RESEARCH

Trăsături personologice individuale în opţiunea profesională a studenţilor medicinişti şi a medicilor rezidenţi

 Individual personological features in the professional choice of medical students and resident doctors

First published: 16 aprilie 2021

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Psih.64.1.2021.4775

Abstract

The medical specialty contributes to the professional training process through the development of personal skills, through the permanent accumulation of knowledge, but also through the acquisition of new skills, things that are dependent on each individual personality. Choosing an inappropriate specialty can lead to a low level of fulfillment and resolution of the specific requirements of the profession, failures, frustrations, lack of satisfaction and self-affirmation through the profession, overwork, aspects that sometimes even lead to loss of control. Their presence for a longer period can trigger the burnout syndrome. That is why it is very important that the medical specialty be chosen in accordance with the personality, individual abilities, interests, values, but also with personal expectations. Quality of life pursues several aspects, such as physical and mental health, self-esteem, interpersonal relationships and environmental conditions. The right medical specialty will improve the quality of the medical act through the ability to fulfill the obligations at work, but at the same time it also contributes to increasing the quality of life by reducing stress at work. This approach can be integrated in the future in educational programs in order to guide medical graduates in choosing the right medical specialty.

Keywords
medical specialty, quality of life, personality traits, motivation, dimensional perspective

Rezumat

Specialitatea medicală contribuie la procesul de formare profesională, prin dezvoltarea competenţelor personale, prin acumularea permanentă de cunoştinţe, dar şi prin dobândirea de noi abilităţi, lucruri care sunt dependente de personalitatea fiecăruia. Alegerea unei specialităţi nepotrivite poate duce la un nivel scăzut de îndeplinire şi rezolvare a cerinţelor specifice profesiei, la eşecuri, frustrări, lipsa satisfacţiilor şi afirmării de sine prin profesie sau suprasolicitare, aspecte care uneori duc chiar la pierderea controlului. Prezenţa acestora mai mult timp poate declanşa sindromul de burnout. De aceea, este foarte important ca specialitatea medicală să fie aleasă în concordanţă cu personalitatea, abilităţile individuale, interesele, valorile, dar şi cu aşteptările personale. Calitatea vieţii urmăreşte mai multe aspecte, precum sănătatea fizică şi psihică, stima de sine, relaţiile interpersonale, cât şi condiţiile de mediu. Specialitatea medicală potrivită va îmbunătăţi calitatea actului medical prin capacitatea persoanei de a-şi îndeplini obligaţiile la locul de muncă, dar în acelaşi timp contribuie şi la creşterea calităţii vieţii, prin reducerea stresului la locul de muncă. Acest demers poate fi integrat în viitor în programe educaţionale, în vederea ghidării absolvenţilor medicinişti în alegerea specialităţii medicale potrivite.

Medical education involves investments of material resources, time and energy, whose beneficiary will be in the end the patient(1).

The medical specialty contributes to the profession training process through the development of personal skills and accumulation of knowledge, things that are dependent on each individual’s personality. In this way, the personality is in close connection with profession(2).

Personality is considered to be the most important factor in the choice of medical professional. The profession satisfies the personality characteristics in terms of aspirations and level of achievement(3).

Doctors are often viewed through the chosen specialty(4). The choice of medical profession is influenced by personal motivation, personal interests and values, aspects related to personal subjectivity. Academic achievements, the possibilities offered by the specialty as a social and financial status, the opportunities related to research, but also the possibility to practice the specialty in the private or public system are factors related to the objective conditions(5).

In many cases, there are discrepancies and mismatches between the personal style and the characteristics of the medical field chosen(6).

An improvement in the quality of the medical act can be obtained by studying the personality of doctors. The right specialty will help reduce stress at work that can reach high levels, the medical career being one of the most stressful professions(3).

The quality of life of both the student and the doctor includes several aspects, such as physical and mental health, interpersonal relationships at work and in the family, but also the conditions in which the student or doctor lives and works(7). Throughout their careers, doctors are attentive to the quality of life of patients, thus neglecting their personal life, which over time can lead to a decrease in the quality of life. The existing studies currently suggest that medical students have a lower quality of life than people of the same age in the general population. This is due to the unbalanced lifestyle, academic failures that impact the student’s mental state, factors related to the environment in which they operate, interpersonal relationships that due to the busy schedule may be lacking, but also low self-esteem(8). That is why it can become difficult to find a balance between academic requirements and daily activities.

