Do You Have the "Right Stuff" to Be a Doctor?

Not long ago a friend confessed that her son, who spends much of his free time volunteering at a children’s hospital and who is applying to medical school, has been particularly anxious about his future. “His test scores are just O.K.,” my friend said, the despair in her voice nearly palpable. “I know he’d be a great doctor, but who he is doesn’t seem to matter to medical schools as much as how he does on tests.”

Her comment brought me back to the many anxious conversations I had had with friends when we were applying to medical school. Over and over again, we asked ourselves: Do we really need to be good at multiple-choice exams in order to be a good doctor?

We were referring of course to not just any exam, but to the Big One -- the Medical College Admission Test, or MCAT, the standardized cognitive assessment exam that measures mastery of the premedical curriculum. Back then, as now, American medical school admissions committees required every applicant to sit for the MCAT.  And with the competition fiercer than ever for slots in medical school, it seems inevitable that the MCAT would play a crucial role in admissions decisions.

But does that guarantee that the applicants admitted are also destined to become the best doctors? 

Now a new study by three industrial and organizational psychologists finds that another type of exam may be more helpful in determining which students are likely to succeed in, and after, medical school: personality testing. 

In this week's "Doctor and Patient" column, I write about the fascinating results of this study and speak with one of the study authors. Is the current admissions process doing the best job in choosing who will be part of the next generation of doctors? And can personality tests improve that process? Please read the full article and leave your thoughts below or on Tara Parker-Pope's "Well" blog. 

Comments

[Ed Volpintesta MD]

February 20, 2010

The New York Times
Well Blog

Dr. \Pauline Chen broached a serious subject in “Do You Have the ‘Right Stuff” to be a doctor” in the Jan. 15 issue of the New York Times.

For almost a hundred years American medical schools have focused mainly on medical research. To be admitted to medical school, a student has to demonstrate a high aptitude for science. That is the reason why they turn out physicians who contribute greatly to the advance of medical science.

But, as Dr. Chen pointed out, are students who might not have strong aptitudes for science, but who have personal qualities that would make them good practitioners being overlooked by the screening process? Should personal qualities like openness, conscientiousness, extraversion, and agreeableness also be taken into account as well?

This question is not a new one. It was suggested that the answer lies with whether medical schools want to turn out great researchers or great practitioners. I don’t think however that this is an either/or situation. Since both kinds of doctors are needed why not decide what percentage of each will satisfy society’s needs; and adjust the medical school admission rate accordingly?

However medical educators decide to handle this problem, the predominance of the sciences in medical school will make the transformation difficult.

The shortage of primary care doctors is the most obvious example of how medical schools have created a lop-sided physician workforce. By over-concentrating on students’ scientific aptitudes, they have created a medical culture that rewards medical specialization to a much greater degree than primary care.

The result is an unbalanced, over expensive, work force that under serves many of society’s basic medical needs. The lack of primary care providers is one of the central issues of the health care debate. I most likely will be solved, in part, by recruiting suitable trained nurses to provide some primary care services independently.