Being a co-signer on a personal loan for a friend or family member is a very generous offer as it will likely mean the difference between them being able to qualify for such a loan and not being eligible. However, the decision of being a co-signer for a personal loan should not be made lighter. It is the responsibility of potential co-signers to educate themselves about how this situation affects them, especially with regard to their responsibility to the loan should the borrower default.
Most co-signers don’t realize that this loan is going to show up on their credit report. Keep in mind that this might affect your ability to get your own loan down the road as the personal loan you co-signed on with by used to calculate your debt to income ratio. It can also affect the interest rate you get your own loans at. If you feel it is a good idea to co-sign a personal loan for a friend or family member, do so with the understanding that after a set amount of making on time payments the borrower will attempt to redo the loan under their own name only. The more money you co-sign for, the longer you can expect to be a part of that loan.
Since the loan can both positively and negatively impact the credit rating of the co-signer it is important to set the loan up so that they co-signer can access the account information. This will allow you to find out what has been paid on the loan and what is still owed. Make sure the lender will inform you of any late payments or non-payment issues with the borrower as soon as they happen. Too often co-signers aren’t aware there was an issue with the loan until it has already impacted their credit.
While co-signing a loan for a friend or family member can help them, be aware of how it will affect not only your credit but your relationship as well. Nothing can sour relationships faster than money issues. It is important for a co-signer to look at the circumstances that lead to the individual needing one in the first place. If it comes down to simple money mismanagement, then you aren’t doing them or yourself any favors. However, it is the result of circumstances they had no control over you may want to consider it.
To minimize your risk as a co-signer, don’t make it habit of offering to do so for friends and family. The word will spread like wildfire with more requests heading your direction. If you don’t feel your own credit and finances can’t hold up if the borrower doesn’t repay the loan, then do not co-sign for a personal loan. It can be difficult to say no, but it is important you are able to.
You might consider having the borrower provide your with verification that payments are being made including regular statements or cancelled checks. To further reduce your risk as a co-signer insist the borrower purchases personal loan insurance that can cover loan payments for a particular amount of time due to unemployment, illness, or death.
Co-signing a personal loan for someone is more than giving your signature. You are putting your financial history and worthiness on the line for that person. It is important that you carefully review the borrowers need for the money as well as their spending patterns. If they owe other people money or continually live beyond their means, walk away with a clear conscious. There are times that being a co-signer on a personal loan is the right thing to do. Only you can make that decision. If you decide to go forward with it make sure you can afford the cost of any missed payments and that the lender is going to keep you informed on the payment status on the personal loan.
Books on Personal Loans
Personal loans and all the terminology that goes with it can make your head spin after awhile. However, it is very important to educate yourself with the ins and outs of personal loans if you are considering obtaining one for any financial reason. Doing so can help ensure you get the right loan for your needs as well as prevent heartbreak down the road for you.
There are many wonderful books on the market today offering information on personal loans. Several of these books are a great investment for ensuring you will make solid financial choices in the area of personal loans after arming yourself with the facts of the industry.
The “Beginners Guide to Real Estate Investing” by Gary W. Eldred is of course geared towards real estate. However, it does have excellent information regarding personal loans. If you are considering a personal loan for real estate related issues including fixing up homes, then this book will give you quality information in both areas.
“The Book of Inside Information” explains the world of personal loans in very simple terms, making the process much easier to understand than books full of industry jargon. This book is a great financial resource. In addition to providing you will information about personal loans, it discusses the areas of family finances and managing family spending. One of the newest books out there is “The 21st Century Family Legal Guide: The Law You Must Know to Protect Yourself and Your Family”. This book is more technical, but still offers excellent information regarding personal loans.
In addition to quality books offering you information about personal loans, there are a few that provide you information on how to pay off debt, including credit cards and personal loans. “Live Debt Free” (3rd Edition) is full of level headed advice for doing so. This isn’t a book that promotes pyramid schemes or get rich quick schemes. Instead, the book offers forward budgeting and money management tips to help individuals devise a realistic plan that fits their income. The plan will help individuals reduce their debt in the areas of credit cards and personal loans.
