Intellectual and Attitudinal Characteristics of Medical Students Selecting Family Practice Forrest Collins, MS CD J Robert Roessler, MD Houston, T e x a s Family practice residents were compared with residents in internal and pediatrics (n=8). The number of medicine, surgery, obstetrics-gynecology, and pediatrics in terms of women was too small for statistical cognitive and non-cognitive characteristics. Family practice residents comparison, as was the number of men were in most instances significantly different from the other four in eight other specialties (eg, path­ groups. On non-cognitive measures they scored higher on affiliation ology, radiology, urology). All statistical analyses were single need and lower on aggression and materialism. Their scores on several factor analyses of variance for unequal cognitive measures were among the highest of the five groups. These sample size. When F ratios exceeded results were contrary to others from earlier studies. However, if the the .10 level of probability, differences trend reported here is confirmed on other samples, it is the more between pairs of means were tested for intellectually gifted and idealistic physician who is currently being significance with t-tests for uncorre­ lated means. attracted to the practice of family medicine. There is a need for more family graduates choosing other major Results practice and primary care physicians. specialties. The means for all significant What influences physicians to choose Procedure non-cognitive and cognitive variables this career pathway in medicine? for the five specialty groups are shown In Spring 1972, 1 18 volunteers A number of investigators have in Table 1. This table reveals that the from the third and fourth-year classes reported on personality factors related family practice residents differed from at Baylor College of Medicine partici­ to the choice of medical specialty. the other four groups of specialty pated in a group testing session. They Bruhn and Parsons1 found consider­ residents on the non-cognitive vari­ were told that the purpose of this able agreement in medical students’ ables in a number of ways. They project was to investigate variables perception of the characteristics asso­ scored higher on the need for affilia­ predicting success in medical school ciated with various medical specialists. tion, and their mean score on this and medical practice, and to investi­ They perceived the typical general variable was significantly higher than gate the relationship between these practitioner to be deeply interested in the mean score of the residents in variables and subsequent specialty surgery and internal medicine. They people, aggressive, energetic, patient, choice. The students were paid for were also among the least aggressive, and friendly. Yufit found general their participation and gave their differing significantly from every practitioners to be a heterogeneous informed consent. group except the pediatric residents, group with no distinguishing person­ All volunteers completed the entire and they were less materialistic than ality or attitudinal characteristics. Edwards Personal Preference Schedule any other resident group. They viewed Otis, of the University of New Mexico, (EPPS),3 the Eysenck Personality other people as being less dominant found medical students interested in Inventory (EPI),4 and the Birkman than did any other group, and they general practice to be, in fact, con­ Vocational Interest and Attitude Sur­ differed from all groups except the cerned about practical matters such as vey.5 In addition, the depression, pediatric residents in this respect. money, disinclined toward theoretical psychopathic deviate, and ego strength They also viewed other people as being values, and low on cognitive measures scales from the Minnesota Multiphasic less materialistic than did any other such as the MCAT (unpublished data). Personality Inventory (MMPI),6 the group and differed significantly from In addition, they were more often capacity for status, tolerance, intellec­ the surgeons, who scored highest in married at the time of their graduation tual efficiency, communality, and this characteristic. In addition, though from medical school than were other sociability scales from the California none of these differences achieved physicians. Psychological Inventory (CPI),7 a self­ statistical significance, the family prac­ The purpose of this study was to derogation scale8 and an impulsivity tice residents scored higher on the examine the current validity of this scale9 were administered. Scores for needs for autonomy, intraception family practice stereotype and to the four subtests of the Medical (empathy), and nurturance scales of