People make choices in a variety of ways and the way doctors decide on their specialty choice can also vary. Here we will look at two different approaches which can be helpful when deciding which specialty is best for you. Personality or SWOT Analysis? The first approach focuses on your individual personality characteristics. By having a deeper understanding of your personality preferences, you can make a more informed decision about why you are attracted (and repulsed!) towards certain specialties. The second approach is one that uses a structured framework commonly used to analyse options and alternatives. This can be helpful to interrogate your specialty decision-making, however clear you are about your choice. Personality Factors and MBTI One approach to help us understand the idea of personality preferences and the way we differ from other people is the Jungian-based instrument, the Myers-Briggs Type Indicator (MBTI). Many doctors will already be familiar with this tool which can be used to indentify four prime ways in which people are different (Houghton, 2004, BMJ Careers). These ways are: how we focus our attention; the way we like to absorb information; the sort of information we prioritise in decision making; our preferred style of working and living our lives. Remember though, MBTI is only one instrument and its important to acknowledge that one of the key principles of the measurement is that all types are valuable. Only an individual can decide on her/his type, regardless of their responses to the questionnaire used to ascertain that type. Moreover, ones type is linked to preferred styles rather than abilities; indeed, all of us can learn to use non-preferred behaviours. So what does this have to do with specialty choice? Well, the argument is that if you improve your understanding of your personality preferences you are more likely to appreciate why you make the choices that you do. Furthermore, you will be more satisfied and fuflfilled in the work that you do, or the specialty that you choose. Much has been written about how personality differences between doctors can have implications for their specialty choice (Gilligan et al, 1999, Clack et al, 2004) and how certain personality preferences are perhaps cultivated and rewarded within a changing NHS system, (Houghton, 2005). Equally, some recent research has issued a note of caution about using personality to explain rather just inform specialty choice (Leong et al 2005, Borges & Savickas 2002) based on evidence of a wide range of personality types within specialities, not just between specialities. Here though is a brief summary of how the four dimensions of personality highlighted by the MBTI tool can provide an insight into the types of activities and, to a lesser extent, specialties which you may prefer: Different ways we focus our attention: Extroverted E (on the outside world) or Introverted I (on the world inside our heads): Activities within Medicine which require extroversion and introversion: E Seeing lots of patients Teaching, presenting Team working I Thinking through clinical problems Focusing on individual patients Examining data, writing reports Different ways we prefer to absorb information: Sensing S (take in information in a factual, step by step fashion) or Intution N (take in information by creating meanings and patterns out of that information) Activities within Medicine which require Sensing and Intution: S Taking structured histories Collecting data for research Following clear care pathways N Generating ideas for research Drawing meaning out of histories Developing new ideas to approach issues Different kinds of information we prioritise in our decision making: Thinking T (use logical analysis to weigh up the pros and cons) or Feeling F (refer to their values and the consequences of the decision may be on other people involved) Activities within Medicine which require Thinking and Feeling: T Explaining cause and effect Treating according to evidence Technical work and analysis F Talking to patients and relatives Explaining personal consequences Different way we prefer to work and live our lives: Judging J (likes to be scheduled and organised) or Perceiving P (likes to be flexible and energised by last minute pressures) Activities within Medicine which require Judging and Perceiving types: J Organising schedules Making clear decisions Clinics P Being flexible Emergencies Gathering information needed for decision making No doubt you can see there is a bias towards certain preferences within Medicine, particularly the Thinking and Judging preferences across all specialities, with some studies suggesting that a significant majority (85%) of doctors describe themselves as Thinking types (see Gilligan, 1999). Personality informs rather than explains choice Clearly, it would be unwise to suggest that only certain specialites require or appeal to certain personality types. Like any other profession, medicine needs all types of personalities, although some specialties may tend to attract some types more than others. As Houghton notes (2003), one of the main differences between different specialties can be the tangibility of results and timescales involved. For this reason, those who are of the Sensing preference, may find Emergency Medicine and Surgery appealing because of its pace and tangible results. Alternatively, those who are more of the Intuitive preference may find the longer term and more abstract results of Public Health or Psychiatry more satisifying. Specialites which require high levels of patient and relatives contact, ranging from Paediatrics to General Practice may feel more attractive to those of an Extroverted preference, whilst Introverts may find the lab-based work within Pathology more appealing. Essentially though, these personality factors are there to help you understand your natural inclincations towards certain specialities and help you interpret what job satisfaction means for you in your work. They are not there to provide a somewhat crude formula, such as all anaesthetists are INSPs! That said, as we know, most medics describe themselves as having a Thinking preference so here is an additional tool to help you analyse your speciality choice and one that should appeal to those Thinkers amongst you! SWOT analysis. Whether your specialty choice is crystal clear or rather foggy, appealing a structured analysis to your decision could be a useful way of ensuring you have assessed your choice in a thorough and systematic way. SWOT analyses (Strengths, Weaknesses, Opportunities, Threats) are used in various industries as a way to compare and contrast options in an objective way. This type of analysis enables you to assess the current appeal of the specialty, but also acknowledge future factors which might influence your choice. Clearly, how you would complete your individual SWOT analyis would depend on what you regard as your individual strengths and weaknesses and what you regard as positive and negatives aspects of that speciality. Here though are two example outlines of a SWOT analysis for two very different medical specialites: General Practice STRENGTHS Autonomy Lots of patient contact WEAKNESSES Time pressures within consultations Responsibilites of Partnership, beyond clinical work OPPORTUNITIES Possibility of part-time work, flexible hours Opportunity to develop specialist skills THREATS Future unknown for some practices; Darzi, polyclinics Orthopaedic Surgery STRENGTHS Tangible results Development of technical skills WEAKNESSES Significant on-call responsibilities, even at Consultant grade OPPORTUNITIES Opportunity to hone your specialist surgical skills THREATS Highly competitive training route Therefore, whether you choose to learn more about your personality preferences or apply a rigorous SWOT analysis to your specialty choice, hopefully these two appoaches will assist you in the next stage of your career decision making. source