Quality magazines including Reader’s Digest and Money Today often run articles on types of loans. You can research the internet to find great articles from these magazine and many others that discuss personal loans. Don’t forget to look for reviews including those published by the National Consumer Council on the issue of personal loans.
Personal loans are a great financial tool when used properly. Take the time to read some quality books in the area of personal loans to establish a strong understanding of how the process works. To get the best results, choose books that are unbiased. You want to read the good, the bad, and the ugly about personal loans. The more you know, the better decisions you can make regarding your financial dealings with personal loans.
If you already have personal loans, consider reading books that provide excellent information for ensuring those loans are repaid as well as how to eliminate personal loan debt with effective debt management systems. The information is very straightforward and worth investing your time and energy into reading. The internet is a great place to search out such important books on the issue of personal loans. You can also ask for them at your local library.
There are many wonderful books on the market today offering information on personal loans. Several of these books are a great investment for ensuring you will make solid financial choices in the area of personal loans after arming yourself with the facts of the industry.
The “Beginners Guide to Real Estate Investing” by Gary W. Eldred is of course geared towards real estate. However, it does have excellent information regarding personal loans. If you are considering a personal loan for real estate related issues including fixing up homes, then this book will give you quality information in both areas.
“The Book of Inside Information” explains the world of personal loans in very simple terms, making the process much easier to understand than books full of industry jargon. This book is a great financial resource. In addition to providing you will information about personal loans, it discusses the areas of family finances and managing family spending. One of the newest books out there is “The 21st Century Family Legal Guide: The Law You Must Know to Protect Yourself and Your Family”. This book is more technical, but still offers excellent information regarding personal loans.
In addition to quality books offering you information about personal loans, there are a few that provide you information on how to pay off debt, including credit cards and personal loans. “Live Debt Free” (3rd Edition) is full of level headed advice for doing so. This isn’t a book that promotes pyramid schemes or get rich quick schemes. Instead, the book offers forward budgeting and money management tips to help individuals devise a realistic plan that fits their income. The plan will help individuals reduce their debt in the areas of credit cards and personal loans.
Quality magazines including Reader’s Digest and Money Today often run articles on types of loans. You can research the internet to find great articles from these magazine and many others that discuss personal loans. Don’t forget to look for reviews including those published by the National Consumer Council on the issue of personal loans.
Personal loans are a great financial tool when used properly. Take the time to read some quality books in the area of personal loans to establish a strong understanding of how the process works. To get the best results, choose books that are unbiased. You want to read the good, the bad, and the ugly about personal loans. The more you know, the better decisions you can make regarding your financial dealings with personal loans.
If you already have personal loans, consider reading books that provide excellent information for ensuring those loans are repaid as well as how to eliminate personal loan debt with effective debt management systems. The information is very straightforward and worth investing your time and energy into reading. The internet is a great place to search out such important books on the issue of personal loans. You can also ask for them at your local library.
Collection Process on Personal Loans
Personal loans are available for a variety of uses. Most individuals who obtain them have every intention of repaying them as outlined in the terms of the loan. However, we all know that life can have plans for us that differ from what we envision for ourselves. There are also individuals out there who suck the life from any financial resource available, with absolutely no intention of repaying the funds.
There are many courses of action lenders can take in an effort to collect unpaid personal loans. If you find yourself in a situation where you can’t repay your personal loan, it is in your best interest to contact the lender immediately. They are more willing to work with you than to turn you into collections. Being honest about your situation will help them explore all the available options with you. In some cases, you can revise the loan to have lower payments or even skip a few payments without it causing a negative impact on your credit report.
The collection process for each lender is different. It is an area you should familiarize yourself with prior to accepting the terms of the loan. If you obtained a personal loan using the assistance of collateral attached to the personal loan or a co-signer than you in a dire situation that requires your attention to remedy it as quickly as possible.
