To evaluate associations between burnout, perfectionism, and grit among urology residents and attendings, hypothesizing that perfectionism would be associated with increased burnout and higher grit would be protective.

We conducted a prospective, multi-institutional cross-sectional survey from January to May 2025. Participants completed the Maslach Burnout Inventory, Frost Multidimensional Perfectionism Scale, and Grit Scale. Burnout was defined as Emotional Exhaustion >27 or Depersonalization >10. Perfectionism and grit scores (2-5) were analyzed relative to burnout, including analyses of individuals above the 90th percentile for perfectionism.

A total of 108 urologists responded (39% response rate), including 68 attendings (64%) and 39 residents (36%); 70% completed the perfectionism scale. Burnout was identified in 56 respondents (52%; 95% CI, 42%-62%) and was more common among residents than attendings (77% vs 37%; P < .001). Perfectionism showed non-linear association with burnout: moderate levels were associated with lower burnout, while scores above the 90th percentile were associated with higher burnout (77% vs 46%; OR 3.9; 95% CI, 1.3-11.2; P < .01). Grit was inversely associated with burnout; 92% of respondents with low grit were burned out versus 7% with the highest grit ( P < .001).

Burnout remains prevalent among urologists, particularly trainees. Perfectionism is associated with higher burnout, while grit appears strongly protective, suggesting potential targets for intervention.