Central JSM Neurosurgery and Spine

Cite this article Spiotta AM Mullin J Weil RJ Schlenk R Sean GM et al (2014) Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United States JSM Neurosurg Spine 2(3) 1022

Corresponding authorAlejandro M Spiotta Department of Neurosciences Division of Neurosurgery 96 Jonathan Lucas Street 301 CSB MSC 616 Charleston SC 29425 Tel 8437927031 Fax 8437929279 Email

Submitted 27 January 2014

Accepted 28 February 2014

Published 05 March 2014

Copyrightcopy 2014 Spiotta et al

OPEN ACCESS

KeywordsbullContemporarybullNeurosurgical

Research Article

Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United StatesAlejandro M Spiotta1 Jeffrey Mullin2 Robert J Weil2 Richard Schlenk2 Sean Grady M3 and Edward C Benzel2

1Department of Neurosciences Division of Neurosurgery Medical University of South Carolina Charleston SC2Department of Neurological Surgery Cleveland Clinic Cleveland OH3Department of Neurosurgery University of Pennsylvania Philadelphia PA

Abstract

Introduction The purpose of this study was to investigate patterns of personality typing of current neurosurgical residents training in the United States

Methods Data was gathered on a volunteer basis through an online data collection website regarding Myers-Briggs personality instrument (MBPI) typing of present neurosurgical trainees

Results Data was obtained from one hundred and eight neurosurgery residents Residents reported a slight preference for extraversion over introversion although this was neither statistically significant nor different from the general population However compared to the general population residents demonstrated a strong preference for gathering data from intuition (N) over sensing (S) (648 vs 236 p=002) thinking (T) over feeling (F) to guide the decision making process (75 vs 404 p lt0001) and a judging (J) rather than perceiving (P) lifestyle (944 vs 543 plt0001) The three most common types among all respondents were INTJ (lsquoscientistrsquo) ENTJ (lsquoexecutiversquo) and ISTJ (lsquoduty fulfillerrsquo)

Conclusions We have provided insights from contemporary neurosurgical residents by compiling MBPI responses across training programs A strong preference for intuition thinking and judging functions is apparent This combination of preferences (NTJ) distinguishes neurosurgical residents from any other medical group that has been described in the literature

INTRODUCTIONThe care of the neurosurgical patient can be challenging and

presents a unique set of technical and cognitive demands on the neurosurgical trainee Emergencies in neurosurgery create an unpredictable environment and daily schedule for the surgeon including the neurosurgery resident The field of neurosurgery requires a high degree of technical skills and neurosurgery residents routinely encounter critically ill patients and must evaluate them expeditiously to arrive at an intervention that could be life-saving Thus neurosurgical residents must be technically adept decisive organized efficient tough minded and conscientious individuals who are content with at times placing the needs of patients above self and family obligations They must perform well under stress and be comfortable with

making difficult life-or-death decisions Finally they must be confident regarding the decisions they make and regarding the procedures they perform

The purpose of this study is to attempt to more accurately define the contemporary neurosurgical resident to provide insight into the physicians who currently choose to pursue the field To do so we investigate patterns of personality typing of neurosurgical residents throughout the United States (US) Since individuals can vary widely with respect to how they process both external and internal information and how they interact with the outside world including other people an understanding of the common personality types entering the field could be beneficial to educators attempting to optimize training methodologies and improve the resident selection process

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 26

METHODSCurrent neurosurgical residents from all Accreditation

Council for Graduate Medical Education accredited programs in the US were contacted via email and offered the opportunity to take an on-line survey to determine their Carl Jung and Isabel Briggs Myers personality types It was stressed that participation was strictly on a volunteer basis The survey results display personality typing based on four preferences (extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P) refer to Table 1 for an explanation of the dichotomies) to create a four letter type of which there are sixteen permutations (eg ENFJ ISTPhellipetc) The distribution of these types in the general population is shown in Figure 1 Using an online survey for data collection the results were then sorted by result and postgraduate year Additionally participants were given the option of reporting their training institution

Statistics were performed on commercially available software For comparison of proportions between groups a Fisher test was performed A p value of 005 was predetermined to be significant For the sample size of the general population available from wwwmyersbriggsorg a sample size of 1000 was assumed as a conservative estimate so as not to overstate our findings

RESULTSA total of 108 resident responses were received (~15

response rate) The distribution of responses by postgraduate year (PGY) was as follows PGY 1 (n=7) PGY 2 (n=7) PGY3 (n=31) PGY 4 (n=15) PGY 5 (n=10) PGY 6 (n=15) PGY 7 (n=15)

48 (444) respondents listed their training program From these responses residents represent at least twelve programs While the Midwest region was the most common location programs covered all areas of the country Table 2 summarizes the differences between the distributions of the four dichotomies in the general population compared to resident responses

Extraversion vs Introversion

Overall residents reported a slight preference for

extraversion (546) over introversion (453) which is not unlike the distribution among the general population (p=048)

Intuition vs Sensing

Neurosurgical residents were more likely to gather data from intuition over sensing compared to the general population (648 vs 236 p=002)

Thinking vs Feeling

Residents demonstrated a very strong preference for thinking rather than feeling in the decision making process compared to the general population (75 vs 404 plt0001)

Judging vs Perceiving

Residents demonstrated a strong preference for a judging rather than perceiving lifestyle compared to the general population (944 vs 543 plt0001)

Figure 2 illustrates the distribution of the sixteen Myers Briggs personality types among all residents Thirteen of the possible sixteen MBPT were observed those not represented include ISFP (lsquoartistrsquo) ISTP (lsquomechanicrsquo) and INFP (lsquoidealistrsquo) Overall the most common types among neurosurgical residents were the four Thinking-Judging types (INTJ ndashlsquoscientistrsquo ENTJ ndash lsquoexecutiversquo ISTJ ndash lsquoduty fulfillerrsquo ESTJ ndash lsquoadministratorrsquo) and ENFJ (lsquoteacherrsquo) Cumulatively these five types are present in 833 of residents as compared to 267 of the general population (plt0001) The four TJ types are present in 722 of residents compared to 242 in the general population (plt0001) Of these the most disproportionately represented types compared to the normal distribution are INTJ (25 vs 21 plt0001) and ENTJ (26 vs 18 plt0001) (Figure 3) These two types alone while cumulatively present in only 39 of the general population accounted for 51 of resident responses

DISCUSSIONPersonality typing in medicine

The Myers-Briggs personality typing instrument (MBPI) is the most widely adopted instrument used to assess a personrsquos innate preferences and is commonly employed for job interviews

