Medical school selection: screening for dysfunctional tendencies

AIM One of the aims of medical selection is to deselect students who have personal characteristics that would impact negatively on their ability to interact with patients, supervisors and peers and impede their ability to cope with the stress of medical training. The arduous requirements of the formal curriculum, the customs and rituals of the socialisation process and the mistreatment and abuse reportedly experienced by students all contribute to stress, mental illness, suicide, lowered self-confidence in clinical ability, decreased ability to learn and alcohol and substance abuse. There has been little research on the effectiveness of the selection interview in deselecting students with negative personal characteristics. Our research profiles the dysfunctional interpersonal tendencies of students already selected into a medical programme through the process of academic merit, application and interview. METHODS During 2001 and 2002, 159 students enrolled in an Australian undergraduate medical programme completed the Hogan Development Survey (HDS), which is a self-report measure of dysfunctional personality characteristics that inhibit the development of working relationships with others. RESULTS The HDS identified negative personality characteristics in medical students that were not detected in the selection interview. CONCLUSIONS The presence of patterns of dysfunctional behaviour in medical training has implications for the selection, teaching and pastoral care of medical students. The HDS has the potential to identify negative personal characteristics that are hard to detect during a selection interview, and may be a valuable adjunct to the interview.