Personality selection: An argument against the homogenisation of medical students

Dear Sir

Powis (2015) suggests that an increase in complaints against doctors is secondary to a medical school selection process which, by emphasising academic rigor, overlooks personally flawed individuals. He proposes his personality questionnaire could be a means of filtering out future “unsatisfactory doctors”. We have a number of apprehensions about such an approach.

Firstly and most importantly, any “desirable” personality characteristics that are screened for selection can be learnt pre-application, rendering the whole concept redundant. Indeed a reduction in the majority of medical applicants' desired personality characteristics post-selection has been demonstrated (Griffin & Wilson 2012). Through training, applicants can exhibit desired personality traits and mask extreme traits, paradoxically favouring the selection of more manipulative individuals.

Many great doctors throughout history have harnessed extreme personality traits to great benefit. William Osler was known to be mischievously libertarian in prolifically submitting “joke” pseudoscientific journal articles. Though his professional disregard might be screened as disorderly by Powis’ ‘Personal Quality Assessment’, it could be argued that these traits, in combination with creativity and wit, made one of the greatest innovators in medical education and a man who is widely known as the “father of modern medicine”. Dr William Halsted displayed even more extreme characteristics of anti-social behaviour and impulsivity, culminating in drug addiction. His own radical experimentations led to multiple innovations in anaesthetic and surgical technique, ultimately saving countless lives. Whilst unsafe and unprofessional practise is not condoned, research processes are now much better suited to nurture pioneering individuals.

Personality testing could lead to the homogenisation of the medical student body, which may reduce the diversity of viewpoints and a subsequent increase in biases. Personality is linked with speciality choice; students choosing surgery for example have been found to exhibit increased impulsivity and neuroticism (Mehmood et al. 2013) – which are proposed medical application exclusion characteristics. Hence restricting the diversity of personalities entering medical school may have implications for workforce planning.

Lastly, studies show personality traits continue developing until the age of 30, so it might be unreasonable to expect ideal traits in applicants at a young age (as young as 18). Taking the aforementioned points into account, we believe it is the responsibility of the medical school to guide students’ personality development during their training. A more meaningful alternative might be screening for specific “at risk” traits during medical school and guiding personality development, rather than excluding those that are deemed inappropriate by a cross-sectional personality test at or prior to interview.

Declaration of interest: The authors have no declarations of interest to disclose.