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Personality Types of Otolaryngology Resident Applicants as Described by the Myers-Briggs Type Indicator
Shawn Zardouz, Michael A. German, Edward C. Wu and Hamid R. Djalilian Otolaryngology -- Head and Neck Surgery 2011 144: 714 originally published online 24 February 2011 DOI: 10.1177/0194599810397793 The online version of this article can be found at: http://oto.sagepub.com/content/144/5/714

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ryngologyHead and Neck SurgeryZardouz et al The Author(s) 2010 Reprints and permission: sagepub.com/journalsPermissions.nav

OTOXXX10.1177/0194599810397793Otola

Original ResearchGeneral Otolaryngology

Personality Types of Otolaryngology Resident Applicants as Described by the Myers-Briggs Type Indicator
Shawn Zardouz1,*, Michael A. German, MD1,*, Edward C. Wu1, and Hamid R. Djalilian, MD1

Otolaryngology Head and Neck Surgery 144(5) 714 718 American Academy of OtolaryngologyHead and Neck Surgery Foundation 2011 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599810397793 http://otojournal.org

No sponsorships or competing interests have been disclosed for this article.

Keywords personality type, otolaryngology, MBTI, Meyers-Briggs

Received September 23, 2010; revised December 1, 2010; accepted December 28, 2010.

Abstract Objective. To assess the personality types of applicants to a single otolaryngology residency program using the MyersBriggs Type Indicator. The personality types were compared with those of the general population and with physicians in other medical specialties. Study Design. Cross-sectional survey. Setting. University hospital. Subjects and Methods. A personality survey was emailed to 327 resident physician applicants over 2 consecutive years (20082009). Analysis was accomplished by calculating prevalence estimates. Results. Of the 327 anonymous surveys, 137 were completed (response rate = 42%). The Introverted/Sensing/Thinking/ Judging personality type was the most prevalent (14.6%), representing 13% of the general population. Prospective applicants displayed mostly Extroverted (E; 58%), Sensing (S; 54%), Thinking (T; 62%), and Judging (J; 61%) personality traits. Of the 16 personality types, statistically significant differences were found between otolaryngology resident applicants and the general population only for the Extroverted/Sensing/Thinking/ Perceiving (P = .002) personality type after correcting for multiple comparisons. The Intuitive (N; 46%) and Feeling (F; 38%) types correlated closely with the reported personality types of those individuals in nonprimary care specialties, 47% and 28%, respectively. Extroverted (E) and Thinking (T) individuals appeared to prefer surgical specialties, which occurred in 58% and 62% of the applicants, respectively. There were no significant differences between male and female applicants. Conclusion. This study examines the personality types of medical students applying to an otolaryngology residency. The results support a highly structured, data-driven teaching preference among applicants. These results may allow for a better understanding of the personalities of medical students who are interested in otolaryngology.

he Myers-Briggs Type Indicator (MBTI) has been used for decades for assessing individual personality types and characterizing groups of people. Based on work developed by psychologist Carl Jung, this instrument characterizes individuals by their decision-making processes and perceptions of the world. In practical applications, this tool has been used to reduce workplace conflict, improve individual and team performance, and develop leadership abilities at every level of an organization.1 The MBTI is a forced-choice questionnaire designed to measure an individuals preferences, which are combined to form an individuals personality type. The 4 MBTI dimensions analyzed are Extroversion-Introversion (E-I), Sensing-Intuition (S-N), Thinking-Feeling (T-F), and Judging-Perception (J-P). It is important to note that personality traits described by the MBTI do not imply ability or aptitude. Rather, they are indicators of an individuals preferred method of interpreting and using information and how they relate to the outside world. Much has been written on each of the 16 possible types; however, a detailed review is beyond the scope of the present study. Following is a review of the key characteristics of each dimension of the MBTI.

University of California, Irvine, Department of Otolaryngology, Irvine, California, USA

*

These authors contributed equally to this article.

This article was presented at the 2010 AAO-HNSF Annual Meeting & OTO EXPO; September 26-29, 2010; Boston, Massachusetts. Corresponding Author: Hamid R. Djalilian, MD, Bldg 56, Suite 500, 101 The City Drive, Orange, CA 92868 Email: hdjalili@uci.edu

