Does personality drive specialty choice in medicine?
One doctor has a dominant personality, is process-driven, brusque with patients and likes to watch rugby when not working. The other is more kindly and empathetic, and takes a real interest in patients’ lives. Can you guess which is the surgeon and which is the GP?
Such doctor stereotypes pervade not just medicine but the general culture itself. Surgeons are bullish and poor communicators; paediatricians are maternal and all smiles; GPs are people persons; pathologists have a morbid fascination with death; radiologists hide out in a dark room. Of course they’re exaggerations – but is it true that certain personalities are associated with certain specialties? Unsurprisingly, there has been some research done on this.
Two Scandinavian studies published this year look at personality traits and speciality choice. One from Sweden involved 400 doctors training for medical specialties, who were assessed for extraversion, agreeableness, conscientiousness, neuroticism and openness to experience.
Doctors training in surgery and general practice did indeed play to type, with lower scores for agreeableness in the former compared with the latter. On the other hand, psychiatrists and hospital service physicians scored lower for conscientiousness compared with surgeons. The study authors speculate that this may be because surgery is dominated by task-based procedural work and organisational skills that require conscientiousness. Psychiatrists, on the other hand, scored highest for openness to experience, which is perhaps linked to intellectual curiosity.
A Finnish study of almost 3000 physicians had some similar findings using the same assessment test of five personality traits. It, too, found that psychiatrists had a greater openness to experience than other specialists, and it also found openness to experience correlated more with working in private practice. Again, agreeableness levels were higher for general practitioners, while surgeons were more conscientious, although they were also more neurotic. Higher levels of extraversion were found in paediatricians and were also associated with a change of specialty.
The authors of both these studies suggest that personality assessment could play a role in medical career counselling and might enhance the person-job fit among doctors.
Another study, this one from the UK, looked at three pathological personality traits – narcissism, Machiavellianism and psychopathy – in 248 healthcare professionals and compared them with a control group of 159 members of the general public. Thankfully for the medical profession, doctors scored lower for these personality traits compared with the controls. But among doctors, surgeons came off the worst, with higher levels of narcissism and primary psychopathy. And in surgery, vascular surgeons were the most narcissistic. The least narcissistic doctors, on the other hand, were geriatricians, cardiologists, GPs and and paediatricians. They were also the ones least likely to show signs of psychopathy – unlike neurologists and vascular surgeons, who were the most likely.
The authors suggest high levels of narcissism in surgery might actually be a good thing, particularly in vascular surgery, where a strong sense of self-assurance and confidence in one’s abilities might be needed to deal with catastrophic emergencies, such as a ruptured abdominal aneurysm.
And finally a couple of studies suggest that doctors in general have a personality profile that doesn’t match that of the general population. A UK study submitted 464 doctors to the Myers-Briggs personality assessment, finding that they differed from the UK adult population on a number of norms. They were more likely to score as introverted rather than extroverted, were more likely to be judgemental in their approach to life management, and in decision-making were more likely to favour objective evidence over personal values.
And a French study of over 1500 GPs found doctors had very different attitudes to health compared with that of their patients. Doctors were more willing to take risks with their health than their patients were. But they were also more cautious with their patients’ health than they were of their own.