Measuring the fire in their hearts: assessing passion for the profession among students pursuing surgical careers

BACKGROUND: Leaders in surgery have posited that passion for the surgery profession is diminishing among entering trainees, and that its scarcity is related to the high levels of attrition observed in general surgery training. This study explores trends in passion for the profession among applicants to general surgery training. METHODS: Applicants to a large midwestern academic general surgery program were invited to complete a voluntary, anonymous 12-item Passion for Surgery Index (PSI) as part of their supplementary application package during the 2020–2021 and 2021–2022 residency selection seasons. The PSI is adapted from a generic work-related passion index and is based on the dualistic model of passion, organizing scores into harmonious passion and consuming passion. Applicants completed the index on a stand-alone website which automatically generated results pertaining to overall passion, harmonious passion, and consuming passion for the surgery profession. Applicants were provided with their results and provided feedback. RESULTS: Sixty-one percent (871/1428) of invited applicants completed the PSI. Approximately 67.4% (N = 587) of these applicants reported an overall high level of passion for surgery, while 31.1% (N = 271) reported a moderate level and the remaining 1.5% (N = 13) reported a low level. When comparing the two different types of passion, the vast majority of applicants (92.8%; N = 808) reported a high level of harmonious passion and only 7.1% (N = 62) reported a moderate level of harmonious passion. The results for consuming passion were much more varied, with 36.9% (N = 321) reporting a high level, 47.5% (N = 414) reporting a moderate level, and 15.6% (N = 136) reporting a low level of consuming passion for the profession. DISCUSSION: These results suggest that there is substantial variation in passion for the profession among those pursuing a career in surgery. While the majority of applicants reported a high level of harmonious passion for surgery, less than half of applicants reported a high level of consuming passion for surgery. This variability in consuming passion among entering trainees is concerning, as individuals with low or only moderate passion for the profession may not have the motivation or drive to persist in demanding training environments.