Figure 1 The distribution of the sixteen Myers Briggs personality types in the general population Personality typing is based on four preferences (extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P)) to create a four letter type The estimated frequency table was compiled from data from 1972 through 2002 including data banks at the Center for Applications of Psychological Type Inc and Stanford Research Institute and is available at wwwmyersbriggsorg

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 26

METHODSCurrent neurosurgical residents from all Accreditation

Council for Graduate Medical Education accredited programs in the US were contacted via email and offered the opportunity to take an on-line survey to determine their Carl Jung and Isabel Briggs Myers personality types It was stressed that participation was strictly on a volunteer basis The survey results display personality typing based on four preferences (extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P) refer to Table 1 for an explanation of the dichotomies) to create a four letter type of which there are sixteen permutations (eg ENFJ ISTPhellipetc) The distribution of these types in the general population is shown in Figure 1 Using an online survey for data collection the results were then sorted by result and postgraduate year Additionally participants were given the option of reporting their training institution

Statistics were performed on commercially available software For comparison of proportions between groups a Fisher test was performed A p value of 005 was predetermined to be significant For the sample size of the general population available from wwwmyersbriggsorg a sample size of 1000 was assumed as a conservative estimate so as not to overstate our findings

RESULTSA total of 108 resident responses were received (~15

response rate) The distribution of responses by postgraduate year (PGY) was as follows PGY 1 (n=7) PGY 2 (n=7) PGY3 (n=31) PGY 4 (n=15) PGY 5 (n=10) PGY 6 (n=15) PGY 7 (n=15)

48 (444) respondents listed their training program From these responses residents represent at least twelve programs While the Midwest region was the most common location programs covered all areas of the country Table 2 summarizes the differences between the distributions of the four dichotomies in the general population compared to resident responses

Extraversion vs Introversion

Overall residents reported a slight preference for

extraversion (546) over introversion (453) which is not unlike the distribution among the general population (p=048)

Intuition vs Sensing

Neurosurgical residents were more likely to gather data from intuition over sensing compared to the general population (648 vs 236 p=002)

Thinking vs Feeling

Residents demonstrated a very strong preference for thinking rather than feeling in the decision making process compared to the general population (75 vs 404 plt0001)

Judging vs Perceiving

Residents demonstrated a strong preference for a judging rather than perceiving lifestyle compared to the general population (944 vs 543 plt0001)

Figure 2 illustrates the distribution of the sixteen Myers Briggs personality types among all residents Thirteen of the possible sixteen MBPT were observed those not represented include ISFP (lsquoartistrsquo) ISTP (lsquomechanicrsquo) and INFP (lsquoidealistrsquo) Overall the most common types among neurosurgical residents were the four Thinking-Judging types (INTJ ndashlsquoscientistrsquo ENTJ ndash lsquoexecutiversquo ISTJ ndash lsquoduty fulfillerrsquo ESTJ ndash lsquoadministratorrsquo) and ENFJ (lsquoteacherrsquo) Cumulatively these five types are present in 833 of residents as compared to 267 of the general population (plt0001) The four TJ types are present in 722 of residents compared to 242 in the general population (plt0001) Of these the most disproportionately represented types compared to the normal distribution are INTJ (25 vs 21 plt0001) and ENTJ (26 vs 18 plt0001) (Figure 3) These two types alone while cumulatively present in only 39 of the general population accounted for 51 of resident responses

DISCUSSIONPersonality typing in medicine

The Myers-Briggs personality typing instrument (MBPI) is the most widely adopted instrument used to assess a personrsquos innate preferences and is commonly employed for job interviews

Figure 1 The distribution of the sixteen Myers Briggs personality types in the general population Personality typing is based on four preferences (extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P)) to create a four letter type The estimated frequency table was compiled from data from 1972 through 2002 including data banks at the Center for Applications of Psychological Type Inc and Stanford Research Institute and is available at wwwmyersbriggsorg

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 36

Extraversion (E) vs Introversion (I) Sensing (S) vs Intuition (N)

Prefer action over reflection Prefer reflection over action Prefer facts and details Prefer general conceptsLearn best through doing or discussing

Learn best through thorough mental practice

Build card fully and thoroughly to conclusions

Move quickly to conclusions follows hunches

Are sociable and expressive Are private and contained Trust experience Trust inspiration

Thinking (T) vs Feeling (F) Judging (J) vs Perceiving (P) Strive for objective standard of truth

Strive for harmony and positive interactions Are scheduledorganized Are spontaneuousflexible

Described as reasonable Described as compassionate Sees routines as effective Sees routines as limiting

Want everyone treated equally Want everyone treated as an individual

Try to avoid last minute stresses finishes tasks well before deadlines

Feel energized by last minute pressures finishes tasks at the deadlin

Table 1 A description of some of the key defining characteristics of the four dichotomies which make up the sixteen Myers Briggs personality types

Dichotomy Population () (n=1000)

All Neurosurgery Resident Respondents(n=108)

EI 491509 4959 (435) p=048

SN 737236 3870 (352)p=002

TF 404596 8121(75)plt0001

JP 543457 1026 (944)plt0001

Table 2 Relative proportions of the four Myers Briggs personality type dichotomies among all neurosurgical residents compared to the general population Data is listed as ratio of each dichotomy as a percentage for the general population and for the resident responses as (nn) and percentage of the total () Significance values are listed as a comparison to the general population (sample size of 1000 source Myersbriggsorg) Abbreviations extraverted (E) introverted (I) intuitive (N) sensing (S) thinking (T) feeling (F) judging (J) perceiving (P)

Figure 2 Distribution of the sixteen Myers Briggs personality types among neurosurgical residents Each type is depicted by the number (n) and percentage () The three most common types are highlighted in bold lettering Personality typing is based on four preferences (extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P)) to create a four letter type

team building exercises and for increasing self-awareness The MBPI has been utilized in medicine most extensively in the study of medical students and their eventual career paths Of the four preference functions a feeling tendency has been most correlated with entering a primary care field as opposed to a specialty care field [1-5] and an extraverted and thinking type is most correlated with a surgical field [6] While there are limitations to MBPI we chose to employ this assessment tool to provide insights into the current neurosurgical trainee across the country

