Tips for Using Your Myers Briggs Personality Type to Optimize Your Performance in the Clinical Years

Tips for Using Your Myers Briggs Personality Type to Optimize Your Performance in the Clinical Years

As you know, your Myers-Briggs Personality Type is a measure of your preferences not necessarily behaviors. Yet, when stressed it is easy to default to our preferences whether they are adaptive or not. The clinical years are very rewarding but also stressful and there is no doubt certain behaviors lead to greater (or lesser) success. The following observations are based solely on the experiences and observations or Drs. Harrell and Hagen and are in no way formally studied or “scientific”. However, we hope they will still help you have the more rewarding and successful third year experience possible.

Introvert vs. Extrovert

Introverts: You are energized from your inner world more so than the outside world so tend to be more quiet and contemplative.

Strengths- You may think about your patients’ problems and your plans more completely before sharing them and thus appear more independent and knowledgeable if you speak up. You may be more observant during clinical encounters such as ward rounds as you may be less engaged in talking and more engaged in observing.

Pitfalls- If you don’t speak up and share your thoughts at best your team won’t know how you are doing but at worst this can be perceived as disinterest. You may feel more comfortable being off on your own quietly reading or getting your work done, but if others can’t find you or don’t know what you’ve been doing, you may not seem like a “team player”. Oral presentations may be one of the most stressful aspects of the clinical years for you. You may also find it difficult to find enough quiet time to study.

Tips-

1. Make sure you make lots of eye contact and smile, particularly if you are on a more extroverted team.

2. Practice presentations by yourself or with a student or resident you feel comfortable with before attending rounds.

3. Make sure you are sharing your thoughts with your immediate supervisors even if it is one-on-one outside of team activities (like rounds).

4. Do your quiet reading where team members can find you (not in the blue room or the library) and share what you are reading (even if it’s simply bringing in an article you think is relevant).

5. Ask how you can help often as this conveys a sense of interest and caring no matter how quiet you are by nature.

6. Ask for specific feedback about your level of engagement- don’t expect people to volunteer that they think you are too quiet or not engaged enough but they still may place it on your final evaluation!

7. Team work is critical in medicine so it is not bragging when you let team members know what you’ve been doing.

Extroverts: You are energized by being around others and the outside world so you will tend to thrive in the team-based settings of medicine like the wards and Ors.

Strengths- Engagement with people, whether patients or team members, is a major part of medicine and you thrive being around people. You will tend to rapidly integrate into teams and enjoy speaking with patients and team members. You will not be as intimidated by presentations on rounds or calling consultants. You also will tend to be quicker to speak up whether it is when being pimped on rounds or simply letting the team know what you’ve been up to. This is frequently interpreted by team members as being very interesting and engaged, which is a good thing.

Pitfalls- At times you may be too quick to speak up or ask questions before thinking about what you plan to say or how to find the information yourself. If done too frequently, this can be interpreted as being too dependent on the team for answers or as being less knowledgeable (if you are frequently blurting out wrong answers).

Tips-

1. Use your outgoing nature to facilitate communication among the team and advocate for your patients.

2. If you are paired with a quieter classmate or team in general, watch that you don’t dominant discussions too much as this can be interpreted as being a gunner.

3. Be careful that you do not interrupt patients or team members in your enthusiasm to be involved in patient care.

4. If you tend to have a particularly vibrant and enthusiastic personality, be very careful about tempering it in the presence of patients who are in distress or more reserved as it can seem overwhelming at best and insensitive at worst.

Intuitive vs. Sensing

Intuitive: You tend to take in information using a “sixth sense” rather than just your five senses and you think about things in more general and often idealistic ways.

Strengths- You may be much quicker at gathering the big picture and integrating data, which are difficult skills for medical students to master. You enjoy complex tasks and problems. You tend to get inspired about something and work in bursts or energy which can be very productive and demonstrate great enthusiasm to your team.

Pitfalls- You may tend to overlook data when coming up with a diagnosis or plan because you too quickly decided what was wrong with the patient. You may also not be as systematic in how you gather data in the history and physical—favoring an approach of more jumping around based on your hunch of what is

going on. Much of medicine is following up on mundane details and you may tend to neglect this in favor of tracking down some zebra diagnosis or reading up on something that sparked your interest. If you do this instead of following through with day to day tasks of checking on labs, making phones, calls, paperwork, etc., you will be seen as unreliable and possibly even as arrogant (if the team thinks you are neglecting daily tasks because they are beneath you).