Most creditors don’t care who repays the loan, as long as the funds get paid. Therefore, they have every intention of holding a co-signer liable for the balance due on the loan when the borrower is in default. The creditor may still desire to pursue legal action against the borrower. This can be done by taking the borrower to court. However, due to the time and cost involved they will likely just choose to pursue the co-signer for the funds. If a co-signer refuses to pay, then the creditor is likely to take both the borrower and co-signer to court or send the account to a collection agency.
Neither option works well for the borrower or co-signer. Court costs are expensive and you may need to pay for legal representation. The court can mandate you pay a set amount of money each month, or face the consequences of the legal system. Collection agencies generally will continually hound both the borrower and co-signer with phone calls and letters. They can also choose to garnish your paycheck, greatly reducing the amount of take home income you have.
Secured personal loans that go into default mean the creditor will be taking the asset you tied into the loan. This can be property, a vehicle, or other type of asset. Keep in mind that just because they have that asset, your loan may not be settled. Often, they will sell the asset for whatever amount they can get, and then apply that amount towards the balance due. The remaining balance will still be your responsibility, thus it could result in court proceedings or collections.
To prevent your personal loan from spiraling out of control, make sure you only borrow the amount of money you absolutely need. This will help keep your monthly payments low. Budget each month for repayment of your personal loan. If you have extra funds, consider paying in advance or placing the money into a savings account for emergencies.
Lenders find court proceedings and collections a costly and time consuming part of doing business. They will also collect on any collateral you put forth to secure the loan. They don’t enjoy it, but will take such action as means of recovering the money they lend. It is very important that you contact your lender immediately if you are not able to make a payment. This will allow them to work with you before the issue gets out of control. If you find a lender can’t help you, consider contacting a consumer counseling agency for further assistance.
There are many courses of action lenders can take in an effort to collect unpaid personal loans. If you find yourself in a situation where you can’t repay your personal loan, it is in your best interest to contact the lender immediately. They are more willing to work with you than to turn you into collections. Being honest about your situation will help them explore all the available options with you. In some cases, you can revise the loan to have lower payments or even skip a few payments without it causing a negative impact on your credit report.
The collection process for each lender is different. It is an area you should familiarize yourself with prior to accepting the terms of the loan. If you obtained a personal loan using the assistance of collateral attached to the personal loan or a co-signer than you in a dire situation that requires your attention to remedy it as quickly as possible.
Most creditors don’t care who repays the loan, as long as the funds get paid. Therefore, they have every intention of holding a co-signer liable for the balance due on the loan when the borrower is in default. The creditor may still desire to pursue legal action against the borrower. This can be done by taking the borrower to court. However, due to the time and cost involved they will likely just choose to pursue the co-signer for the funds. If a co-signer refuses to pay, then the creditor is likely to take both the borrower and co-signer to court or send the account to a collection agency.
Neither option works well for the borrower or co-signer. Court costs are expensive and you may need to pay for legal representation. The court can mandate you pay a set amount of money each month, or face the consequences of the legal system. Collection agencies generally will continually hound both the borrower and co-signer with phone calls and letters. They can also choose to garnish your paycheck, greatly reducing the amount of take home income you have.
Secured personal loans that go into default mean the creditor will be taking the asset you tied into the loan. This can be property, a vehicle, or other type of asset. Keep in mind that just because they have that asset, your loan may not be settled. Often, they will sell the asset for whatever amount they can get, and then apply that amount towards the balance due. The remaining balance will still be your responsibility, thus it could result in court proceedings or collections.
To prevent your personal loan from spiraling out of control, make sure you only borrow the amount of money you absolutely need. This will help keep your monthly payments low. Budget each month for repayment of your personal loan. If you have extra funds, consider paying in advance or placing the money into a savings account for emergencies.
Lenders find court proceedings and collections a costly and time consuming part of doing business. They will also collect on any collateral you put forth to secure the loan. They don’t enjoy it, but will take such action as means of recovering the money they lend. It is very important that you contact your lender immediately if you are not able to make a payment. This will allow them to work with you before the issue gets out of control. If you find a lender can’t help you, consider contacting a consumer counseling agency for further assistance.