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Zardouz et al E-I describes whether an individual garners energy and focuses attention internally or from interactions with others. Extroverts (E) are energized by other people and outside ideas, while Introverts (I) get their energy by concentrating on internal thoughts and emotions. The S-N attitude describes how individuals interpret information. Sensing (S) types tend to focus on tangible facts, while Intuitive (N) types focus on meaning and possibilities. The T-F attitude relates to how individuals use information to make decisions. Thinking (T) types prefer to be objective and logical and make decisions quickly. Feeling (F) types prefer subjective data and readily incorporate input from others. The Judging-Perception (J-P) dimension describes how individuals behave in their surroundings and approach tasks. Judging (J) types like structure and enjoy planning and decision making. They also are critical of the beliefs and work of others. Perceiving (P) types are more comfortable in unstructured environments and embrace others ideas and opinions.2 What personality traits best characterize otolaryngologists? Taylor3 writes that in temperament, the otolaryngologist is action-oriented, decisive, and perfectionistic. They prefer to deal with problems that can be solved quickly and afford immediate feedback. Other traits are independence, aggressive without being rude, and an open, questioning mind. Prior MBTI data4 show that similar personality types are attracted to ophthalmology and otolaryngology, with those choosing ophthalmology more patient oriented and those choosing otolaryngology more technically oriented. One might expect certain personality types to gravitate toward this selective surgical subspecialty. By understanding the personality types among medical students applying for otolaryngology positions, more effective teaching approaches can be tailored to these individuals based on their learning preferences, as indexed by the MBTI.5 This study attempts to quantify and categorize the personalities of medical students who have chosen to pursue a residency in otolaryngology. We compared applicant personality types with those of the general population and with individuals pursuing other specialties in medicine.

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Table 1. Prevalence Estimates of Personality Types of Otolaryngology Resident Applicants and the General Population5,a Personality Type INFP INFJ INTJ INTP ISTJ ISTP ISFJ ISFP ENFP ENFJ ENTJ ENTP ESFP ESFJ ESTP ESTJ Percentage of Applicants (n) 5.8 (8) 2.9 (4) 4.3 (6) 5.1 (7) 14.6 (20) 0.8 (1) 6.6 (9) 2.2 (3) 6.6 (9) 3.6 (5) 9.5 (13) 8.0 (11) 2.9 (4) 7.3 (10) 8.0 (11) 11.7 (16) General Population, % 6 4 5 4 10 3 9 5 9 6 6 5 5 9 3 11 P Value .883 .509 .847 .501 .103 .093 333 .194 .278 .344 .071 .060 .208 .396 .002 .644

Abbreviations: E, extroverted; F, Feeling; I, Introverted; J, Judging; N, Intuitive; P, Perceiving; S, Sensing; T, Thinking. a Bold type indicates a significant value.

Methods

to evaluate statistically significant differences in the 4-letter personality profiles of the residents as compared with the general population. The personality types were compared with those of physicians in primary and nonprimary care specialties. The personality profiles of the general population6 and of other physicians7 were chosen based on published literature. In addition, the personality types of the applicants were further classified by gender, and corresponding P values were calculated between gender and the various personality type dichotomies using the Fisher exact test. A Bonferroni adjustment was applied to account for multiple comparisons. All tests were considered statistically significant when P < .05.

Results After obtaining institutional review board approval from the University of California, Irvine, Office of Research The MBTI survey was issued to 327 medical students applying to Administration, an anonymous electronic MBTI survey writthe authors otolaryngology residency program, of which 137 ten in Visual Basic for Applications (Microsoft, Seattle, were completed (response rate = 42%). Within the entire cohort Washington) was distributed to all medical student applicants of 327 applicants, men (63%) outnumbered women (37%). Of the to a single otolaryngology residency program over a 2-year 137 completed surveys, a similar trend was seen in men (61%) period (2008-2009). All surveys were sent via email, and versus women (39%). The Introverted/Sensing/Thinking/Judging information regarding the applicants was obtained from the (ISTJ) type was exhibited by 14.6% of the participants, while the Electronic Residency Application Service. The data on each Extroverted/Sensing/Thinking/Judging (ESTJ) and Extroverted/ applicant were deidentified prior to analysis. Intuitive/Thinking/Judging (ENTJ) were represented by 12% and The survey consisted of various questions regarding per10% of the participants, respectively. Statistically significant difsonal preferences, social interactions, and working conditions. ferences were found between the resident applicants and the Based on the individuals responses to the questions, a 4-letter general population6 for the Extroverted/Sensing/Thinking/ personality type was generated. The 4-letter personality type Perceiving (ESTP) personality type (Table 1). (eg, INTJ) consists of 4 dimensions, each consisting of 2 posWith regard to the individual traits, a fairly even distribusibilities (eg, extroversion or introversion). As such, there are tion was seen when comparing the dichotomous dimensions a total of 16 possible personality types. (Table 2). The Extroverted (E; 58%), Sensing (S; 54%), Data were analyzed using SPSS for Windows, version 16.0 Thinking (T; 62%), and Judging (J; 61%) types represented (SPSS Inc, Chicago, Illinois). Chi-squared analysis was used most of the individual personality traits. The prevalence Downloaded from oto.sagepub.com by farcau ioana on October 30, 2012