The MBPI and other personality instruments have been used in the assessment of members of a variety of healthcare groups [47-14] In all instances the group composition has varied significantly from the normal (ie population) distribution of types reflecting that specialized groups can become quite different from the general population through self-selection processes (Table 4) For example family medicine (_SFJ) obstetrics-gynecology (_STJ) general surgery (_STJ) and psychiatry (_NFP) have unique tendencies [11516] In addition peer selection can also be a

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 46

Figure 3 Frequency of the three most common types among neurosurgical residents compared to the general population Two of the Thinking-Judging types (INTJ and ENJT) are disproportionately represented compared to the general population Statistical significance (plt0001) is denoted by ()

Myers Briggs Personality Type Description

INTJ ndash the Scientist Mastermind

Have original minds and great drive for implementing their ideas and achieving their goals Quickly see patterns in external events and develop long-range explanatory perspectives When committed organize a job and carry it through Skeptical and independent have high standards of competence and performance

ENTJ ndash the Executive Leader

Frank decisive assume leadership readily Quickly see illogical and inefficient procedures and policies develop and implement comprehensive systems to solve organizational problems Enjoy long-term planning and goal setting Usually well informed well read enjoy expanding their knowledge and passing it on to others Forceful in presenting their ideas

ISTJ ndash the Duty Fulfiller

Quiet serious painstaking systematic hard-working and careful with detail earn success by thoroughness and dependability Practical matter-of-fact realistic and responsible Decide logically what should be done and work toward it steadily regardless of distractions Hold a tremendous amount of facts Take pleasure in making everything orderly and organized Value traditions and loyalty

Table 3 Description of the three most common Myers Briggs personality types among neurosurgical residents Adapted from descriptions available at wwwmyersbriggsorg Extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P)

strong driving force towards the specialization of a group by personality composition and personality bias (like favoring the like) has also been observed during resident selection in surgical subspecialties [17]

Personality typing in neurosurgery

To date no studies have studied the neurosurgical personality exclusively Likely due to its relatively small size this specialty has been either excluded or lumped together with other surgical specialties in broad terms as ldquosurgeonsrdquo Very strong preferences for thinking and judging over feeling and perceiving are evident among current trainees In addition gathering data through an intuition rather than sensing function has also been observed

Thus a prototype of a contemporary neurosurgical resident has emerged (_NTJ followed by _STJ) This distribution of types among neurosurgical trainees varies significantly from the normal distribution as well as from other medical specialties Of this set of preferences __TJ is shared most in common with other surgical specialties and health care executives while health care providers such as family medicine and pediatrics and support staff such as nurses and occupational therapists share a strong _SFJ preference which is not common among neurosurgical residents

NTJ prototype Of these preferences the most strongly prevalent among neurosurgical residents is a judging over perceiving lifestyle It may come as no surprise since people

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 56

Health Care Provider Prototype

(EI) (SN) (TF) (PJ)

Source

Surgical specialty _ _ T _ Friedman et al 1988

Primary care _ _ F _

Friedman et al 1988 Harris et al 1985 Stilwell et al 2000 Taylor et al 1990

Health care executives _ _ T J OrsquoConnor et al 1992

Obstetrics gynecology _ S T J McCaulley et al 1978 Friedman et al 1988

General surgery _ S T J Swanson et al 2010 McCaulley et al 1978

Orthopedics _ S T J McCaulley et al 1978

Endodontists and dentists _ S T J

OrsquoNeill et al 2007 Westerman et al 1991

Wu et al 2007Otorhinolaryngology _ S T J Zardouz et al 2011

Family medicine _ S F J Taylor et al 1990 Friedman et al 1988

Pediatrics _ S F J Myers et al 1976

Dental hygienists _ S F J Saline et al 1991 McDonald et al 1998

Occupational therapist I S F J Radonsky et al 1980

Registered nurses I S F J Bean et al 1993 Jain et al 1996

Anesthesiology I S _ P Myers et al 1976Physical medicine and rehabilitation E _ _ P Sliwa et al 1994

Flight crew members (RNs RT and pilots) E _ _ P Gabram et al 1994

Pathology I N T _ Myers et al 1976Psychiatry _ N F P Friedman et al 1988

Table 4 Summary of the available literature regarding Myers Briggs Personality Typing in the various medical groups that have been sampled Results are clustered by similar types to demonstrate similarities and differences between the different specialties Extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P) Registered nurse (RN) respiratory therapist (RT)

with a preference for J over P strive to maintain an organized and structured schedule with clear deadlines and expectations The lifestyle of a neurosurgery resident is highly hierarchical and structured consisting of morning rounds operative cases during the day and overnight call The second strongest preference is thinking over feeling as a means to make decisions This preference coincides well with the requirement of a resident to remain objective and calm during a critical event not allowing emotions to interfere with reaching the most rationale decision A strong preference for intuition over sensing is also evident Striking a balance between gathering sufficient detail (S) to guide onersquos clinical decision making without losing sight of the big picture (N) can be challenging and both are required In contradistinction to contemporary neurosurgical residents there is a clear preference for S over N in other surgical fields like general surgery [7] otorhinolaryngology [10] and gynecology [13] The field of neurological surgery requires an assessment of

the nervous system and may be less concrete than other fields with a stronger requirement for an intuitive sense

Implications of personality typing

There is evidence that different personality types favor certain learning strategies and tend to score differently on subjective evaluations These differences may have implications for likelihood of success in academic settings including residency training Among medical students the _S_ J followed course objectives most closely while the _N_P was more prone to independent learning [18] Among dental students the _S_J earned the highest grades overall introverts scored highest on the board examination and perceivers were most likely to be on probation [19] While introverted medical students scored highest on objective examinations extroverts scored more favorably on subjective evaluations [20] which ultimately placed them higher on class rank [19] which takes into account both subjective and objective measures Among naval academy midshipmen the ESTJ was most likely to graduate while the _F_P was the highest risk to drop out [21] Given these differences some graduate schools have begun tailoring teaching methodologies to certain personality types [2223] Additionally knowledge of a groupsrsquo MBPT composition can be utilized to improve teamwork productivity moral and efficiency a strategy which has proven effective when applied by nurse managers in their units [2425] and which the business world has utilized for decades