Debt Management for Personal Loans
Personal loans can offer individuals a way to have the funds for an array of uses. Some are necessary while others are for pure enjoyment. It is important that you consider the financial obligation that comes with personal loans. Too often, individuals access money quickly then struggle to repay it. If you don’t have a good budget in place you may find yourself unable to make the payments on your personal loan.
An area where many individuals get into trouble with personal loans is debt consolidation. Within a year most people who use personal loans for this find themselves in even worse financial shape. This is because they have not altered their spending habits any. The result is they charge their credit cards up to the limit and now have those payments to make again as well as a personal loan payment. They may soon find they are drowning in the swimming pool of debt.
Enrolling in a debt management plan may be a great alternative for you to help you meet your financial obligations. Most debt management plans involve working with your creditors to reduce interest rates as well as working with the individual to establish a realistic budget and work to change spending habits.
The first step in the process is to do some research on the debt management programs available. Find out how long they have been in business and check for any reports from customers with the Better Business Bureau. Once you have chosen one, call to discuss your situation with them and schedule an appointment. You will need to bring statements for all of your bills as well as verification of your income.
With a debt management counselor you will discuss your monthly obligations. They will work with your creditors to reduce the interest on your debt. This will reduce your monthly payments. You will then make one monthly payment to the debt management agency. They will then disburse the funds to your creditors. You will continue to get monthly statements from your creditors for your records.
It is important that you understand you can’t use any of your credit cards that you place into a debt management program. Keeping that in mind, you might want to choose one with a very small limit that you pay separately. You will avoid making any additional charges on that credit card unless it is an absolute emergency. You will want to discuss this with your debt management counselor.
Most creditors are willing to accept the terms of a debt management program because it shows you are accepting responsibility for your debt. They want to recoup the money you owe so this is a very realistic way for that to happen. Most debt management agencies have policies in place about missing payments. Generally, if you miss two payments in a row they will drop you from the program. It is important you notify the debt management agency if you are having difficulties with making a payment.
Obtaining credit is often too easy, yet repaying it can be a struggle you have for a large portion of your life. If your personal loans and other debt have spiraled out of control, contact a debt management program to see if they can help your situation.
An area where many individuals get into trouble with personal loans is debt consolidation. Within a year most people who use personal loans for this find themselves in even worse financial shape. This is because they have not altered their spending habits any. The result is they charge their credit cards up to the limit and now have those payments to make again as well as a personal loan payment. They may soon find they are drowning in the swimming pool of debt.
Enrolling in a debt management plan may be a great alternative for you to help you meet your financial obligations. Most debt management plans involve working with your creditors to reduce interest rates as well as working with the individual to establish a realistic budget and work to change spending habits.
The first step in the process is to do some research on the debt management programs available. Find out how long they have been in business and check for any reports from customers with the Better Business Bureau. Once you have chosen one, call to discuss your situation with them and schedule an appointment. You will need to bring statements for all of your bills as well as verification of your income.
With a debt management counselor you will discuss your monthly obligations. They will work with your creditors to reduce the interest on your debt. This will reduce your monthly payments. You will then make one monthly payment to the debt management agency. They will then disburse the funds to your creditors. You will continue to get monthly statements from your creditors for your records.
It is important that you understand you can’t use any of your credit cards that you place into a debt management program. Keeping that in mind, you might want to choose one with a very small limit that you pay separately. You will avoid making any additional charges on that credit card unless it is an absolute emergency. You will want to discuss this with your debt management counselor.
Most creditors are willing to accept the terms of a debt management program because it shows you are accepting responsibility for your debt. They want to recoup the money you owe so this is a very realistic way for that to happen. Most debt management agencies have policies in place about missing payments. Generally, if you miss two payments in a row they will drop you from the program. It is important you notify the debt management agency if you are having difficulties with making a payment.
Obtaining credit is often too easy, yet repaying it can be a struggle you have for a large portion of your life. If your personal loans and other debt have spiraled out of control, contact a debt management program to see if they can help your situation.
