Association between grit and wellness outcomes among Japanese medical residents: A nationwide cross-sectional study

The well-being of resident physicians is a globally recognized concern, with high rates of burnout, stress, and attrition. Studies proposed grit-a personality trait defined as perseverance and passion for long-term goals-as a protective factor against poor psychological outcomes. Although studies in Western countries have linked grit with lower burnout and depression among residents, evidence from collectivist cultures, such as Japan, remains limited.

This nationwide cross-sectional study included data from 2,876 postgraduate year (PGY) 1-2 resident physicians across 553 hospitals in Japan. Participants completed self-administered surveys following the 2024 General Medicine In-Training Examination. Grit was measured using the validated Japanese version of the Short Grit Scale (Grit-S); wellness outcomes-including burnout, job satisfaction, stress, and depressive symptoms-were assessed using the single Mini-Z 2.0 item and the two-item Patient Health Questionnaire. Multilevel logistic regression models with a random intercept for hospital were used to evaluate the associations between grit and wellness outcomes, adjusting for demographic and institutional covariates.

Higher Grit-S scores were significantly associated with lower odds of burnout (adjusted odds ratio [AOR], 0.54; 95% CI, 0.45-0.64), high stress (AOR, 0.63; 95% CI, 0.55-0.71), and depressive symptoms (AOR, 0.54; 95% CI, 0.48-0.62). Grit was also associated with greater job satisfaction (AOR, 2.09; 95% CI, 1.80-2.43).

In this national sample of Japanese resident physicians, higher grit was consistently associated with improved psychological well-being, including lower burnout, reduced stress, fewer depressive symptoms, and increased job satisfaction. These findings suggest that grit is a critical protective trait for residents, even within a collectivist culture. Future research should explore whether the identification of residents with lower grit, especially those with reduced perseverance or inconsistent interests, can help inform customized support programs such as mentoring or structured stress management to enhance well-being.