PERSONALITYTYPE

AND
MEDICALSPECIALTY
(ExcerptfromTheultimateguidetochoosingamedicalspeciality)
By
BrianFreeman,MD
ResidentinAnesthesiologyandCriticalCare
UniversityofChicagoHospitals
Chicago,Illinois

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Whatmakesyoutick?Howdoyouhandlestress?Whatgivesyousatisfactionandfulfillment?
How do you interact with your peers? These are all dimensions of a doctors personality.
Discerningyourpersonalitytypeisnotsimplyfindingastereotypethatfits.Instead,itmeans
identifying your distinctive attributes, values, and affinities and finding the natural comfort
zonewhereyourtruepreferenceslieasaphysician.

Although itis especially important for doctorsintraining to select a specialty that is the best
matchwiththeirpersonality,bestmatchdoesnotmeanithastobeperfect.Takeahardlookat
the physicians you have met and make sure that your personality type is well represented
(rather than underrepresented) in the specialty that interests you. The notion that opposites
attractwillprobablynotleadtoalong,satisfyingmedicalcareer.Forinstance,mostphysicians
wouldnotdisputetheideathatempathic,laidbackmedicalstudentsmakebetterpsychiatrists,
and strongminded, authoritarian, nononsense ones should become surgeons. In these
examples, students find themselves most comfortable working sidebyside with other
physicians who share their personality traits. When you get along well with your colleagues,
patientsendupreceivingthebestmedicalcarepossible.

Many physicians have studied the relationship between a doctors personality and chosen
specialty. A group of surgeons sought to determine whether there were differences in the
characteristics and temperament of physicians in three types of medical careers: surgical,
primary care (family practice, internal medicine, and pediatrics), and controllable lifestyle
specialties (anesthesiology, dermatology, emergency medicine, neurology, ophthalmology,
pathology, psychiatry, and radiology).1 Most students think of surgeons as dominant,
uninhibited,andaggressive.Theytendtooverlookthefactthatsurgeryrequiresacertaintype
ofpersonwhocanhandleitstasksandchallenges.Areyouoneofthem?Theirstudyfoundthat
surgeons tend to score higher than other specialists on being extroverted, practical, social,
competitive,andstructured.Atthesametime,however,surgeonswerelesscreativethantheir
colleaguesincontrollablelifestylespecialties(whowerefoundtobethemostwithdrawnand
rebellious).Neithergroupdifferedsignificantlyfromtheprimarycarephysicians.Thisparticular
study,therefore,helpstosupporttheideathataphysicianssatisfactioninagivenspecialtyhas
alottodowithpersonalityfactors,liketemperamentandsociability.

Anotherlandmarkstudysurveyedagroupofmedicalstudentstodetermineanyrelationships
between personality type and specialty choice.2 Students entering the hospitalbased
specialties(anesthesiology,radiology,oremergencymedicine)hadlesstoleranceforambiguity
andpreferredhighlystructuredenvironmentswithfixedguidelinesandimmediateclosureto
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every patient encounter. Future obstetriciangynecologists saw themselves as warm and

helpful, but they were also emotionally vulnerable, uncomfortable around others, and very
concernedaboutappearancesandmakingagoodimpression.Futurepediatricians,whosought
warm and close interactions with their patients, were the most extroverted and sociable
people. In contrast, the introverted students with fewer social connectionsparticularly the
oneswhohadbeeninpsychotherapythemselvesbecamepsychiatrists.Thestudyalsofound
thatstudentsinterestedinsurgeryweremorelikelytobecompetitive,aggressive,andhighly
confident.Theywerethedoctorstobewhocarriedastrongconvictionthattheiractionscould
rapidlyinfluencethecourseofevents.

Whencheckingoutallthedifferentchoices,medicalstudentsshouldkeepinmindthatmore
thanonespecialtycouldmeettheirpreferences.Foreverypersonalitytype,itispossibletofind
asatisfyingmatchwithmorethanoneareaofmedicine.Ifyouareavisuallyorientedperson,
consider specialties like pathology, dermatology, and radiology. For students who want to
speak only the language of medicine every day as a doctors doctor, radiology and pathology
areidealchoices.Primarycarespecialties,likeinternalmedicineandfamilypractice,aregreat
opportunitiestohavelongterm,intimatepatientrelationships.Ifyoupreferanactionoriented
specialty that gives immediate gratification, then consider anesthesiology, any surgical
subspecialty,andemergencymedicine.Someareasoverlapconsiderablylikethegreatvariety
ofmedicalproblemsencounteredinbothfamilypracticeandemergencymedicine.Butatthe
sametime,theycanhavesignificantdifferenceslikethelongtermfollowupnatureoffamily
practice versus the acute, stabilizethepatientandmoveon style of emergency medicine.
Thus,tomakethebestdecision,youhavetoknowyourselfandyourdesireswell.