As a student or doctor, motivation is an extremely important aspect in the medical career. Motivation is defined as the process by which a person is mobilized to achieve goals. Motivation for profession is made up of several factors that determine the engagement in a behavior. The most important internal factor is represented by personality. The external factors are represented by environmental factors. Motivation is a faceted construct that includes: confidence in one’s own abilities, reasons for engaging in the activity, but also the reactions that the activity provokes. This can be seen as a process of choosing the goal and the effort required to achieve it(9).

Motivational involvement is the qualitative and adaptive aspect of motivation and refers to a person’s ability and willingness to set certain goals and try to achieve them. In other words, motivational involvement can be represented by activating, but also motivational targeting to achieve the proposed goal. Through motivational involvement, one can identify job satisfaction from which we can extrapolate individual and professional productivity(9).

Motivational persistence provides the quantitative component of motivation, representing a person’s ability to persevere and make an effort to achieve the proposed goals. It follows several elements: the effort that represents the energy exerted by a person to achieve the goals; self-confidence; the perseverance with which the person directs his effort to achieve the goals; the purpose for which the person engages in the activity; organizing the dosing of the effort to achieve the objectives; focusing on the essentials, on the activities necessary to achieve the objectives; the obstacle that can intervene and the ability to overcome it, but also the ambition to achieve more than others and to be in competition(9).

In Romania, the duration of the faculty of medicine is six years, training that ends with the bachelor’s exam. In order to be able to complete the residency training, the graduates must take the residency exam. In this regard, the choice of medical specialty can be an elaborate, conjunctural or imposed option and is conditioned by several factors. The first factor mentioned is individual self-knowledge, in the sense of matching the characteristics of professional activity, the dominance of personality and the intellectual and physical abilities of the doctor. The second factor that can condition the choice of specialty is represented by the work places that are provided by the Ministry of Health. The third factor is represented by the grade acquired by the future doctor at the National Residency Contest. The family model plays an important role, as there are professions with family transmission. Another aspect is related to the social and financial status that each specialty can offer; there are specialties with an incre               ased danger that can make a specialty more attractive from a financial point of view.

The international literature has shown that surgeons are confident in their own strengths with increased extroversion, supported by Mehmood et al. (2013)(11). Psychiatrists have a lower conscientiousness than the rest of doctors form the other specialties, as demonstrated by Bexelius et al. (2016)(6). Mullola et al. (2018) argue that physicians in paraclinical specialties have low extroversion(1). Internists have increased conscientiousness, as highlighted by Mullola et al. (2018)(1).

The sample of the study consists of a number of 129 resident doctors from different medical specialties, whose personality was evaluated from a dimensional point of view, after the Big Five model, with the help of the DECAS personality inventory scale.

Given the importance of personality in different medical specialties, our first study(10) was conducted on 129 doctors as subjects, from different specialties: 18 resident doctors in surgery (13.96%), 34 resident doctors in psychiatry (26.36%), 42 resident doctors in internal medicine (32.56%), 11 resident doctors in paraclinical specialties (8.51%), and 24 resident doctors in other specialties (18.61%). 

The personality profile of the resident doctors in surgery is associated with increased levels of extraversion (p<0.0049) and agreability (p<0.0440). People with high extroversion are pragmatic individuals, who take easy risks, are talkative, enthusiastic, optimistic and self-confident. They prefer action and rapid take-up of the initiative(10).

Resident doctors in psychiatry are characterized as casual people, who manifest easily and have a nonconformist spirit.

Those who have opted for this specialty have high values of agreeableness compared to doctors in other specialties (p<0.0382). Doctors dominated by this dimension are altruistic people, less pretentious, with high common sense, friendly and with a high degree of empathy, they trust those around them. Increased emotional stability characterizes psychiatrists as strong, persevering, rational in thinking, with well-developed coping mechanisms to deal with extreme situations(10). On the other hand, the study highlights lower values of conscientiousness in psychiatric residents compared to other specialties (p<0.0151).

Internal medicine residents have increased agreeableness and conscientiousness (p<0.0478). The increased agreeableness characterizes doctors as altruistic, friendly, empathetic people, trusting those around them, being oriented towards the needs of those around them. Increased conscientiousness indicates a high level of control, perseverance and meticulousness, the activities undertaken being well organized and structured(10).

