yeah. Like -- Yeah.
37:36
-- back in the day, which is what I hear from my
37:38
consultants all the time, you would have, like,
37:40
someone who, you know, a senior person
37:42
who would kind of take you under their wing, you
37:44
know, would support you through trading and
37:48
and kind of prevent all of these issues
37:50
from arising or not arising, but
37:53
having an effect as an effect
37:55
as it may be doing now. And I
37:57
think there's just a complete lack
37:59
of mentoring within our training
38:01
programs nowadays. I wouldn't I wouldn't know
38:03
who to turn to from the consultant wanted
38:05
go to. And for that level of support?
38:08
Yeah. Absolutely. And I mean,
38:10
I personally feel like almost the opposite. I
38:13
mean, I remember raising a few concerns
38:15
about different things and you feel quite
38:18
isolated as a junior because, you know, you
38:20
you rotated quite frequently so the consultants
38:22
aren't in my in my
38:24
personal opinion don't appear as
38:28
invested in you as they may be in the rest
38:30
of the team, not they have spend the time with.
38:32
So it's a very isolated position to be as
38:34
a junior doctor, I think, at the moment now.
38:36
Because the consultants have a pretty rubbish job
38:39
generally as it is. They're
38:41
trying to, you know, keep everything great
38:43
in the whole team. And then you have the, you
38:45
know, s h who well, F1SH who's
38:48
and registras who are doing a hell
38:50
of a lot of the groundwork, but really
38:52
don't know where to turn. So I I do
38:54
think that's a a major major factor.
39:00
Simone, you talked about grit
39:03
not being this kind of unchanged
39:06
entity that somebody just possesses
39:08
or doesn't possess, that it changes it
39:10
with time and place,
39:13
I imagine, and job. And
39:15
we talked about things you can do to increase
39:17
somebody's grit. But conversely, are
39:19
there things that you have seen or
39:21
you've you know, come across
39:24
that reduce somebody's
39:25
grit, either in the short term or the long
39:28
term. Do you mean more like circumstance
39:31
that might occur or a
39:33
personality,
39:34
another personality trait that comes into
39:36
play that tempers it Yeah.
39:39
I mean, I guess we've talked a lot about the former,
39:41
and I think we all know what circumstances will
39:44
erode our own grit or I'd like think we have an
39:46
DI. But, yeah, I suppose the the
39:48
the latter, like, from a personality point
39:50
of view or, you know, for instance, you
39:52
talked about You talked
39:54
about most most of the evidence
39:57
points towards that as people get older,
39:59
their grit improves. Conversely,
40:01
is there any you kind of like overarching
40:04
life event or personality trait that
40:06
reduces somebody's
40:07
grit. I think that the
40:09
interaction is probably difficult to
40:12
measure or to, you know, say
40:14
that this one thing takes credit
40:17
for it. You know, the relationship
40:19
between things like resilience, success,
40:22
grid and burnout are interesting.
40:27
Certainly, we've seen correlations. The question
40:29
is, is there a causation there.
40:31
Right? Always careful as doctors
40:34
and scientists is thinking about is
40:36
correlation the same as causation. And
40:39
so I I do wonder if, you know,
40:42
burnout separate from your grit can
40:44
then in a flywheel
40:46
kind of circle back and impact level
40:49
of grit. So if you do have a certain level of
40:51
burnout, does that then impact
40:53
your willingness to persevere and
40:55
persist on this goal for
40:57
a long time? If
41:00
you don't have success, does that
41:02
come back and tell you that your grid
41:04
should go down? I don't know of anything that
41:06
shows that. I tend to
41:08
think that if you're if it's
41:10
time to quit something or something's
41:12
not going right, you need other personality traits
41:15
that come that will tell you that
41:18
this is more stubbornness than grit, and it's
41:20
time to move on to something
41:22
else. So I think it's a self
41:23
awareness. So maybe it's
41:25
that, you know, that you're a mindfulness almost
41:28
that you need that can counteract
41:30
when the grid is not your friend anymore.