THEMYERSBRIGGSTYPEINDICATOR

Firstdevelopedinthe1950sbyIsabelBriggsMyersandKatherineBriggs,theMyersBriggsType
Indicator(MBTI)hasbecomethemostpopularandwidelyusedpsychologicaltestintheworld.
BasedonCarlJungstheoryofpersonalitytypes,theMBTIwasdesignedtoanalyzepersonality
inasystematic,scientificmanner.Whereotherquestionnaires(typetests)onlyillustratetype,
theMBTIpreciselyidentifiesapersonspersonalitytypepreferences.

The MBTI can help medical students to choose the right specialty for their personality and
temperament.Thetestenablesyoutolearnmoreabouthowyouperceiveandjudgeothers,
whetherinanoccupationalorsocialsituation.Itidentifiesyourstrengthsandweaknessesand
showswhetheryouvalueautonomyorpreferinterdependence.

MedicalstudentsusuallytaketheMBTIatsomepointduringthefirst2yearsofmedicalschool.
It is a very understandable and useful test for health professionals. Your Dean of Students
Office will use the valuable information for career planning and development purposes
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especiallywhenitcomestimetofiguringoutwhichspecialtymightbethebestoneforyou.For
thosewhohavenotyettakentheMBTI,nowistheperfecttimetodosoinconjunctionwith
readingthisbook.ManywebsitesofferdifferentversionsoftheMBTI.YoucandoanInternet
search for these, or simply log on to the official site of the Center for Applications of
PsychologicalTypeat<http://www.capt.org>.Forafee,theywillsendyoutheofficialtestand
provide personalized expert feedback over the telephone about your results and how to use
theirinterpretation.Whentakingthetest,besuretoanswereveryquestiontruthfully;honesty
is the only way to yield the most accurate results and help you pick the most appropriate
specialty.

BreakingDowntheMBTI:SixteenPersonalityTypes

According to the theory behind the MBTI, every individual falls into one of 16 types of
personality.ThesepersonalitytypesarederivedfromthefourmainindicesoftheMBTI.Each
index represents one of the four basic preferences (described by Jung) about how every
individual perceives and processes external stimuli and then uses that information to make
some kind of cognitive judgment. As part of ones overall personality, this judgment guides
behavioralpreferencesinanysituationinvolvingotherpeoplelikecolleaguesorpatients.The
fourdimensionsmeasuredbytheMBTIare:

1. Extroversion(E)versusIntroversion(I):
Howdoyourelatetoothers?Wheredoyoubestderiveyourenergyfromyourselfor
fromothers?Introvertsprefertofocustheirinterestandenergyonaninnerworldof
ideas, impressions, and reactions. Being introverted does not mean being asocial.
Instead,introverts
prefer interactions with greater focus and depth, with others who are also good
listenersandwhothinkbeforetheyactorspeak.Extroverts,ontheotherhand,derive
theirenergyfromexternalstimuliandtendtofocustheirinterestontheoutsideworld.
Theypreferdealingwithfacts,objects,andactions.Notallextrovertsarethelifeofthe
party,however.Theysimplypreferbeingengagedinmanythingsatonce,withlotsof
expression,impulsivity,andthinkingoutloud.

2.Sensing(S)versusIntuition(N):
What kinds of stimuli do you prefer when collecting, processing, and remembering
information?Sensorsaretheoneswhoaredrawntothehard,immediatefactsoflife
practicaldetailsandevidencethatcanbetakeninthroughoneofthefivesenses.They
are sensible, matteroffact people who look at the reality of the world around them,
rely on prior experiences, and take things literally. Intuitives, on the other hand, look
beyond the facts and evidence for meanings, possibilities, connections, and
relationships. They are more imaginative and creative people who like to see the big
picture and abstract concepts. Using intuition often means relying on a hunch or gut

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feeling rather than past experience. They eschew facts for theories and look beyond
simplytheobvious.

3.Thinking(T)versusFeeling(F):
Howdoyoumakedecisionsandcometoconclusions?Thisindexconcernsthekindof
judgment you trust when you need to make a decision. Thinkers make their decisions
impersonally,based
mainlyonobjectivedatathatmakessensetothem.Asanalyticalpeoplemotivatedby
achievement, they always consider the logical consequences of their decisions. Unlike
thinkers,feelersrelyonpersonal,subjectivefeelingsintheirdecisions.Asempathetic,
compassionate,andsensitivepeople,theytakethetimetoconsiderhowtheirdecision
mightaffectothers.Feelerslikepleasingothersandtendtogettheirfeelingshurtrather
easily.