Educate yourself about Personal Loans on the Internet
The internet is a wonderful place to find information. You can educate yourself about personal loans on the internet. There are many great sites that explain the types of loans to you. Here you will find definitions for terms pertaining to personal loans. You will also find sites that offer you tips and pointers for getting the best possible personal loan. If you are interested in comparing personal loan rates, the information is at your fingertips.
You can use the information on the internet about personal loans to educate yourself about the dangers of scams in the area of personal loans. This is valuable information that all of us can learn from. You can access the Better Business Bureau online to help you investigate a lender about possible issues prior to pursuing a personal loan with them.
Many websites offer you valuable tools for personal loans. The information is very comprehensive and the site is well designed. There are two sections on the site that allow you some great comparison shopping for personal loans. One section is for secured loans and the other is for unsecured loans.
There are consolidation tools that allow you to enter the amount of money you own on various loans as well as the interest rate. The tool gives you the total amount you will pay overall to repay that debt. This will give you a number to use when deciding if a personal loan to consolidate your debt with be cost effective.
Another great tool found on the internet will help you find the lenders who offer personal loans that meet your profile. This means you will be able to apply for a loan with a lender that is more likely to approve your loan than just randomly choosing a lender. To use this tool, answer questions with the drop down option that best matches your criteria. The questions will be about your credit rating, employment, the loan amount you are looking for, the length of repayment you are interested in, the purpose of the loan, and what types of collateral you have available.
Informing yourself about personal loans before you apply for one will help ensure you are approved for the loan you need at the best possible rates. Using the tools available online helps you make an informed decision about such loans as well as prevent you from falling victim to the scams out there. The online tools will help you find out if you can benefit from a personal loan for debt consolidation as well as help you locate the lenders that are likely to offer a personal loan that fits your personal profile.
You can find the information on personal loans as well as the wonderful calculation tools for free on many websites. Don’t waste your money paying for such services when you can find it for free. If you have questions about any of the information you find on the internet regarding personal loans, consult a financial institution. This is very important to do if you are finding conflicting information on the internet. In addition to educating yourself on personal loans, consider looking up information on budgeting and financial planning to help ensure you will have a healthy financial history and credit score down the road.
You can use the information on the internet about personal loans to educate yourself about the dangers of scams in the area of personal loans. This is valuable information that all of us can learn from. You can access the Better Business Bureau online to help you investigate a lender about possible issues prior to pursuing a personal loan with them.
Many websites offer you valuable tools for personal loans. The information is very comprehensive and the site is well designed. There are two sections on the site that allow you some great comparison shopping for personal loans. One section is for secured loans and the other is for unsecured loans.
There are consolidation tools that allow you to enter the amount of money you own on various loans as well as the interest rate. The tool gives you the total amount you will pay overall to repay that debt. This will give you a number to use when deciding if a personal loan to consolidate your debt with be cost effective.
Another great tool found on the internet will help you find the lenders who offer personal loans that meet your profile. This means you will be able to apply for a loan with a lender that is more likely to approve your loan than just randomly choosing a lender. To use this tool, answer questions with the drop down option that best matches your criteria. The questions will be about your credit rating, employment, the loan amount you are looking for, the length of repayment you are interested in, the purpose of the loan, and what types of collateral you have available.
Informing yourself about personal loans before you apply for one will help ensure you are approved for the loan you need at the best possible rates. Using the tools available online helps you make an informed decision about such loans as well as prevent you from falling victim to the scams out there. The online tools will help you find out if you can benefit from a personal loan for debt consolidation as well as help you locate the lenders that are likely to offer a personal loan that fits your personal profile.
You can find the information on personal loans as well as the wonderful calculation tools for free on many websites. Don’t waste your money paying for such services when you can find it for free. If you have questions about any of the information you find on the internet regarding personal loans, consult a financial institution. This is very important to do if you are finding conflicting information on the internet. In addition to educating yourself on personal loans, consider looking up information on budgeting and financial planning to help ensure you will have a healthy financial history and credit score down the road.