41:34
I'm really glad that you brought up the word resilience
41:36
because it's a
41:38
word that's come on this podcast loads. We've had
41:40
a load of discussion about it. And one
41:43
of the studies that I came across when I was
41:45
reading this, which I will link in
41:47
the show nights. And this is
41:49
a twenty seventeen study by
41:51
Laura Halladay, Abigail Walker, Selivig,
41:54
John Hynsen, John suggested
41:57
that grit could be used to sort of target
41:59
for one of the better term, individuals who
42:01
need more support. And that could be
42:03
done in the form of resilience
42:05
training. And I know, as
42:07
I say, that that's a bit of trigger word for some
42:10
of us on this podcast. But
42:12
taking aside what people think about resilience
42:14
training and how it can be sort of weaponized
42:18
as an intervention. What do people
42:20
think about using these grips scores
42:22
as as a way of sort of helping
42:24
people by by supporting them
42:26
better, I suppose. I I mean, I'd
42:28
be interested in hearing what people as
42:31
Chinese you know, earlier on in their
42:33
career feel because I
42:35
do think that if we're going to use it as
42:37
a screening in the aims
42:40
of helping and not as
42:42
a way to weed certain people
42:44
out. You know, there has to be obviously
42:46
the same kind of privacy that you get
42:49
from any other medical examination
42:53
or data that people get. So there has
42:55
to be obviously section and a privacy
42:57
issue with the data. And then
43:00
if we think about as an institution
43:02
or a health service that we're going to
43:04
help to build people, protect
43:07
them against burnout or build resilience or
43:10
grit. Then there has to be before you
43:12
actually screen for that, there has to be a program
43:14
in place that is
43:16
going to be, you know, proven
43:18
to be beneficial. Because if we're gonna use
43:20
it to, then we have to be able to help them. Right?
43:23
We can't just get this data and say,
43:25
boy, you might be a risk for burnout or
43:27
or, you know, who You need to work on something.
43:30
You know, so I think you need to have a plan in
43:32
place first.
43:33
Yeah. But I'd be interested to hear
43:35
what some of the other folks think
43:37
on the panel about whether
43:39
that's even a good idea or if that's
43:42
kind of crossing a line for
43:43
them. I'm not sure, you know, because
43:46
it always feels like you're setting
43:48
up like a two tier system based
43:51
on a score so that some people
43:53
get some support, which can either be seen
43:55
as they're getting lots of extra help. Or
43:58
it could be seen as, oh, you're not good enough
44:00
so you're getting extra help. And
44:02
then, like, the rest. And
44:05
I I think it does the opposite of leveling
44:07
the playing field. I think it makes it
44:09
completely uneven. And I don't I don't think
44:11
I would like that as a
44:12
trainee? No. I mean, you wouldn't
44:14
you you wouldn't like it
44:15
if you were in the like no grit group
44:18
or the low grit group. Would you I don't
44:20
I don't know. I don't think I'd like it. Any
44:22
any of those groups to be honest, because you can
44:24
argue like each each group
44:26
has its own
44:27
benefit. Stating.
44:28
Mhmm. What do you think, Daqlyn?
44:30
Yeah. I mean, you you may have to admit. I honestly
44:32
thought that might be a good DI. As
44:36
as long as, like Simone said, there's
44:38
an actual, you know,
44:41
reasonable evidence based plan.
44:44
For those who are struggling because anyone at least,
44:46
you know, showing that they're at least trying to care about
44:49
us and, you know, trying
44:51
to quantify in that? And is there a way
44:53
to find those who are most at risk? But,
44:56
like, you just said that will come with a million challenges.