4.Judgment(J)versusPerception(P):
How do you order your life? What kind of environment makes you the most
comfortable? This index describes how a person deals with the outside world. Those
who prefer judgment are serious, timeconscious individuals who live by schedules.
Theylikethingsorderly,planned,andcontrolled.Judgersneedaworldofstructureand
predictability to have a sense of control over their environment and to be their most
organizedandproductive.Judgersworkhard,makedecisionsquicklyanddecisively,and
sometimescanbeclosedminded.Ontheotherhand,perceiversaremuchmoreopen
minded,relaxed,andnonconforming.Theyaremuchmoreawareofideas,events,and
things.Theirflexibilityandspontaneity,however,cansometimesleadtoirresponsibility.
Althoughjudgersneedtofinishprojectsandsettleallissues,perceiverstendtogather
information in a leisurely way before making a final decision. Perceivers prefer to
experienceasmuchoftheworldaspossible,sotheyliketokeeptheiroptionsopenand
aremostcomfortableadapting.

According to the theory behind the MBTI, personality type indicates an innate preference
(similartohanddominance)towardoneofthetwopolesineachindex,meaningthataperson
isprobablynevera100%introvert,butmaylieclosertotheintroversionpole(thedominantor
leadingprocess)onacontinuumscale,whilestillhavingsomequalitiesofextroversion(which
inthiscasewouldbeconsideredthenondominantorauxiliarytrait).WhenyoutaketheMBTI,
youreceiveascorethatshowsthestrengthandconsistencyofyournaturaltendencyineachof
these four dimensions. It is the interplay between the four poles that ultimately gives us our
individual personality and temperament. Thus, the test classifies you as one of 16 different
personalitytypescombinations:INTP,ESTJ,ENFJ,ISTP,andsoon.Acompletedescriptionofthe
16personalitytypescanbefoundonthewebsiteoftheCenterforApplicationsofPersonality
Type.

HowtheMBTICanWorkforYou

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Atthispoint,youareprobablythinkingEnoughwithallthispsychologystuff!Howdoesthis
helpmechooseaspecialty?ThebestapproachistotaketheMBTIandidentifyyourspecific
personalitytype.Usetheexpertfeedbackandinterpretationofyourresultstolearnmore
aboutthetypesofpeoplewithwhomyouworkbest.Then,asyourotatethroughthedifferent
fieldsofmedicineduringthejunioryear,lookcloselyateachspecialistandtrytodiscerntheir
personalitytype.Dopediatriciansseemmorelikeintroverts?Aresurgeonsjudgersor
perceivers?Whatdospecialtieschosenbyyourpersonalitytypehaveincommon?Theoverall
goalistomakesureyouknowyourselfwellbeforedeterminingwhichspecialtyisrightforyou.

Ideally, medical students should think about taking the MBTI more than once, because
personalitytypemaychangeovertime(especiallyinyoungpeople).Personalgrowthandnew
experiences can often change the way a person interacts. Introverts may become more
extroverted, or thinkers might become feelers from one year to the next. In fact, one study
comparedMBTIresultsinagroupofmedicalstudentswhotookthetestduringtheirfirstand
fourth years of school.3 The authors found that nearly 57% of students had changed their
personalitytypepreferencesononeormoreoftheMBTIindices.

TheMBTIhasbeenstudiedquiteextensivelywithinthemedicalprofessiontodrawconclusions
about the relationship between personality type and career choice. One study examined
whethertheresultsoftheMBTItakeninthefirstyearofmedicalschoolaccuratelypredicted
thechoiceofmedicalspecialtyinthepostgraduateyear.4Theauthorsfoundthatthreeoutof
the four type indices (SN, TF, JP) were predictive of future specialty choice: Students who
weresensing,feeling,andjudgingtypesselectedfamilypractice.Studentswhoweresensing,
thinking, and judging types chose obstetrics and gynecology. Students who were intuitive,
feeling,andperceivingtypesundertookcareersinpsychiatry.

Another study looked closely at the association between these two variables for medical
studentsdecidingbetweenprimarycareandnonprimarycarespecialties.5Theauthorsfound
thattheextroversionintroversion(EI)andthinkingfeeling(TF)axeswerethemoststatistically
significantMBTIpredictorswithregardtospecialtyselection.Introvertsandfeelersweremore
likely to choose primary care, a highly serviceoriented area of medicine with the rewards of
longtermpatientrelationships.Forgraduateswhochosenonprimarycarefields,extroverted
thinkers preferred surgical specialties, which is to be expected given the nature of surgical
practicehigh patient volume, less longterm continuity of care, and clinical situations that
requirerapiddecisionsbasedonfacts.