Personality traits that predict success in medical school
This is the third in a series of posts about my concern with the students that we are bringing into medical school. I am constantly reminded that not everyone believes that there is a problem. Some think that we are getting the right students into medical school. My question. The burning question for this series of posts is: if we are getting the right students in, why is the end product not meeting the needs of America? Or the needs of our individual states? There was a recent op-ed in the New England Journal of Medicine by Stephen R. Smith, MD, MPH from the Warren Alpert Medical School at Brown University.(1) Dr Smith said "medical schools must recognize the current factors that discourage medical students from pursuing primary care careers and then devise ways to overcome these barriers."
My first post in this series, Why do we put so much import on the MCAT? was about the MCAT and why (in my opinion) we need to de-emphasize the MCAT as a criterion for entry into medical school. I am not the only one saying this. Dr. Smith said, "The first test of this commitment will come in the way in which admissions are handled. The little evidence that is available on factors predicting career choice indicates that students who express a desire to serve underserved populations, who demonstrate altruism, and who are committed to social responsibility are more likely to go into primary care." Dr. Smith went on to say that "admissions criteria need to be broadened beyond scores on the Medical College Admission Test (MCAT) to include these personal attributes. The school should adopt an “MCAT-blind” admissions policy, dictating that students whose MCAT scores are at or above a predefined minimum that predicts a likelihood of success in medical school should then be considered further for admission without the reporting of their MCAT scores to the admissions committee."
In my last post, Characteristics of Future Physicians, I blogged about characteristics that I believe that we should want in graduates of our medical schools. There are several factors that medical school faculty have rated as extremely important but very hard to teach. My argument is that we should select students who already have those traits prior to matriculation. Some of the traits listed are obvious: (1) is emotionally stable; (2) is a person of unquestionable integrity; (5) is unusually intelligent; and (6) has sustained genuine concern for patients during their illness. Some are less obvious but seem really important: (9) is motivated primarily by idealism, compassion, and service; (14) is able and willing to learn from others; (17) is observant; and (18) is adaptable.
So the question for today is: are there personalities that do better in a medical curriculum and those that do worse? If you read the article by Dr Sade (2) I am sure that it is no surprise that there are some personalities that do better in medical school and some that seem to struggle more. Medical school is an extremely stressful environment. Many of the students that come to medical school, have never struggled academically in their lives. I have heard folks say, medical school is a pressure cooker.
The pressure cooker brings out all of the problems. It stresses them. It pushes them in ways that many of these students have never been pushed. 28 percent of physicians report that they have stress that affects their ability to provide clinical care.(3) A recent systematic review found that medical students perceive similar levels of stress to physicians.(4)
I see students struggle because they have never been in this kind of situation. Students are young, they are often coming straight from undergraduate school. Students that come to medical school have often not had any real life experiences. They have not had a job, or had extensive life experiences. Then we put them into an academically stressful environment that is extremely competitive and at some schools even cutthroat. The good news is that some personalities may be better at handling the stress of medical school, and then potentially life as a physician. McManus (5) studied stress in UK students over a period of 12 years. The authors found that stress could exacerbated or even caused by personality factors, specifically by high levels of neuroticism, low levels of extraversion and low levels of conscientiousness. These traits are dimensions that are part of the Five Factor model of personality. This model is well accepted and validated. The model is used by many of the studies of personality contributing to success in academic settings.
Another study from the UK (6) looked at Goldberg's "Big Five dimensions of personality" to study 176 medical students at the Nottingham Medical School. The authors compared the students' personality scores and academic assessments in Years 1 through 5. The conscientiousness dimension was a significant predictor of academic performance in the pre-clinical years but interestingly in the clinical years (Years 4 and 5) it correlated with poorer performance.