44:59
And I think yeah, there
45:01
would be conflict between different
45:03
trainees, different, like, healthcare professionals,
45:06
why the doctors get in there, but we're not, we're doing
45:09
Eximal hours than that if that's the
45:11
case. think it would be difficult to
45:13
roll out. But,
45:15
I mean, generally, it would be nice
45:17
to see that as an organization, the
45:19
NHS are trying to use some sort of
45:21
evidence to intervene to those
45:23
who may be most at
45:25
risk. As we've kind of already talked
45:27
about, it's not just about your grit score,
45:29
but it's it's your personality as
45:31
a whole. So you could how can you,
45:33
you know, stratify risk based on
45:36
just a great
45:36
school.
45:37
Yeah. I mean, they may well add additional things
45:39
in, I I guess, to make it a bit
45:41
more.
45:42
Yeah. A bit more thorough.
45:45
I'm curious. Would you be in
45:47
favor then of having if
45:49
there was a proven training or
45:51
program that could build things like
45:54
written resilience. Would you be interested
45:57
in having it then available on just
46:00
if you want it, you can go and do it
46:02
basis or a mandatory everybody
46:06
has to go and do this because that important
46:09
for us. And so there is no
46:11
two tiered system
46:12
between the haves and the haves knots. No.
46:16
I was just gonna say we've we've discussed resilience
46:18
resilience training we have in the
46:20
NHS. And I imagine that there is, you
46:23
know, something similar in a
46:25
lot of other places. And I think
46:27
that the criticism, certainly
46:29
from people that I've spoken to you, on this
46:31
podcast or off this podcast, And I
46:33
think I heard someone say recently, resilience
46:36
training in the way that we have it at the
46:38
moment, particularly with the NHS
46:40
being in situation it is is asking
46:42
a person to run into a burning building,
46:45
waiting for them to catch fire, and then once they've
46:47
caught fire, bringing them out and saying, here's how
46:49
you can put the fire out. But by the way, now you have
46:51
to get back in the building again. And that's why
46:53
a lot of people feel, actually, we're not fit
46:56
fixing the systemic problems that
46:58
have created, you know, that
47:00
have meant that person is now on we
47:02
are just fixing the individual and making
47:04
it an, you know, an individual problem when
47:06
actually a lot of this is systems based.
47:08
So I can totally see why the idea of this
47:11
resilience training comes from and
47:13
that there is a lot of good in it. But
47:15
I think I can always say see
47:17
the other the frustration when there's a systems
47:20
based problem. And somebody
47:22
saying, you know, I don't think a trading program's
47:24
gonna sort this out. I
47:27
guess my my final crash question
47:29
was gonna be whether we call it
47:31
grit or whether we call it
47:33
resilience or whether we call it
47:35
toughness or stubbornness, whatever the name
47:38
is for it, is actually
47:40
one of the issues that a lot
47:42
of healthcare systems, whether that public
47:44
or private, have relied on
47:47
any healthcare practitioners'
47:50
grittiness for too
47:53
long. And actually, we're getting kind
47:55
of to the end of people's gritty tethers.
47:57
Now when it comes
47:59
to, you know, wide scale
48:01
burnout and and germany
48:04
poor well-being and people leaving the professions?
48:06
Yes. Absolutely. I mean, there's there's
48:08
no different factors that come in, you know, economic.
48:11
You know, we we aren't getting paid as much we
48:13
want to learn. We can't afford to to
48:15
live on the salaries that we're on. And then
48:18
you go and you have increasing amount of challenges
48:21
at work and you feel devalued
48:23
in our role. You
48:25
could argue it's less respected and
48:28
whether it be by the public or not. So I think there's
48:30
an accumulation of all of those. And I
48:32
mean, for me anyway, you know, having been
48:34
someone who I would probably say is fairly
48:36
gritty, throw medical school in the
48:38
early part of my career at the
48:40
end of my tether. And there
48:43
are other alternative, which which
48:45
give you a better better work like balancing
48:48
and you need focus on your own. Well-being.
48:51
So yeah, I I completely agree.