Tips-

1. Capitalize on your ability to see the big picture (working diagnosis in many cases) and state it clearly but also make sure you double check that your impression aligns with all the facts. If it doesn’t them take a step back and re-examine (remember you like a challenge).

2. Make a list of things to do and prioritize it with the help of your residents. (You may often find that they will want things that seem less interesting or important to you done first.)

3. Force yourself to be rigorously organized in your data gathering as you will want to be an early adopter of the more intuitive/pattern-recognition approach experts use (but you’re not an expert yet and need to practice the routine).

4. If you are working with a supervisor who is more of a sensing type, touch base with them frequently about what you are doing. You may have all kinds of things going on in your head but if they can’t see it or hear it, they may think you’re not working. (For example, you may put off writing your notes until a burst at the end of the day as you’ve been composing them in your head, but to everyone else this may look like you are a disorganized procrastinator.)

5. Try to get your notes complete prior to oral presentations as you will have a tendency to want to jump around in your presentations to get to the “good stuff” right away. (Your teams are likely to think you forgot what you skipped and be frustrated by the lack of organization.)

Sensing- You take in information using your five senses. You tend to follow a more stepwise approach to data gathering and problem solving and tend to be very practical minded.

Strengths- You will tend to be a very methodical and well-organized data gatherer. You will present your thoughts in a well organized fashion and likely have your notes mostly complete early. You are also very good about checking up on details and will likely be perceived as a very dependable team member. You will tend to be good about keeping your team posted about patients’ progress, updates in new information like lab data, and even where you will be. These are very helpful qualities in fostering teamwork.

Pitfalls- You may have trouble integrating all the data you gather and coming up with an assessment. (This is why your notes may be mostly done early as you may want to wait for your team to come up with the assessment.) You may find you feel more comfortable generating a plan even before you have an assessment (or rationale for ordering certain tests as you are comfortable in gathering facts).

Tips-

1. Capitalize on your ability to gather complete data and alert the team to any information that you may uncover that was previously missed (you have more time than your residents so if done respectfully this is a big help and will be appreciated).

2. Recognize that some of the detail you gather really is not that important to the patients’ acute problems and don’t get discouraged or hurt feelings if team members seem to blow off some of the information you try to present or tell you to skip certain details. (This does not imply a problem with your data gathering ability).

3. Remember that although individual pieces of data are useful trends in data (for example how a lab result has changed from one day to the next) are even more important. You may be able to uncover trends before the rest of the team if you have been closely following a patient’s data.

4. Push yourself to commit to working diagnoses for all symptoms and abnormalities you uncover no matter how clueless you may feel. Residents and faculty are generally much more interested in teaching you how they are thinking if you show evidence of thinking for yourself first.

5. If you are working with a resident that seems to have trouble getting all their daily tasks completed, you can become invaluable to them by making your own list of tasks and then running it by the resident and asking them which they would like you to do. This will seem simple to you but it’s not for everyone.

Thinking vs. Feeling

Thinking: You tend to rely on logic and analysis to solve problems. You tend to value being objective, fact- based, and like to critically appraise information to draw conclusions.

Strengths- You are the quintessential scientist. You will have a natural affinity for the concept of evidence based medicine and will tend to question things rather than simply take things at face value. You are not unfeeling but just don’t rely on your feelings to make decisions. You tend to be fair minded and do not have trouble offering honest critiques.

Pitfalls- as mentioned above, you are not unfeeling, however, you may not value people’s feeling as much when making decisions. This could lead you to be perceived as less empathetic. You also may not see how your actions affect other people’s feeling which could create tensions in a team. Although you are not in a position of power as a medical student so are less likely to be critiquing the team, you may tend to ask very legitimate and perceptive questions in a way or setting that could be perceived as confrontational by residents or faculty.

Tips-

1. Don’t try to fake emotions you don’t feel as patients and colleagues will see through this. Rather get in the habit of asking how information you are imparting makes the patient feel.

2. Don’t be dismissive of patients’ feelings or those of other team members even if it doesn’t make sense to you why it should matter in certain circumstances.