compare medical school graduates College Admissions Test (MCAT) and the EPPS, and lower on the exhibition choosing this type of practice with the undergraduate grade point averages and change scale than any other group. (GPAs) were obtained. They were also lowest on the psycho­ The results reported here concern pathic deviate scale of MMPI and From the Department of Psychiatry, Baylor College o f M e dicine, H o u sto n , Texas. Re­ 83 men who subsequently chose resi­ lowest on the capacity for status and quests for reprints should be addressed to dencies in internal medicine (n=26), the sociability scale of the CPI. On the Dr. Robert Roessler, Professor, Department Birkman interest variables they scored of Psychiatry, Baylor College of Medicine, surgery (n = 28), family practice Texas Medical Center, Houston, Texas (n=l 1), obstetrics-gynecology (n=l0), higher than any other group on the 77025. 431 THE JOURNAL OF FAMILY PRACTICE, VOL. 2, NO. 6, 1975 Table 1. Mean Scores for Five Medical Specialty Groups on Cognitive and Non-Cognitive Variables Internal Family Obstetrics- Surgery Medicine Practice Gynecology Pediatrics F ratio P (n = 28) (n = 26) (n = 11) (n = 10) (n = 8) Edwards Personal Preference Schedule Affiliation 1 3 .6 8 a * 13.27® 1 7 .7 3 b 14.90® b 14.75® b 2.62 0.05 Aggression 1 4 .8 9 a 13.31 ®C 1 0 .6 4 b 14.20® 1 0 .3 8 b° 3.59 0.01 Birkman Attitudes Dominance O thers 7 2 .1 8 3 66.85® 4 9 .0 9 b 74.60® 66.25® b 2.42 0.10 S e lf 2 4 .3 2 a 32.46® b 4 2 .5 4 b 28.20® b 4 8 .7 5 b 2.0 5 0.10 Materialism O thers 73.82® 6 1 .9 2 b 4 5 .6 4 b 62.40® b 58.38® b 2.3 6 0.10 S elf 6 0 .7 1 a 4 5 .9 6 b 3 2 .9 1 ° 53.70® b 49.38® b 2.59 0.05 Medical College Admissions Test V erb al 572® 6 1 4 b 609® b 562® 580®b 2.7 3 0.05 General information 5 6 4 a 6 1 3 b 584®b 588®b 585®b 2.7 6 0.05 Science 5 5 9 bC 605® 600®° 5 4 8 b 594®b ° 2.9 8 0.05 •Means sharing the same alphabetical superscript do not differ significantly from each other. social service, personal contact, and family practice residents in this study These results must be viewed tenta­ thought scales. similar to those in other studies. Nine tively since the analyses are based on There were no significant differ­ of the eleven, or 82 percent, were data from graduates of only one ences in intellectual characteristics married, as compared to 52 percent of medical school. With this qualification, between the family practice residents the other four groups. it appears that it is the intellectually and any other group, except that they gifted and idealistic physician who is scored significantly higher than resi­ now choosing family practice. dents in obstetrics-gynecology on the Discussion science subtest of the MCAT. Table 1 These results are noteworthy since Acknowledgements shows that the significant F ratios for they are contrary to the results of This research was supported in part by a the verbal, general information, and earlier studies. It appears that family grant from the Department of Health, Education, and Welfare, # PE 00394-01. science subtests of the MCAT were practitioners of the future may differ Computational services were supported in due almost entirely to the differences from the general practitioners of the part by a grant from the National Institutes of Health, # RR-00259. The use of the between those choosing internal medi­ past. These family practice residents Birkman survey was supported in part by a cine and the other four specialty were not aggressive, nor were they grant from Birkman and Associates. groups. Residents in internal medicine highly materialistic; the Birkman mate­ References scored higher on these subtests than rialism score is a percentile score based 1. B ru h n JG , Parsons O A : Medical any other group. They also scored on a large heterogeneous group, and s tu d e n ts ' a ttitu d e s to w a rd fo u r medical specialties. J Med Educ 39:40-49, 1965 higher on the MCAT quantitative the family practice residents were far 2. Y ufit Rl, Pollock GH, Wasserman E: subtest although these means are not below the population average of 50. In Medical specialty choice and personality. Arch Gen Psychiatry 20:89-99, 1969 tabled since the F ratio was not addition, they were among the highest 3. Edwards AL: Manual for the Ed­ significant across the five groups. In scoring groups on all the measures of wards Personal Preference Schedule. New York, The Psychological Corporation, 1959 every instance the medical residents pre-medical school intellectual per­ 4. E ysenck HJ: T h e B iological Basis of P e rso n a lity. S p rin g fie ld , Charles C Thomas, scored significantly higher than the formance. 1967 surgical residents, and for the verbal In most of the literature it has been 5.