Resident doctors in paraclinical specialties are predominantly introverted, a dimension accentuated by the reduced contact with the patient. They have a low extraversion dimension of personality (p<0.0284), avoiding taking the initiative due to the fact that they deplete them energetically, preferring solitary activities(10).

Low emotional stability in doctors of other medical specialties can be explained by the fact that there is a structural anxiety that in a first phase can be adaptive, but if stressors intervene, it can manifest clinically(10).

It is proven that the conscientiousness is the factor that frames the doctor in the professional role. High conscientiousness indicates an increased level of control, perseverance and meticulousness(12). It can be considered a marker of efficiency, but also of success in the medical profession.

Choosing an inappropriate specialty can lead to a low level of fulfillment and resolution of the specific requirements of the profession, to failures, frustrations, lack of satisfaction and self-assertion through the profession, overwork, and loss of control. Their persistence for a long period can trigger the burnout syndrome.

In the medical profession, the highest degree of satisfaction remains the one offered by the specialty, the quality of the doctor’s life and the life satisfactions that are based on the quality of the involvement and the results of the medical act.

Extensive research in this field is absolutely necessary due to the large number of resident doctors who change their chosen specialty motivated by the fact that they realize that they are incompatible with working conditions, with the time spent in hospital, but also with the expectations that are not in line with reality, therefore the choice of medical specialty is extremely important to the future.

The potential impact of the research results underlines the fact that self-knowledge in the sense of personality dimensions allows the recognition of personological factors that can facilitate an appropriate choice according to their skills in vocational training.

The results of such a study can be integrated into educational programs in order to support the decision-making process in choosing the medical specialty and in increasing the efficiency of the medical act and the quality of life in the medical world.

Bibliografie

  1. Mullola S, Hakulinen C, Presseau J, et al. Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty. BMC Med Educ. 2018;18(1):52.
  2. Fang JT, Lii SC. Relationship between personality traits and choosing a medical specialty. J Formos Med Assoc. 2015;114(11):1116-1121.
  3. Nireştean A, Ardelean M. Personalitate şi profesie. Târgu-Mureş. Univeristy Press. 2001. 
  4. Chang YC, Tseng HM, Xiao X, Ngerng RYL, Wu CL, Chaou CH. Examining the association of career stage and medical specialty with personality preferences – a cross-sectional survey of junior doctors and attending physicians from various specialties. BMC Med Educ. 2019;19(1):363.
  5. Kuriata A, Borys E, Misiolek U, et al. Choice of medical specialty and personality traits measured with the EPQ-R(S) in medical students and specialist doctors. Archives of psychiatry and psychotherapy. 2019;21(2):56-70.
  6. Bexelius TS, Olsson C, Järnbert-Pettersson H, Parmskog M, Ponzer S, Dahlin M. Association between personality traits and future choice of specialisation among Swedish doctors: a cross-sectional study. Postgrad Med J. 2016 Aug;92(1090):441-6.
  7. Maron BA, Fein S, Maron BJ, Hillel AT, El Baghdadi MM, Rodenhauser P. Ability of prospective assessment of personality profiles to predict the practice specialty of medical students. Proc (Bayl Univ Med Cent). 2007;20(1):22–26. 
  8. Pagnin D, de Queiroz V. Comparison of quality of life between medical students and young general populations. Educ Health (Abingdon). 2015 Sep-Dec;28(3):209-12.
  9. Constantin T. Determinanţi ai motivaţiei în muncă de la teorie la analiza realităţii organizaţională. Editura Universităţii „Alexandru Ioan Cuza” Iaşi. 2009. 
  10. Muntean LM, Nireştean AP, Lukacs E. Dimensional personological predisposition in the medical professional choice. Romanian Journal of Psychiatry. 2019 Sep;XXI(3):150-153.
  11. Mehmood SI, Khan MA, Walsh KM, Borleffs JCC. Personality types and specialist choices in medical students. Medical Teacher. 2013;35(1):63–8.
  12. Israel S, Moffitt TE. Assessing conscientious personality in primary care: an op­portunity for prevention and health promotion. Dev Psychol. 2014;50(5):1475-1477. 

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