For these reasons it is imperative to collect data on personality types of all neurosurgical residents prospectively This knowledge may aid in customizing teaching methods both in the operating room and in didactic sessions It may also help to optimize the performance of the resident team managing a busy inpatient service This is increasingly important in the era of resident duty hour regulations when teaching exposures must become higher yield In addition it may be of value to understand each individualrsquos preferences potential strengths and weaknesses under different stressors Such understanding could enhance the grouprsquos performance as it strives to deliver the best possible patient care There are certain personality types that are very likely to misunderstand each other and could result in team conflict (J vs P and T vs F for example) This is of special importance in an era of work hour reform and increased bureaucratic demands (ie more work to be done in less time) In addition as programs assess the progress of residents achieving milestones by incorporating subjective data from faculty evaluations directors must be cognizant of the fact that extroverts tend to score higher on these measures [1920] Lastly among faculty a type bias exists that favors their own type which can impact the assessment of trainees [26]

Importantly it should be stressed that there is no evidence that a single type is ldquobest suitedrdquo for a career in neurosurgery Rather the relative strengths and weakness of each should be recognized to maximize patient care and the satisfaction and success of each trainee

Study limitations

While the study attempted to survey all current neurosurgery residents the response rate achieved was lower than expected (15) This yield could potentially bias the data towards

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 66

personality types who are more likely to respond to survey requests Additionally our institution made up a disproportionate amount of the sample size (25) which could also bias the data if our program self- and peer-selects for a certain personality type However we found no major differences between the results from our institution compared to those around the country

CONCLUSIONSWe have provided insights from contemporary neurosurgical

residents by compiling MBPI responses from a survey offered to all current neurosurgical residents in the US A strong preference for thinking judging and intuition functions is apparent This combination of preferences (NTJ) distinguishes neurosurgical residents from any other medical group that has been described in the literature Further study including larger sample size longitudinal studies of residents career paths job satisfaction and success will determine how to apply this data to allow for the most beneficial impact on resident selection and education

REFERENCES1 Friedman CP Slatt LM New results relating the Myers-Briggs Type

Indicator and medical specialty choice J Med Educ 1988 63 325-327

2 Nieman LZ Holbert D Bremer CC Career preferences career decision-making and orientation toward medicine among third-year students J Med Educ 1988 63 474-476

3 Burkett GL Gelula MH Characteristics of students preferring family practiceprimary care careers J Fam Pract 1982 15 505-512

4 Taylor AD Clark C Sinclair AE Personality types of family practice residents in the 1980s Acad Med 1990 65 216-218

5 Wallick MM Cambre KM Randall HM Personality type and medical specialty choice J La State Med Soc 1999 151 463-469

6 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 14-20

7 Swanson JA Antonoff MB DrsquoCunha J Maddaus MA Personality profiling of the modern surgical trainee insights into generation X J Surg Educ 2010 67 417-420

8 Gabram SG Hodges J Allen PT Allen LW Schwartz RJ Jacobs LM Personality types of flight crew members in a hospital-based helicopter program Air Med J 1994 13 13-17

9 Warschkow R Steffen T Spillmann M Kolb W Lange J Tarantino I A comparative cross-sectional study of personality traits in internists and surgeons Surgery 2010 148 901-907

10 Zardouz S German MA Wu EC Djalilian HR Personality types of otolaryngology resident applicants as described by the Myers-Briggs Type Indicator Otolaryngol Head Neck Surg 2011 144 714-718

11 Eng MK Macneily AE Alden L The urological personality is it unique

Can J Urol 2004 11 2401-2406

12 Boyd R Brown T Pilot study of Myers Briggs Type Indicator personality profiling in emergency department senior medical staff Emerg Med Australas 2005 17 200-203

13 Neral SM Collins J Gandy MJ Hampton HL Morrison JC Non-cognitive variables and residency choice J Miss State Med Assoc 2008 49 327-329

14 Needleman HL Bang S Zhou J Johnson JR McPeek B Graham D Personality types of pediatric dentists comparative analysis and associated factors Pediatr Dent 2011 33 37-45

15 McCaulley MH Application of the myers briggs type indicator to medicine and other professions Washington DC US Department of Health Education and Welfare 1978

16 McCaulley MH The myers-briggs type indicator in career planning Gainesvile Florida Center for Applications of Psychological Type 1981

17 Quintero AJ Segal LS King TS Black KP The personal interview assessing the potential for personality similarity to bias the selection of orthopaedic residents Acad Med 2009 84 1364-1372

18 Harasym PH Leong EJ Lucier GE Lorscheider FL Relationship between Myers-Briggs psychological traits and use of course objectives in anatomy and physiology Eval Health Prof 1996 19 243-252

19 Jones AC Courts FJ Sandow PL Watson RE Myers-Briggs Type Indicator and dental school performance J Dent Educ 1997 61 928-933

20 Davis KR Banken JA Personality type and clinical evaluations in an obstetricsgynecology medical student clerkship Am J Obstet Gynecol 2005 193 1807-1810

21 Murray KM Johnson WB Personality type and success among female naval academy midshipmen Mil Med 2001 166 889-893

22 Jessee SA OrsquoNeill PN Dosch RO Matching student personality types and learning preferences to teaching methodologies J Dent Educ 2006 70 644-651

23 McNulty JA Espiritu B Halsey M Mendez M Personality preference influences medical student use of specific computer-aided instruction (CAI) BMC Med Educ 2006 6 7

24 Schoessler M Conedera F Bell LF Marshall D Gilson M Use of the Myers-Briggs Type Indicator to develop a continuing education department J Nurs Staff Dev 1993 9 8-13

25 Costello K The Myers-Briggs type indicator--a management tool Nurs Manage 1993 24 46-47 50-1

26 Bell MA Wales PS Torbeck LJ Kunzer JM Thurston VC Brokaw JJ Do personality differences between teachers and learners impact studentsrsquo evaluations of a surgery clerkship J Surg Educ 2011 68 190-193

Spiotta AM Mullin J Weil RJ Schlenk R Sean GM et al (2014) Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United States JSM Neurosurg Spine 2(3) 1022

Cite this article

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 46

Figure 3 Frequency of the three most common types among neurosurgical residents compared to the general population Two of the Thinking-Judging types (INTJ and ENJT) are disproportionately represented compared to the general population Statistical significance (plt0001) is denoted by ()

Myers Briggs Personality Type Description

INTJ ndash the Scientist Mastermind

Have original minds and great drive for implementing their ideas and achieving their goals Quickly see patterns in external events and develop long-range explanatory perspectives When committed organize a job and carry it through Skeptical and independent have high standards of competence and performance

ENTJ ndash the Executive Leader

Frank decisive assume leadership readily Quickly see illogical and inefficient procedures and policies develop and implement comprehensive systems to solve organizational problems Enjoy long-term planning and goal setting Usually well informed well read enjoy expanding their knowledge and passing it on to others Forceful in presenting their ideas