48:53
I'm very much the teller of my
48:55
grit. Simeon, you said something right
48:57
at the beginning, which I just wanted to
48:59
circle back to to sort of, you know, come
49:01
full circle, say to speak, is One of in
49:03
your definition of grit, one of the things that
49:06
you said was that
49:08
it's the being able to continue even
49:10
when you're not getting that validation,
49:13
you know, somebody saying, well, don't you keep going?
49:16
And I actually wondered if maybe that
49:19
is one of those protective factors that
49:21
we were talking about from burnout is actually
49:24
somebody saying to you, you've done a good job, keep
49:26
going, you know, in whatever format comes
49:28
public or or personal. I don't know
49:30
if that's something that you you think
49:32
protects you Ayesha
49:35
from from feeling burnt out. Definitely.
49:38
I mean, so
49:42
funny story, but as
49:44
at the beginning of my training, every
49:46
cesarean section I went to. I fainted
49:49
in. Every one of them. I
49:51
spent most of that year lying on the floor
49:54
on labor ward. But
49:57
the thing that got me through that year
49:59
was my peers and my consultants being
50:01
like, look, it's fine. You're gonna get over
50:04
this. You're, like, don't
50:06
don't let this, like, completely destroy
50:08
you because it was. Yeah. Because I was like,
50:10
god, how am I ever gonna do specialty. Like,
50:12
I have to be able to stay upright. And
50:16
it it was it was then saying, you're doing
50:18
a good job. You know, you're good at
50:20
every every other part of your job. This
50:22
is just a little hiccup. You'll get through it. And
50:25
eventually, I did. But
50:28
yeah, definitely think that was something
50:30
that kept me in training and
50:32
managed and kept me going
50:35
through to
50:36
SD five now. Even
50:39
even when all these systems base things, even
50:41
when the house is on fire. That's that's
50:43
still keeps you
50:44
going. It's pretty interesting. Grid
50:46
is not the BL end all. There are other
50:48
things that are very important to us as
50:50
physicians and as people And
50:54
while we are already self selected
50:56
as a pretty gritty crowd, obviously,
51:00
things like integrity on this
51:02
see, you know, hardworking, tolerance,
51:05
kindness. These are all
51:07
important factors for being
51:10
a good citizen, good human being, and
51:12
certainly good physician as well. And
51:15
I think making any overreaching
51:18
statements that grid is, you know, the most
51:20
important thing that we
51:22
look for is saying
51:24
too much. It happens to be the topic we're
51:26
talking about today, but I I, you know, I don't
51:29
want anyone to walk away thinking
51:31
it's the only personality
51:34
trait that should be looked at or cared
51:36
about or
51:38
thought about when we think about who we are
51:40
and what's protective of our own personal
51:43
you know, burnout and whether it's grid
51:45
or a combination of things. And
51:47
I think that both
51:50
Ayesha and Deckelen have made really good
51:52
points that for things that are protective
51:54
are having potentially mentors and
51:56
peers. And those are things
51:59
that, you know, are very hard to measure we
52:02
had toyed with the idea of success. So
52:05
I think that there's this obviously
52:07
is multifactorial.
52:08
It's not really easy to pick out one
52:10
thing. And I
52:13
think we each as individuals will
52:15
need to do our own self exploration about
52:18
what it is that, you know, we think
52:20
makes us grittier or
52:22
less DI or will protect us against
52:24
burnout because it's probably a little
52:26
bit different for everyone.
52:28
I think that's a really good note, probably
52:31
the most positive note. To leave
52:33
this podcast on, say thank
52:35
you so much for joining us
52:37
for this episode. And
52:43
thank you for listening to doctor informed. That's
52:46
all we have time for today. We're
52:48
really keen to hear from our listeners. For
52:50
ideas of future discussions and reflections
52:52
on the topics we've discussed today, please
52:55
get in touch. If you like our show,
52:57
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52:59
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53:02
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53:08
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53:11
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53:19
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53:21
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53:24
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