3. Make an effort to understand the values of your team and your patients as this may be influencing their own decision making more than you could imagine.

4. Seek out colleagues who may seem particularly sensitive and emotional to you and discuss cases together as you both will likely benefit from each others’ perspectives and achieve a more balanced and better plan of care for patients. (Who knows what “the science of hope” is, but balancing logic and emotions is very much at the heart of “the art of medicine”.)

Feeling- You place a heavy emphasis on values, both your own and others’ when forming decisions. You tend to act in a way that promotes harmony.

Strengths- Because people’s values and feelings are important to you, you tend to be very in tune to them and will frequently be described as compassionate and empathetic. You like to please people and for everyone to be happy and get along which very much promotes good team work.

Pitfalls- You may have trouble telling people things they don’t want to hear. You may tend to overemphasize patients’ preferences and sacrifice providing them all the factual information to make sure their preference is an informed one. You may at times find yourself getting too emotionally involved in a patient’s case. Because you work so hard to make others feel good and appreciated, you may find it particularly discouraging if you are not being appreciated for all your hard work. You may tend to take feedback more personally even when it is not meant to be.

Tips-

1. Most patients can’t get enough concern and compassion when t hey are ill and afraid, so this is your chance to really shine so take advantage.

2. Make sure that when you advocate for your patients you have taken the time to become well-versed in the more objective facts of the case.

3. You may find it frustrating that other people on the team do not feel as passionately about your patient as you do. Try to accept that you may have more of a “special calling” in this area and that others on the team may express their concerns for patients by focusing on details of their disease rather than on the patient themselves.

4. It can be natural to feel strong emotions and attachments to some of your patients. On certain rotations where patients are very ill, this can become quite overwhelming. Make sure you talk to people if you find yourself becoming too emotionally involved with a patient’s care.

5. Ask for very specific feedback from your team if you want to know how you are doing. It may be easier for them to let you know how a particular write up or physical exam could be improved than how you are doing over all.

Perceiving vs. Judging

Perceiving: You tend to value spontaneity and flexibility.

Strengths- You are good at adapting so switching rotations and teams frequently as occurs during third year will not be as difficult for you. In general the clinical years are much less structured and this will be a relief for you. Patient care is also full of surprises and you will likely enjoy the constant give and take of clinical medicine. You are likely a good trouble shooter and able to think on your feet well.

Pitfalls- You tend to dislike a lot of formal structure and deadlines. You may tend to resent structured conferences and other clerkship activities that take you away from the frontlines of patient care. However, if you are slack about attendance, not showing up on time (even if it’s because you were going with the flow of patient care), or not completing work in a timely manner, this can be interpreted as unprofessional and get you in a lot of trouble. Watch that you aren’t marching to your own drum too much as this could be perceived as not being a good team player.

Tips-

1. Make lists and set deadlines for yourself (even if there aren’t firm deadlines in place).

2. Set up a study plan for yourself for the shelf exams as you are likely to put off studying as there will be so many legitimate distracters in the care of patients.

3. If your resident asks you to do something, make sure you prioritize it. This is not the thing to put off as you get sidetracked.

4. Try to set specific goals or learning objectives for each new rotation (whether or not it is required) and make sure you reflect on your progress.

Judging: You tend to value preparation and order.

Strengths- You tend to be very well organized and reliably get your work done on time, which will make you a highly valuable team member. You tend to be focused on the task at hand and follow things through to completion. You tend to be good at making decisions which is very important in patient care.

Pitfalls- There is not nearly the structure during the clinical years that there was during the preclinical years. Furthermore, some teams tend to be much less structured that others and you will likely find this frustrating. You may have trouble with the constant change of teams, routine, and expectations that characterizes the clinical years. Things frequently do not go as planned in the hospital and clinics which may frustrate you more than others.

Tips-

1. Take heart that the lists and various tools you use to organize yourself will likely work well on all your rotations, which can serve as a source of continuity for you.

2. When you join a new team don’t be afraid to inquire early on what the schedule is and what expectations they have for you so that you feel prepared.

3. If you are on a team or clerkship that is less structured, you can create your own schedule to give you a sense of structure.

4. You are likely already a goal setter, so keep this up for each rotation even when not required.