I like Pauline Chen. Recently I interviewed her for the SGIM Forum (will provide a link when it is published). I like all her NY Times articles; I love some of her articles. I love today's article.
Do You Have the ‘Right Stuff’ to Be a Doctor?
Dr. Chen does a wonderful job stressing the importance of personality type for physician success.
The investigators found that the results of the personality test had a striking correlation with the students’ performance. Neuroticism, or an individual’s likelihood of becoming emotionally upset, was a constant predictor of a student’s poor academic performance and even attrition. Being conscientious, on the other hand, was a particularly important predictor of success throughout medical school. And the importance of openness and agreeableness increased over time, though neither did as significantly as extraversion. Extraverts invariably struggled early on but ended up excelling as their training entailed less time in the classroom and more time with patients.
“The noncognitive, personality domain is an untapped area for medical school admissions,” said Deniz S. Ones, a professor of psychology at the University of Minnesota and one of the authors of the study. “We typically address it in a more haphazard way than we do cognitive ability, relying on recommendations, essays and either structured or unstructured interviews. We need to close the loop on all of this.”
I would add this thought to the conversation (and you can read many comments here – Do Test Scores Make the Doctor? Physician excellence requires multiple dimensions. We have room in medicine for left brain physicians and right brain physicians. Dual brained physicians do the best.
While I do not think we have the proper premed requirements or the proper way to teach the first two years of medical school, we cannot discard the importance of good intelligence. We do have a lot to understand in medicine, and I have unfortunately seen students and even residents who could not succeed intellectually. Whether multiple choice testing captures the ability to process the information necessary to succeed as a physician remains unclear. What is clear is that none of us want dumb physicians.
So we can assert that academic ability (tough to measure, but important) is a sine qua non for physician success. Yet as Dr. Chen points out, academic ability is necessary but not sufficient.
For many years I have used the expression – that intern, student or resident has IT! We all know IT when we see it, but describing IT is difficult. Perhaps the studies that Dr. Chen describes make the point that personality defines IT.
We do miss some great potential physicians because of our pre-med requirements and our obsession with MCAT scores. Can we better assess candidates? That challenge should await us.
Please read the article and the comments. Please tell me what you think. BTW I highlighted the sentence about extroverts because I believe it describes me perfectly. The first 2 years of medical school I was a strong member of the "stay in the pack and you'll be back" club. Things go better from there!
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I also enjoy her articles. In this case I think doctoring is a big tent, and the kinds of personalties best suited for physician success and happiness might also be stratified by discipline. I'm not sure extraverted types would be happy doing pathology, medical research, or anesthesiology to name a few stereotypes. Our personality types certainly steer us towards specialties that suit us, with economics, lifestyle, and projected job markets important variables.
What was your back up plan? Mine was teaching, mostly because it resonates with my personality, but certainly not for the big bucks (like I'm making in primary care…damn!)
Thanks for the interesting idea and link.
Since I finished my BFA in furniture design, I've been increasingly interested in neurology (unrelated, I know). I was a participant in clinical trial recently, and the doctor encouraged me to go back to school and study medicine after I'd confessed my interest in it. My response to her: "I don't have the personality for it! I could never withstand the rigors of being an intern." And it's true. If I can see that, why can't med schools see that? It would be really difficult for someone to put so much money and time into med school, then realize they don't have the "right stuff."
I hate all that Meyers Briggs crap.
It's my prejudice that extraversion is a deep and horrible personality flaw. That notion is long-held and central to how I relate to the world.
I will always be skeptical of people that try to tell me that extroverts don't have something wrong with them.
I liked that article. I suspect the quality of extraversion serves some MDs very well.
We got back from a birthday celebration for an Uncle who is a retired GP. He hit his 95th. We went out to lunch with Aunt/Uncle before the birthday dinner and walked to the cafe from their apartment in a small town.
He has a heart condition and stopped several times to catch his breath, and to greet and talk with half a dozen people we encountered on our walk. When we got to the cafe we lucked out and were able to pay for his lunch because he was so busy chatting up two or three other people he encountered. The man isn't starved for company, this is his life. He had his wallet out so we assumed he'd intended to pay and this wasn't just a ruse to stick us with lunch!
IWhen I read Ms. Chens's description I saw him - someone with a good mind, a hard-worker, and the ability to reach out and connect with others.
Matt, Is that because your personality disorder stands out so strongly on MyersBriggs:)?
Most who have been practicing for awhile know this intuitively. How many of us after getting a sense of someone's personality say "Yup, typical surgeon/pediatrician/internist/pathologist", etc. Particularly telling is her comment:
“If a medical school is all about graduating great researchers, then I would tell them not to weigh the results of the personality test that heavily,” Dr. Ones said. “But if you want doctors who are practitioners, valued members in terms of serving greater public, then you have to pay close attention to these results.”
She hit the nail on the head there! Most medical schools are looking for just that (researchers who will make their institution look good), so that's a major reason we get so few primary care doctors out of our medical education system in the US!
As a patient – I disagree for several reasons. First – a patient never meets some of the most important doctors he or she deals with – like the radiologist who reads his/her MRI – her mammogram – etc. Second – a patient rarely has extended FTF contact with other important doctors – like surgeons who operate on them. I want these people to be good at what they do – not top contenders for a "Miss Congeniality" award.
Now I have occasionally met a doctor who is a total jerk – and I wouldn't want that doctor as my primary care doc. But if I knew that doctor was a great heart valve surgeon – and I needed work done on my heart valve – I would ignore the personality factor.
BTW – the one area where a doctor's personality makes a difference is in a malpractice case. Likeable doctors tend to win cases – disagreeable ones don't. Regardless of the merits of the case.
How about family personality. Perhaps we could screen patients and their family personality before we allow them to be admitted.
Happy – I actually had one health care professional – a dentist (prosthodontist) refuse to treat me because of my "personality". He said I asked too many questions. He thought he was G-d – and I thought that if I was entering into a long term relationship with a health care professional to whom I would be paying at least $20k out of pocket (for implant work) – I had the right to ask (carefully researched)questions. At least the guy was decent enough to refund my $250 consult fee after refusing to accept me as a patient.
BTW – I don't know why doctors shouldn't have the right to refuse patients for various reasons. Ranging from they don't accept Medicaid – to the patient seeking her 20th cosmetic surgery is a wingnut. OTOH – since you're a hospitalist – you probably have an obligation to accept all patients who wind up in the hospital (because they can't exactly get up – walk out – and find another doctor). Robyn
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