ISTJ ndash the Duty Fulfiller

Quiet serious painstaking systematic hard-working and careful with detail earn success by thoroughness and dependability Practical matter-of-fact realistic and responsible Decide logically what should be done and work toward it steadily regardless of distractions Hold a tremendous amount of facts Take pleasure in making everything orderly and organized Value traditions and loyalty

Table 3 Description of the three most common Myers Briggs personality types among neurosurgical residents Adapted from descriptions available at wwwmyersbriggsorg Extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P)

strong driving force towards the specialization of a group by personality composition and personality bias (like favoring the like) has also been observed during resident selection in surgical subspecialties [17]

Personality typing in neurosurgery

To date no studies have studied the neurosurgical personality exclusively Likely due to its relatively small size this specialty has been either excluded or lumped together with other surgical specialties in broad terms as ldquosurgeonsrdquo Very strong preferences for thinking and judging over feeling and perceiving are evident among current trainees In addition gathering data through an intuition rather than sensing function has also been observed

Thus a prototype of a contemporary neurosurgical resident has emerged (_NTJ followed by _STJ) This distribution of types among neurosurgical trainees varies significantly from the normal distribution as well as from other medical specialties Of this set of preferences __TJ is shared most in common with other surgical specialties and health care executives while health care providers such as family medicine and pediatrics and support staff such as nurses and occupational therapists share a strong _SFJ preference which is not common among neurosurgical residents

NTJ prototype Of these preferences the most strongly prevalent among neurosurgical residents is a judging over perceiving lifestyle It may come as no surprise since people

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 56

Health Care Provider Prototype

(EI) (SN) (TF) (PJ)

Source

Surgical specialty _ _ T _ Friedman et al 1988

Primary care _ _ F _

Friedman et al 1988 Harris et al 1985 Stilwell et al 2000 Taylor et al 1990

Health care executives _ _ T J OrsquoConnor et al 1992

Obstetrics gynecology _ S T J McCaulley et al 1978 Friedman et al 1988

General surgery _ S T J Swanson et al 2010 McCaulley et al 1978

Orthopedics _ S T J McCaulley et al 1978

Endodontists and dentists _ S T J

OrsquoNeill et al 2007 Westerman et al 1991

Wu et al 2007Otorhinolaryngology _ S T J Zardouz et al 2011

Family medicine _ S F J Taylor et al 1990 Friedman et al 1988

Pediatrics _ S F J Myers et al 1976

Dental hygienists _ S F J Saline et al 1991 McDonald et al 1998

Occupational therapist I S F J Radonsky et al 1980

Registered nurses I S F J Bean et al 1993 Jain et al 1996

Anesthesiology I S _ P Myers et al 1976Physical medicine and rehabilitation E _ _ P Sliwa et al 1994

Flight crew members (RNs RT and pilots) E _ _ P Gabram et al 1994

Pathology I N T _ Myers et al 1976Psychiatry _ N F P Friedman et al 1988

Table 4 Summary of the available literature regarding Myers Briggs Personality Typing in the various medical groups that have been sampled Results are clustered by similar types to demonstrate similarities and differences between the different specialties Extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P) Registered nurse (RN) respiratory therapist (RT)

with a preference for J over P strive to maintain an organized and structured schedule with clear deadlines and expectations The lifestyle of a neurosurgery resident is highly hierarchical and structured consisting of morning rounds operative cases during the day and overnight call The second strongest preference is thinking over feeling as a means to make decisions This preference coincides well with the requirement of a resident to remain objective and calm during a critical event not allowing emotions to interfere with reaching the most rationale decision A strong preference for intuition over sensing is also evident Striking a balance between gathering sufficient detail (S) to guide onersquos clinical decision making without losing sight of the big picture (N) can be challenging and both are required In contradistinction to contemporary neurosurgical residents there is a clear preference for S over N in other surgical fields like general surgery [7] otorhinolaryngology [10] and gynecology [13] The field of neurological surgery requires an assessment of

the nervous system and may be less concrete than other fields with a stronger requirement for an intuitive sense

Implications of personality typing

There is evidence that different personality types favor certain learning strategies and tend to score differently on subjective evaluations These differences may have implications for likelihood of success in academic settings including residency training Among medical students the _S_ J followed course objectives most closely while the _N_P was more prone to independent learning [18] Among dental students the _S_J earned the highest grades overall introverts scored highest on the board examination and perceivers were most likely to be on probation [19] While introverted medical students scored highest on objective examinations extroverts scored more favorably on subjective evaluations [20] which ultimately placed them higher on class rank [19] which takes into account both subjective and objective measures Among naval academy midshipmen the ESTJ was most likely to graduate while the _F_P was the highest risk to drop out [21] Given these differences some graduate schools have begun tailoring teaching methodologies to certain personality types [2223] Additionally knowledge of a groupsrsquo MBPT composition can be utilized to improve teamwork productivity moral and efficiency a strategy which has proven effective when applied by nurse managers in their units [2425] and which the business world has utilized for decades

For these reasons it is imperative to collect data on personality types of all neurosurgical residents prospectively This knowledge may aid in customizing teaching methods both in the operating room and in didactic sessions It may also help to optimize the performance of the resident team managing a busy inpatient service This is increasingly important in the era of resident duty hour regulations when teaching exposures must become higher yield In addition it may be of value to understand each individualrsquos preferences potential strengths and weaknesses under different stressors Such understanding could enhance the grouprsquos performance as it strives to deliver the best possible patient care There are certain personality types that are very likely to misunderstand each other and could result in team conflict (J vs P and T vs F for example) This is of special importance in an era of work hour reform and increased bureaucratic demands (ie more work to be done in less time) In addition as programs assess the progress of residents achieving milestones by incorporating subjective data from faculty evaluations directors must be cognizant of the fact that extroverts tend to score higher on these measures [1920] Lastly among faculty a type bias exists that favors their own type which can impact the assessment of trainees [26]

Importantly it should be stressed that there is no evidence that a single type is ldquobest suitedrdquo for a career in neurosurgery Rather the relative strengths and weakness of each should be recognized to maximize patient care and the satisfaction and success of each trainee

Study limitations

While the study attempted to survey all current neurosurgery residents the response rate achieved was lower than expected (15) This yield could potentially bias the data towards

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 66

personality types who are more likely to respond to survey requests Additionally our institution made up a disproportionate amount of the sample size (25) which could also bias the data if our program self- and peer-selects for a certain personality type However we found no major differences between the results from our institution compared to those around the country