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Table 2. Individual Personality Traits of Otolaryngology Applicants and Other Specialties7 Individual Personality Traits Introverted (I) Extroverted (E) Intuitive (N) Sensing (S) Feeling (F) Thinking (T) Judging (J) Perceiving (P) Percentage of Applicants (n) 42 (58) 58 (79) 46 (63) 54 (74) 38 (52) 62 (85) 61 (83) 39 (54) Primary Care, % 56 51 53 55 59 49 54 53

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Nonprimary care, % 44 49 47 45 41 51 46 47

Nonprimarysurgical, % 35 40 36 40 29 43 37 28

Nonprimarynonsurgical, % 65 60 64 60 71 57 63 72

Table 3. Individual Personality Traits by Gender E Women % n Men % n P 47 26 65 54 .058 I 53 29 35 29 S 44 29 54 45 .953 N 46 25 46 38 T 61 33 63 52 .999 F 39 21 37 31 J 60 33 61 51 .865 40 22 39 32 P

Abbreviations: E, extroverted; F, Feeling; I, Introverted; J, Judging; N, Intuitive; P, Perceiving; S, Sensing; T, Thinking.

estimates of all individual personality traits fell within the range of individual personality traits of those physicians in nonprimary care (surgical) and nonsurgical specialties.7 Comparisons of the individual personality traits with those of physicians in other specialties were made (Table 2). The Intuitive (N) type was seen in 46% of our cohort and 47% of nonprimary care specialties. The Thinking (T) and Judging (J) types were seen in 62% and 61% of our cohort and in 57% and 63% of physicians in nonsurgical specialties, respectively. Lastly, the Feeling (F) type was seen in 38% of the otolaryngology applicants and in 41% of nonprimary care specialties. Individual personality traits were compared within each gender category (Table 3). The Introverted (I), Intuitive (N), Thinking (T), and Judging (J) individual personality traits were more prevalent in women, while the Extroverted (E), Sensing (S), Thinking (T), and Judging (J) personality traits were more prevalent in men. These differences were not significant.

Discussion
To our knowledge, there is no published literature that examines the personalities of medical students applying to otolaryngology residency. Studies have been conducted to examine the personality types of physiatrists,8 pediatric residents,9 and emergency department staff.10 It has already been shown that the field of medicine attracts students with specific psychological types, as these individuals are often practical and have an objective and systematic approach to the study of life.11 Furthermore, a longitudinal study was performed to understand how the psychological profiles of medical students have changed over time.12

Trends in our study for applicant preference by dimension shared similarities with published data for medical students applying to surgical versus nonsurgical specialties. Otolaryngology applicants showed a preference for Extroversion (E; 58%) over Introversion (I; 42%). Stilwel et al7 showed that Introvert (I) types chose surgical residencies at a significantly lower rate than did Extrovert (E) types. The largest difference we found was between Thinking (T; 68%) and Feeling (F; 32%) types. The above authors similarly found that Feeling (F) types selected surgical residencies at a significantly lower rate than did Thinking (T) types. In general, Feeling (F) types prefer primary care specialties, while the Thinking (T) types select primary and nonprimary care fields at the same rate. Feeling (F) traits are more applicable to the primary care specialties, in which forming personal relationships with patients is more heavily emphasized than in surgical specialties. Judging (J) types (61%) were almost twice as prevalent as Perceiving (P) types (39%). Several studies have found a preference for Judging (J) types in other health care fields.7,13 Among the applicant pool, ISTJ, ESTJ, and ENTJ types were most prevalent, comprising greater than 35% of otolaryngology applicants. ISTJs are described as quiet, serious, and dependable; they are practical and decide logically what should be done and work toward it steadily. They are orderly and organized. ESTJs are very similar but are more outgoing and forceful in implementing plans. ENTJs are frank, decisive, and assume leadership readily. They enjoy long-term planning and goal setting, they are usually well informed, and they enjoy expanding their knowledge and passing it on to others.5

