Powis (2014) 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 to prevent criminal offences, poor communication skills, substance abuse and mental health concerns. 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 applicant’s 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, impulsivity and overly rigid attention to detail, 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, medical technology and research processes are now much better suited to encompass and help nurture pioneering individuals.

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Contributorship

JM conceived and drafted the response; CR re-drafted and guided its content.

References

Griffin, Barbara, & Wilson, Ian G. (2012). Faking good: self-enhancement in medical school applicants. Medical Education, 46(5), 485-490. doi: 10.1111/j.1365-2923.2011.04208.

Powis, David. (2014). Selecting medical students: An unresolved challenge. Medical Teacher, 37(3), 252-260. doi: 10.3109/0142159X.2014.993600