CONCLUSIONSWe have provided insights from contemporary neurosurgical

residents by compiling MBPI responses from a survey offered to all current neurosurgical residents in the US A strong preference for thinking judging and intuition functions is apparent This combination of preferences (NTJ) distinguishes neurosurgical residents from any other medical group that has been described in the literature Further study including larger sample size longitudinal studies of residents career paths job satisfaction and success will determine how to apply this data to allow for the most beneficial impact on resident selection and education

REFERENCES1 Friedman CP Slatt LM New results relating the Myers-Briggs Type

Indicator and medical specialty choice J Med Educ 1988 63 325-327

2 Nieman LZ Holbert D Bremer CC Career preferences career decision-making and orientation toward medicine among third-year students J Med Educ 1988 63 474-476

3 Burkett GL Gelula MH Characteristics of students preferring family practiceprimary care careers J Fam Pract 1982 15 505-512

4 Taylor AD Clark C Sinclair AE Personality types of family practice residents in the 1980s Acad Med 1990 65 216-218

5 Wallick MM Cambre KM Randall HM Personality type and medical specialty choice J La State Med Soc 1999 151 463-469

6 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 14-20

7 Swanson JA Antonoff MB DrsquoCunha J Maddaus MA Personality profiling of the modern surgical trainee insights into generation X J Surg Educ 2010 67 417-420

8 Gabram SG Hodges J Allen PT Allen LW Schwartz RJ Jacobs LM Personality types of flight crew members in a hospital-based helicopter program Air Med J 1994 13 13-17

9 Warschkow R Steffen T Spillmann M Kolb W Lange J Tarantino I A comparative cross-sectional study of personality traits in internists and surgeons Surgery 2010 148 901-907

10 Zardouz S German MA Wu EC Djalilian HR Personality types of otolaryngology resident applicants as described by the Myers-Briggs Type Indicator Otolaryngol Head Neck Surg 2011 144 714-718

11 Eng MK Macneily AE Alden L The urological personality is it unique

Can J Urol 2004 11 2401-2406

12 Boyd R Brown T Pilot study of Myers Briggs Type Indicator personality profiling in emergency department senior medical staff Emerg Med Australas 2005 17 200-203

13 Neral SM Collins J Gandy MJ Hampton HL Morrison JC Non-cognitive variables and residency choice J Miss State Med Assoc 2008 49 327-329

14 Needleman HL Bang S Zhou J Johnson JR McPeek B Graham D Personality types of pediatric dentists comparative analysis and associated factors Pediatr Dent 2011 33 37-45

15 McCaulley MH Application of the myers briggs type indicator to medicine and other professions Washington DC US Department of Health Education and Welfare 1978

16 McCaulley MH The myers-briggs type indicator in career planning Gainesvile Florida Center for Applications of Psychological Type 1981

17 Quintero AJ Segal LS King TS Black KP The personal interview assessing the potential for personality similarity to bias the selection of orthopaedic residents Acad Med 2009 84 1364-1372

18 Harasym PH Leong EJ Lucier GE Lorscheider FL Relationship between Myers-Briggs psychological traits and use of course objectives in anatomy and physiology Eval Health Prof 1996 19 243-252

19 Jones AC Courts FJ Sandow PL Watson RE Myers-Briggs Type Indicator and dental school performance J Dent Educ 1997 61 928-933

20 Davis KR Banken JA Personality type and clinical evaluations in an obstetricsgynecology medical student clerkship Am J Obstet Gynecol 2005 193 1807-1810

21 Murray KM Johnson WB Personality type and success among female naval academy midshipmen Mil Med 2001 166 889-893

22 Jessee SA OrsquoNeill PN Dosch RO Matching student personality types and learning preferences to teaching methodologies J Dent Educ 2006 70 644-651

23 McNulty JA Espiritu B Halsey M Mendez M Personality preference influences medical student use of specific computer-aided instruction (CAI) BMC Med Educ 2006 6 7

24 Schoessler M Conedera F Bell LF Marshall D Gilson M Use of the Myers-Briggs Type Indicator to develop a continuing education department J Nurs Staff Dev 1993 9 8-13

25 Costello K The Myers-Briggs type indicator--a management tool Nurs Manage 1993 24 46-47 50-1

26 Bell MA Wales PS Torbeck LJ Kunzer JM Thurston VC Brokaw JJ Do personality differences between teachers and learners impact studentsrsquo evaluations of a surgery clerkship J Surg Educ 2011 68 190-193

Spiotta AM Mullin J Weil RJ Schlenk R Sean GM et al (2014) Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United States JSM Neurosurg Spine 2(3) 1022

Cite this article

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 56

Health Care Provider Prototype

(EI) (SN) (TF) (PJ)

Source

Surgical specialty _ _ T _ Friedman et al 1988

Primary care _ _ F _

Friedman et al 1988 Harris et al 1985 Stilwell et al 2000 Taylor et al 1990

Health care executives _ _ T J OrsquoConnor et al 1992

Obstetrics gynecology _ S T J McCaulley et al 1978 Friedman et al 1988

General surgery _ S T J Swanson et al 2010 McCaulley et al 1978

Orthopedics _ S T J McCaulley et al 1978

Endodontists and dentists _ S T J

OrsquoNeill et al 2007 Westerman et al 1991

Wu et al 2007Otorhinolaryngology _ S T J Zardouz et al 2011

Family medicine _ S F J Taylor et al 1990 Friedman et al 1988

Pediatrics _ S F J Myers et al 1976

Dental hygienists _ S F J Saline et al 1991 McDonald et al 1998

Occupational therapist I S F J Radonsky et al 1980

Registered nurses I S F J Bean et al 1993 Jain et al 1996

Anesthesiology I S _ P Myers et al 1976Physical medicine and rehabilitation E _ _ P Sliwa et al 1994