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Zardouz et al Otolaryngology is similar to other surgical specialties with a heavy workload and frequent call responsibilities. Physical examination skills are indispensable, and many diagnoses are made on the initial examination. The field of otolaryngology attracts extremely intelligent, perceptive individuals who can solve problems efficiently. Furthermore, this specialty may appeal to those who prefer solving discreet, well-defined problems, thereby producing tangible results. This study also demonstrates a paucity of certain personality types. The ISTP personality type was represented by 1 individual within our cohort, and the ESFP personality type was represented in 2.9% of the study population. Individuals with these personality types share their flexible and tolerant characteristics. More specifically, ISTPs are quiet observers, acting quickly once a problem appears, while ESFPs learn by trying a new skill with other individuals.5 These personality types are perhaps less independent and are less interested in the level of attention to detail needed for a surgical specialty, such as otolaryngology. We also examined the differences in individual personality traits between men and women. Previous literature suggests that women, Introverted (I), and Feeling (F) types are associated with the choice of primary care.6 The current study population consisted of greater numbers of men as compared with women. In addition, there were greater numbers of male than female Extroverts (E), which nearly met criteria for significance (P = .058). Overall, there were no significant differences between the personality types found among the male and female applicants. The MBTI may be used to identify associated learning styles or preferences that are best suited to individuals. Studies by Lawrence14 indicated that people grouped by MBTI type showed distinctive learning style preferences not explained by other factors. Given that nearly two-thirds of our study population were Thinking (T) and Judging (J), it would make sense to examine teaching preferences that apply specifically to them. Thinking (T) types prefer to learn through facts and data presented in a logical, organized format. An example of this type of teaching is the Comprehensive Otolaryngologic Curriculum Learning through Interactive Approach (COCLIA) program endorsed by the American Academy of OtolaryngologyHead and Neck Surgery. It is a structured framework to cover more than 100 major topics in the specialty that requires residents and faculty to convene weekly and answer a battery of questions. It organizes topics throughout the academic year, and questions are designed with graded difficulty such that residents at different levels can maximize their learning. This program should also appeal to Judging (J) types, who prefer structure and decision making. One possible conflict might arise from the collaborative nature of the COCLIA sessions, in that Judging (J) types tend to be critical of others beliefs and work. Nevertheless, it would appear that a highly structured curriculum in the form of COCLIA or a similar approach would be effective given the predominant personality types in our applicant pool. There are several limitations to this study that must be noted. First, selection bias could have been introduced such that the personality types of those individuals who completed

717 the survey were different from the personality types of those who did not. Second, a response rate of 42% and a small sample size limit the ability to extrapolate the results of this study to other otolaryngologyhead and neck surgery programs. Lastly, because this study represents data from applicants applying to a single program, the results may not be generalizable to the greater pool of 394 applicants to otolaryngology residency programs in the United States in 2009.15

Conclusion
In summary, the prevalence estimates of the various personalities represented suggest greater numbers of ISTJ, ESTJ, and ENTJ personality types. The findings of this study also suggest that Thinking (T) and Judging (J) types were more common than Feeling (F) and Perceiving (P) types by 50% among the otolaryngology resident applicants. Structured teaching methodologies that rely on facts and data appear to best suit these personality types. Additional research is needed to examine whether the high prevalence estimates of the ENTP and ESTP personality types of our cohort as compared with the general population are a random occurrence or a noteworthy association. Further analyses to examine the personality types of residents in otolaryngology programs around the country or practicing otolaryngologists may help elicit more accurate information regarding personality types of physicians in this specialty. This would allow comparisons with individuals applying for residency spots to determine if certain personality types are more successful in matching. Author Contributions
Shawn Zardouz, study design, data collection, statistical analysis, drafting of article, final approval; Michael A. German, study design, data collection, drafting and editing of article, final approval; Edward Wu, acquisition of data, statistical analysis, drafting article, final approval; Hamid R. Djalilian, corresponding author, study design, editing of article, final approval.

Disclosures
Competing interests: None. Sponsorships: None. Funding source: None.

References
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6. Macdaid GP, McCaulley M, Kainz R. Myers-Briggs Type Indicator: Atlas of Type Tables. Palo Alto, CA: Consulting Psychologists Press; 1986. 7. Stilwell NA, Wallick MM, Thal SE, Burleson JA. Myers-Briggs type and medical specialty choice: a new look at an old question. Teach Learn Med. 2000;12(1):14-20. 8. Sliwa JA, Shade-Zeldow Y. Physician personality types in physical medicine and rehabilitation as measured by the Myers-Briggs Type Indicator. Am J Phys Med Rehabil. 1994;73(5):308-312. 9. Lacorte MA, Risucci DA. Personality, clinical performance and knowledge in pediatric residents. Med Educ. 1993;27(2):165-169. 10. Boyd R, Brown T. Pilot study of Myers Briggs Type Indicator personality profiling in emergency department senior medical staff. Emerg Med Australas. 2005;17(3):200-203.

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11. Bitran M, Ziga D, Lafuente M, et al. Psychological features and cognitive styles of students entering medicine and other careers at the Pontificia Universidad Catlica de Chile. Rev Med Chil. 2004;132(7):809-815. 12. Wallick MM, Cambre KM. Personality types in academic medi cine. J La State Med Soc. 1999;151(7):378-383. 13. Westerman GH, Grandy TG, Ersrkine CG. Personality types of dentists. Am J Dent. 1991;4(6):298-302. 14. Lawrence GL. Looking at Type and Learning Styles. Gainesville, FL: Center for Application of Psychological Type; 1997. 15. National Resident Matching Program. Advance data tables, 2009 main residency match. http://www.nrmp.org/data/advancedata tables2009.pdf. Accessed May 7, 2009.

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