So, there are personalities that may be more suited for medical school. And even more importantly, these personality traits can affect success as physicians. The Aussies looked at this a few years ago. In this study, Knight, et al (8) studied whether personality characteristics, measured by the Hogan Developmental Survey (HDS), were associated with academic performance in 139 medical students. They found that borderline/schizoid and narcissistic/antisocial characteristics were negatively correlated with academic success. That one seems pretty obvious. One of the subsections of the HDS, the ‘Diligent syndrome’, were found to be positively correlated to higher exam scores. The Diligent syndrome is students who have a tendency to be attentive and good with details, orderly, rational, careful and well organized.
What about here in the US? The folks at Jefferson Medical College are the only ones who have studied this. Hojat, et al(8) studied six personality measures. They also asked about the students' relationships with their parents and their general health. They compared these assessments with global faculty ratings of competence in the clinical clerkships (family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery). The ratings used a 4-point scale (‘high honours’, ‘excellent’, ‘good’, ‘marginal competence’). The students in the lowest group had significantly lower levels of self-esteem and sociability, they were lonelier, and had less satisfactory relationships with their parents.
So, what should we do? Conscientiousness seems to be an important predictor of success in the preclinical years, but it may also lead to vulnerability to stress. And it is related to worse performance in the clinical years. Extraversion, self-esteem, and sociability seem to be more important in the clinical years. Maybe we should do like the Australians did and have every applicant fill out a personality profile. I am not sure how this was used, but it does not seem that it was used to choose students. Next time, I will write about some of the ways to screen incoming students.
References
(1) Smith S. A Recipe for Medical Schools to Produce Primary Care Physicians. New Eng J Med 2010; 364(6).
(2) Sade M, et al. Criteria for selection of future physicians. Ann Surg. 1985 February; 201(2): 225–230.
(3) Firth-Cozens J. Doctors, their well-being, and their stress. BMJ 2003;326:670–1.
(4) Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med 2006;81 (4):354–73.
(5) McManus IC, et al. Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: a 12-year longitudinal study of UK medical graduates. BMC Med 2004;2:29.
(6) Ferguson E, et al. Pilot study of the roles of personality, references, and personal statements in relation to performance over the five years of a medical degree. BMJ 2003;326 (7386):429–32.
(7) Knights JA, Kennedy BJ. Medical school selection: impact of dysfunctional tendencies on academic performance. Med Educ 2007;41 (4):362–8.
(8) Hojat M, Callahan CA, Gonnella JS. Students’ personality and ratings of clinical competence in medical school clerkships: a longitudinal study. Psychol Health Med 2004;9 (2):247–52.
My first post in this series, Why do we put so much import on the MCAT? was about the MCAT and why (in my opinion) we need to de-emphasize the MCAT as a criterion for entry into medical school. I am not the only one saying this. Dr. Smith said, "The first test of this commitment will come in the way in which admissions are handled. The little evidence that is available on factors predicting career choice indicates that students who express a desire to serve underserved populations, who demonstrate altruism, and who are committed to social responsibility are more likely to go into primary care." Dr. Smith went on to say that "admissions criteria need to be broadened beyond scores on the Medical College Admission Test (MCAT) to include these personal attributes. The school should adopt an “MCAT-blind” admissions policy, dictating that students whose MCAT scores are at or above a predefined minimum that predicts a likelihood of success in medical school should then be considered further for admission without the reporting of their MCAT scores to the admissions committee."
In my last post, Characteristics of Future Physicians, I blogged about characteristics that I believe that we should want in graduates of our medical schools. There are several factors that medical school faculty have rated as extremely important but very hard to teach. My argument is that we should select students who already have those traits prior to matriculation. Some of the traits listed are obvious: (1) is emotionally stable; (2) is a person of unquestionable integrity; (5) is unusually intelligent; and (6) has sustained genuine concern for patients during their illness. Some are less obvious but seem really important: (9) is motivated primarily by idealism, compassion, and service; (14) is able and willing to learn from others; (17) is observant; and (18) is adaptable.
So the question for today is: are there personalities that do better in a medical curriculum and those that do worse? If you read the article by Dr Sade (2) I am sure that it is no surprise that there are some personalities that do better in medical school and some that seem to struggle more. Medical school is an extremely stressful environment. Many of the students that come to medical school, have never struggled academically in their lives. I have heard folks say, medical school is a pressure cooker.