Flight crew members (RNs RT and pilots) E _ _ P Gabram et al 1994

Pathology I N T _ Myers et al 1976Psychiatry _ N F P Friedman et al 1988

Table 4 Summary of the available literature regarding Myers Briggs Personality Typing in the various medical groups that have been sampled Results are clustered by similar types to demonstrate similarities and differences between the different specialties Extraversion (E) and introversion (I) sensing (S) and intuition (N) thinking (T) and feeling (F) judging (J) and perceiving(P) Registered nurse (RN) respiratory therapist (RT)

with a preference for J over P strive to maintain an organized and structured schedule with clear deadlines and expectations The lifestyle of a neurosurgery resident is highly hierarchical and structured consisting of morning rounds operative cases during the day and overnight call The second strongest preference is thinking over feeling as a means to make decisions This preference coincides well with the requirement of a resident to remain objective and calm during a critical event not allowing emotions to interfere with reaching the most rationale decision A strong preference for intuition over sensing is also evident Striking a balance between gathering sufficient detail (S) to guide onersquos clinical decision making without losing sight of the big picture (N) can be challenging and both are required In contradistinction to contemporary neurosurgical residents there is a clear preference for S over N in other surgical fields like general surgery [7] otorhinolaryngology [10] and gynecology [13] The field of neurological surgery requires an assessment of

the nervous system and may be less concrete than other fields with a stronger requirement for an intuitive sense

Implications of personality typing

There is evidence that different personality types favor certain learning strategies and tend to score differently on subjective evaluations These differences may have implications for likelihood of success in academic settings including residency training Among medical students the _S_ J followed course objectives most closely while the _N_P was more prone to independent learning [18] Among dental students the _S_J earned the highest grades overall introverts scored highest on the board examination and perceivers were most likely to be on probation [19] While introverted medical students scored highest on objective examinations extroverts scored more favorably on subjective evaluations [20] which ultimately placed them higher on class rank [19] which takes into account both subjective and objective measures Among naval academy midshipmen the ESTJ was most likely to graduate while the _F_P was the highest risk to drop out [21] Given these differences some graduate schools have begun tailoring teaching methodologies to certain personality types [2223] Additionally knowledge of a groupsrsquo MBPT composition can be utilized to improve teamwork productivity moral and efficiency a strategy which has proven effective when applied by nurse managers in their units [2425] and which the business world has utilized for decades

For these reasons it is imperative to collect data on personality types of all neurosurgical residents prospectively This knowledge may aid in customizing teaching methods both in the operating room and in didactic sessions It may also help to optimize the performance of the resident team managing a busy inpatient service This is increasingly important in the era of resident duty hour regulations when teaching exposures must become higher yield In addition it may be of value to understand each individualrsquos preferences potential strengths and weaknesses under different stressors Such understanding could enhance the grouprsquos performance as it strives to deliver the best possible patient care There are certain personality types that are very likely to misunderstand each other and could result in team conflict (J vs P and T vs F for example) This is of special importance in an era of work hour reform and increased bureaucratic demands (ie more work to be done in less time) In addition as programs assess the progress of residents achieving milestones by incorporating subjective data from faculty evaluations directors must be cognizant of the fact that extroverts tend to score higher on these measures [1920] Lastly among faculty a type bias exists that favors their own type which can impact the assessment of trainees [26]

Importantly it should be stressed that there is no evidence that a single type is ldquobest suitedrdquo for a career in neurosurgery Rather the relative strengths and weakness of each should be recognized to maximize patient care and the satisfaction and success of each trainee

Study limitations

While the study attempted to survey all current neurosurgery residents the response rate achieved was lower than expected (15) This yield could potentially bias the data towards

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 66

personality types who are more likely to respond to survey requests Additionally our institution made up a disproportionate amount of the sample size (25) which could also bias the data if our program self- and peer-selects for a certain personality type However we found no major differences between the results from our institution compared to those around the country

CONCLUSIONSWe have provided insights from contemporary neurosurgical

residents by compiling MBPI responses from a survey offered to all current neurosurgical residents in the US A strong preference for thinking judging and intuition functions is apparent This combination of preferences (NTJ) distinguishes neurosurgical residents from any other medical group that has been described in the literature Further study including larger sample size longitudinal studies of residents career paths job satisfaction and success will determine how to apply this data to allow for the most beneficial impact on resident selection and education

REFERENCES1 Friedman CP Slatt LM New results relating the Myers-Briggs Type

Indicator and medical specialty choice J Med Educ 1988 63 325-327

2 Nieman LZ Holbert D Bremer CC Career preferences career decision-making and orientation toward medicine among third-year students J Med Educ 1988 63 474-476

3 Burkett GL Gelula MH Characteristics of students preferring family practiceprimary care careers J Fam Pract 1982 15 505-512

4 Taylor AD Clark C Sinclair AE Personality types of family practice residents in the 1980s Acad Med 1990 65 216-218

5 Wallick MM Cambre KM Randall HM Personality type and medical specialty choice J La State Med Soc 1999 151 463-469

6 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 14-20

7 Swanson JA Antonoff MB DrsquoCunha J Maddaus MA Personality profiling of the modern surgical trainee insights into generation X J Surg Educ 2010 67 417-420

8 Gabram SG Hodges J Allen PT Allen LW Schwartz RJ Jacobs LM Personality types of flight crew members in a hospital-based helicopter program Air Med J 1994 13 13-17

9 Warschkow R Steffen T Spillmann M Kolb W Lange J Tarantino I A comparative cross-sectional study of personality traits in internists and surgeons Surgery 2010 148 901-907

10 Zardouz S German MA Wu EC Djalilian HR Personality types of otolaryngology resident applicants as described by the Myers-Briggs Type Indicator Otolaryngol Head Neck Surg 2011 144 714-718

11 Eng MK Macneily AE Alden L The urological personality is it unique

Can J Urol 2004 11 2401-2406

12 Boyd R Brown T Pilot study of Myers Briggs Type Indicator personality profiling in emergency department senior medical staff Emerg Med Australas 2005 17 200-203

13 Neral SM Collins J Gandy MJ Hampton HL Morrison JC Non-cognitive variables and residency choice J Miss State Med Assoc 2008 49 327-329

14 Needleman HL Bang S Zhou J Johnson JR McPeek B Graham D Personality types of pediatric dentists comparative analysis and associated factors Pediatr Dent 2011 33 37-45

15 McCaulley MH Application of the myers briggs type indicator to medicine and other professions Washington DC US Department of Health Education and Welfare 1978

16 McCaulley MH The myers-briggs type indicator in career planning Gainesvile Florida Center for Applications of Psychological Type 1981

17 Quintero AJ Segal LS King TS Black KP The personal interview assessing the potential for personality similarity to bias the selection of orthopaedic residents Acad Med 2009 84 1364-1372

18 Harasym PH Leong EJ Lucier GE Lorscheider FL Relationship between Myers-Briggs psychological traits and use of course objectives in anatomy and physiology Eval Health Prof 1996 19 243-252