Recently,researchersatLouisianaStateUniversityupdatedtheoriginallongitudinalstudydone
byMyersinthe1950s(seeTable41)withnewdataondoctorsgraduatingbetween1988and
1998.6 They, too, found that IN types are more drawn to fields like internal medicine and
neurology,whereassurgicalspecialtiesattractEStypes.Introvertsandfeelingtypesaremore
likelytochooseprimarycarebecauseofitsnurturing,compassionateaspects.Withinprimary
care,feelingtypesaremorelikelytochoosefamilypracticeoverinternalmedicine(whichhasa
more technological focus). Anesthesiology seems to attract more ISTPs and ISFPs, and
pediatrics appeals more to ESFJs and ESTJs. Sensorswho love more technological, direct
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approacheswithwelllearnedskillsaremorecommoninsurgery(generalandorthopedic)as
well as obstetricsgynecology. Intuitives prefer complex diagnostic challenges and problems
withsubtlenuances,sotheyaremorelikelytobecomepsychiatrists.INTtypes,whoenjoythe
challengeofmedicinewithouteverseeingapatient,areattractedtopathologyandresearch
due to their ability to detach personally. Thinking types prefer caring for patients where
impartialityandstaminaarerequired.Theyalsoflocktothesurgicalspecialties,
whererapiddecisionsareneededbasedonhardevidenceandfacts.

MEDICALSPECIALTIESBYTEMPERAMENT

IntrovertedSensingThinking
Judging(ISTJ)
Dermatology
Obstetricsgynecology
Familypractice
Urology
Orthopedicsurgery

IntrovertedSensingFeeling
Judging(ISFJ)
Anesthesiology
Ophthalmology
Generalpractice
Familypractice
Pediatrics

IntrovertedSensingThinking
Perceptive(ISTP)
Otolaryngology
Anesthesiology
Radiology
Ophthalmology
Generalpractice

IntrovertedSensingFeeling
Perceptive(ISFP)
Anesthesiology
Urology
Familypractice
Thoracicsurgery
Generalpractice

IntrovertedIntuitiveFeeling
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Judging(INFJ)
Psychiatry
Internalmedicine
Thoracicsurgery
Generalsurgery
Pathology
ExtrovertedSensingThinking
Judging(ESTJ)
Obstetricsgynecology
Generalpractice
Generalsurgery
Orthopedicsurgery
Pediatrics

ExtrovertedSensingFeeling
Judging(ESFJ)
Pediatrics
Orthopedicsurgery
Otolaryngology
Generalpractice
Internalmedicine

ExtrovertedIntuitiveFeeling
Perceptive(ENFP)
Psychiatry
Dermatology
Otolaryngology
Psychiatry
Pediatrics

IntrovertedIntuitiveThinking
Judging(INTJ)
Psychiatry

Perceptive(ESFP)
Pathology
Ophthalmology
Neurology
Thoracicsurgery
Internalmedicine
Anesthesiology
Obstetricsgynecology
Orthopedicsurgery

Generalsurgery
IntrovertedIntuitiveFeeling

Perceptive(INFP)
ExtrovertedIntuitiveThinking
Psychiatry
Cardiology
Perceptive(ENTP)
Otolaryngology
Neurology
Psychiatry
Dermatology
Pathology
Radiology

Pediatrics
IntrovertedIntuitiveThinking
Pathology
Perceptive(INTP)

Neurology
ExtrovertedIntuitiveFeeling
Pathology
Judging(ENFJ)
Psychiatry
Thoracicsurgery
Cardiology
Dermatology
Thoracicsurgery
Psychiatry

Ophthalmology
ExtrovertedSensingThinking
Radiology
Perceptive(ESTP)

Orthopedicsurgery
ExtrovertedIntuitiveThinking
Dermatology
Judging(ENTJ)
Familypractice
Neurology
Radiology
Cardiology
Generalsurgery
Urology

Thoracicsurgery
ExtrovertedSensingFeeling
Internalmedicin

Source:Dataadaptedfrom:McCaulley,M.H.TheMyersLongitudinalMedicalStudy
(MonographII).Gainesville,Fla:CenterforApplicationsofPsychologicalType;1977.

LOOKINGATTHEBIGPICTURE

TheMBTIisausefultoolforidentifyingaspectsofyourpersonality,whichcanhelpyoutofinda
compatible medical specialty. Rememberthe more you understand your temperament and
motivations,thelesslikelyyouwillallowothervariables(suchasthosediscussedinChapter3)
to overshadow them. At the same time, medical students should not rely too heavily on
personality type. Simply be aware that working with people with the same personality
preferencesisanimportantvariabletoconsider.Typically,aphysicianwhoswitchestoanew
specialtychoosesoneinwhichhisorherownpersonalitytypeismuchmorecommon.Afterall,
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medicine is a wonderfully broad profession in which there is an appealing specialty for every
personalitytype!

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