The pressure cooker brings out all of the problems. It stresses them. It pushes them in ways that many of these students have never been pushed. 28 percent of physicians report that they have stress that affects their ability to provide clinical care.(3) A recent systematic review found that medical students perceive similar levels of stress to physicians.(4)
I see students struggle because they have never been in this kind of situation. Students are young, they are often coming straight from undergraduate school. Students that come to medical school have often not had any real life experiences. They have not had a job, or had extensive life experiences. Then we put them into an academically stressful environment that is extremely competitive and at some schools even cutthroat. The good news is that some personalities may be better at handling the stress of medical school, and then potentially life as a physician. McManus (5) studied stress in UK students over a period of 12 years. The authors found that stress could exacerbated or even caused by personality factors, specifically by high levels of neuroticism, low levels of extraversion and low levels of conscientiousness. These traits are dimensions that are part of the Five Factor model of personality. This model is well accepted and validated. The model is used by many of the studies of personality contributing to success in academic settings.
Another study from the UK (6) looked at Goldberg's "Big Five dimensions of personality" to study 176 medical students at the Nottingham Medical School. The authors compared the students' personality scores and academic assessments in Years 1 through 5. The conscientiousness dimension was a significant predictor of academic performance in the pre-clinical years but interestingly in the clinical years (Years 4 and 5) it correlated with poorer performance.
So, there are personalities that may be more suited for medical school. And even more importantly, these personality traits can affect success as physicians. The Aussies looked at this a few years ago. In this study, Knight, et al (8) studied whether personality characteristics, measured by the Hogan Developmental Survey (HDS), were associated with academic performance in 139 medical students. They found that borderline/schizoid and narcissistic/antisocial characteristics were negatively correlated with academic success. That one seems pretty obvious. One of the subsections of the HDS, the ‘Diligent syndrome’, were found to be positively correlated to higher exam scores. The Diligent syndrome is students who have a tendency to be attentive and good with details, orderly, rational, careful and well organized.
What about here in the US? The folks at Jefferson Medical College are the only ones who have studied this. Hojat, et al(8) studied six personality measures. They also asked about the students' relationships with their parents and their general health. They compared these assessments with global faculty ratings of competence in the clinical clerkships (family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery). The ratings used a 4-point scale (‘high honours’, ‘excellent’, ‘good’, ‘marginal competence’). The students in the lowest group had significantly lower levels of self-esteem and sociability, they were lonelier, and had less satisfactory relationships with their parents.
So, what should we do? Conscientiousness seems to be an important predictor of success in the preclinical years, but it may also lead to vulnerability to stress. And it is related to worse performance in the clinical years. Extraversion, self-esteem, and sociability seem to be more important in the clinical years. Maybe we should do like the Australians did and have every applicant fill out a personality profile. I am not sure how this was used, but it does not seem that it was used to choose students. Next time, I will write about some of the ways to screen incoming students.
References
(1) Smith S. A Recipe for Medical Schools to Produce Primary Care Physicians. New Eng J Med 2010; 364(6).
(2) Sade M, et al. Criteria for selection of future physicians. Ann Surg. 1985 February; 201(2): 225–230.
(3) Firth-Cozens J. Doctors, their well-being, and their stress. BMJ 2003;326:670–1.
(4) Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med 2006;81 (4):354–73.
(5) McManus IC, et al. Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: a 12-year longitudinal study of UK medical graduates. BMC Med 2004;2:29.
(6) Ferguson E, et al. Pilot study of the roles of personality, references, and personal statements in relation to performance over the five years of a medical degree. BMJ 2003;326 (7386):429–32.
(7) Knights JA, Kennedy BJ. Medical school selection: impact of dysfunctional tendencies on academic performance. Med Educ 2007;41 (4):362–8.
(8) Hojat M, Callahan CA, Gonnella JS. Students’ personality and ratings of clinical competence in medical school clerkships: a longitudinal study. Psychol Health Med 2004;9 (2):247–52.
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