19 Jones AC Courts FJ Sandow PL Watson RE Myers-Briggs Type Indicator and dental school performance J Dent Educ 1997 61 928-933

20 Davis KR Banken JA Personality type and clinical evaluations in an obstetricsgynecology medical student clerkship Am J Obstet Gynecol 2005 193 1807-1810

21 Murray KM Johnson WB Personality type and success among female naval academy midshipmen Mil Med 2001 166 889-893

22 Jessee SA OrsquoNeill PN Dosch RO Matching student personality types and learning preferences to teaching methodologies J Dent Educ 2006 70 644-651

23 McNulty JA Espiritu B Halsey M Mendez M Personality preference influences medical student use of specific computer-aided instruction (CAI) BMC Med Educ 2006 6 7

24 Schoessler M Conedera F Bell LF Marshall D Gilson M Use of the Myers-Briggs Type Indicator to develop a continuing education department J Nurs Staff Dev 1993 9 8-13

25 Costello K The Myers-Briggs type indicator--a management tool Nurs Manage 1993 24 46-47 50-1

26 Bell MA Wales PS Torbeck LJ Kunzer JM Thurston VC Brokaw JJ Do personality differences between teachers and learners impact studentsrsquo evaluations of a surgery clerkship J Surg Educ 2011 68 190-193

Spiotta AM Mullin J Weil RJ Schlenk R Sean GM et al (2014) Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United States JSM Neurosurg Spine 2(3) 1022

Cite this article

Central

Spiotta et al (2014)Email

JSM Neurosurg Spine 2(3) 1022 (2014) 66

personality types who are more likely to respond to survey requests Additionally our institution made up a disproportionate amount of the sample size (25) which could also bias the data if our program self- and peer-selects for a certain personality type However we found no major differences between the results from our institution compared to those around the country

CONCLUSIONSWe have provided insights from contemporary neurosurgical

residents by compiling MBPI responses from a survey offered to all current neurosurgical residents in the US A strong preference for thinking judging and intuition functions is apparent This combination of preferences (NTJ) distinguishes neurosurgical residents from any other medical group that has been described in the literature Further study including larger sample size longitudinal studies of residents career paths job satisfaction and success will determine how to apply this data to allow for the most beneficial impact on resident selection and education

REFERENCES1 Friedman CP Slatt LM New results relating the Myers-Briggs Type

Indicator and medical specialty choice J Med Educ 1988 63 325-327

2 Nieman LZ Holbert D Bremer CC Career preferences career decision-making and orientation toward medicine among third-year students J Med Educ 1988 63 474-476

3 Burkett GL Gelula MH Characteristics of students preferring family practiceprimary care careers J Fam Pract 1982 15 505-512

4 Taylor AD Clark C Sinclair AE Personality types of family practice residents in the 1980s Acad Med 1990 65 216-218

5 Wallick MM Cambre KM Randall HM Personality type and medical specialty choice J La State Med Soc 1999 151 463-469

6 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 14-20

7 Swanson JA Antonoff MB DrsquoCunha J Maddaus MA Personality profiling of the modern surgical trainee insights into generation X J Surg Educ 2010 67 417-420

8 Gabram SG Hodges J Allen PT Allen LW Schwartz RJ Jacobs LM Personality types of flight crew members in a hospital-based helicopter program Air Med J 1994 13 13-17

9 Warschkow R Steffen T Spillmann M Kolb W Lange J Tarantino I A comparative cross-sectional study of personality traits in internists and surgeons Surgery 2010 148 901-907

10 Zardouz S German MA Wu EC Djalilian HR Personality types of otolaryngology resident applicants as described by the Myers-Briggs Type Indicator Otolaryngol Head Neck Surg 2011 144 714-718

11 Eng MK Macneily AE Alden L The urological personality is it unique

Can J Urol 2004 11 2401-2406

12 Boyd R Brown T Pilot study of Myers Briggs Type Indicator personality profiling in emergency department senior medical staff Emerg Med Australas 2005 17 200-203

13 Neral SM Collins J Gandy MJ Hampton HL Morrison JC Non-cognitive variables and residency choice J Miss State Med Assoc 2008 49 327-329

14 Needleman HL Bang S Zhou J Johnson JR McPeek B Graham D Personality types of pediatric dentists comparative analysis and associated factors Pediatr Dent 2011 33 37-45

15 McCaulley MH Application of the myers briggs type indicator to medicine and other professions Washington DC US Department of Health Education and Welfare 1978

16 McCaulley MH The myers-briggs type indicator in career planning Gainesvile Florida Center for Applications of Psychological Type 1981

17 Quintero AJ Segal LS King TS Black KP The personal interview assessing the potential for personality similarity to bias the selection of orthopaedic residents Acad Med 2009 84 1364-1372

18 Harasym PH Leong EJ Lucier GE Lorscheider FL Relationship between Myers-Briggs psychological traits and use of course objectives in anatomy and physiology Eval Health Prof 1996 19 243-252

19 Jones AC Courts FJ Sandow PL Watson RE Myers-Briggs Type Indicator and dental school performance J Dent Educ 1997 61 928-933

20 Davis KR Banken JA Personality type and clinical evaluations in an obstetricsgynecology medical student clerkship Am J Obstet Gynecol 2005 193 1807-1810

21 Murray KM Johnson WB Personality type and success among female naval academy midshipmen Mil Med 2001 166 889-893

22 Jessee SA OrsquoNeill PN Dosch RO Matching student personality types and learning preferences to teaching methodologies J Dent Educ 2006 70 644-651

23 McNulty JA Espiritu B Halsey M Mendez M Personality preference influences medical student use of specific computer-aided instruction (CAI) BMC Med Educ 2006 6 7

24 Schoessler M Conedera F Bell LF Marshall D Gilson M Use of the Myers-Briggs Type Indicator to develop a continuing education department J Nurs Staff Dev 1993 9 8-13

25 Costello K The Myers-Briggs type indicator--a management tool Nurs Manage 1993 24 46-47 50-1

26 Bell MA Wales PS Torbeck LJ Kunzer JM Thurston VC Brokaw JJ Do personality differences between teachers and learners impact studentsrsquo evaluations of a surgery clerkship J Surg Educ 2011 68 190-193

Spiotta AM Mullin J Weil RJ Schlenk R Sean GM et al (2014) Insights into the Contemporary Neurosurgical Trainee Personality Typing of Residents across the United States JSM Neurosurg Spine 2(3) 1022

Cite this article