Medical students��� personality characteristics and academic performance: a five-factor model perspective Filip Lievens,1 Pol Coetsier,1 Filip De Fruyt2 & Jan De Maeseneer3 Objectives This study investigates: (1) which person- ality traits are typical of medical students as compared to other students, and (2) which personality traits predict medical student performance in pre-clinical years. Design This paper reports a cross-sectional inventory study of students in nine academic majors and a prospective longitudinal study of one cohort of medical students assessed by inventory during their first pre- clinical year and by university examination at the end of each pre-clinical year. Subjects and methods In 1997, a combined total of 785 students entered medical studies courses in five Flem- ish universities. Of these, 631 (80��4%) completed the NEO-PI-R (i.e. a measure of the Five-Factor Model of Personality). This was also completed by 914 Year 1 students of seven other academic majors at Ghent University. Year end scores for medical students were obtained for 607 students in Year 1, for 413 in Year 2, and for 341 in Year 3. Results Medical studies falls into the group of majors where students score highest on extraversion and agree- ableness. Conscientiousness (i.e. self-achievement and self-discipline) significantly predicts final scores in each pre-clinical year. Medical students who score low on conscientiousness and high on gregariousness and excitement-seeking are significantly less likely to sit examinations successfully. Conclusions The higher scores for extraversion and agreeableness, two dimensions defining the interpersonal dynamic, may be beneficial for doctors��� collaboration and communication skills in future professional prac- tice. Because conscientiousness affects examination results and can be reliably assessed at the start of a medical study career, personality assessment may be a useful tool in student counselling and guidance. Keywords education, medical undergraduate ��� *psycho- logy clinical competence ��� *standards *personality edu- cational measurement Belgium. Medical Education 2002 36:1050���1056 Introduction It is often asserted that, besides cognitive abilities, a blend of personality characteristics is necessary for people to be successful in medical studies and eventu- ally in the medical profession. However, there is further debate as to which personality traits are typical of students in medical studies as compared to students in other academic majors1���3 and which specific personal- ity traits predict medical student performance in the pre-clinical years.4,5 An important reason for the difficulty in drawing generalizable and robust conclu- sions is that previous studies have used a variety of personality inventories (e.g. the California Psychologi- cal Inventory,7���9 the Eysenck Personality Inven- tory,10,11 the 16 Personality Factor Questionnaire,10,12,13 the Myers-Briggs Type Indica- tor,14,15 the Edwards Personal Preference Schedule16 and the Comrey Personality Scales3,6) to measure a very divergent set of personality traits. In recent years, there has been emerging consensus among personality psychologists that the myriad of personality characteristics measured by various person- ality inventories can be grouped under five higher- order personality factors: extraversion, agreeableness, conscientiousness, emotional stability and openness to experience.17,18 An overview of the structure of this Five-Factor Model (FFM), also known as the ��Big Five��, is found in Table 1. The FFM dimensions, which 1Department of Personnel Management and Work and Organizational Psychology, Ghent University, Belgium 2Department of Psychology, Ghent University, Belgium 3Department of General Practice and Primary Health Care, Ghent University, Belgium Correspondence: Filip Lievens, Department of Personnel Management and Work and Organizational Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium. Tel.: 00 32 9264 6453 Fax: 00 32 9264 6494 E-mail: filip.lievens@rug.ac.be Medical students 1050 �� Blackwell Science Ltd MEDICAL EDUCATION 2002 36:1050���1056

define the underlying qualities of the diversity of personality traits, have been replicated in an impressive series of studies, across raters and rating scales, but also in different countries and cultures.17,19 The FFM dimensions and their operational manifestations pri- marily represent the normal range of individual differ- ences, contrary to many clinically developed personality descriptive models, making the model suitable for studying traits and samples derived from the general population. Although the FFM has been largely ignored in the medical literature, it may serve as a uniform, comprehensive and robust framework for describing medical students��� personality characteristics and for substantially advancing our understanding of whether these traits relate to academic success.20 Therefore, this study uses the FFM of personality to compare medical students with students of seven other academic majors. This allows us to investigate which personality traits are relatively typical of medical students. As a second objective, we investigate which of the FFM dimensions predict students��� final scores in the pre-clinical years of medical studies. It should be emphasised that we investigate these two objectives at both the FFM domain and FFM facet levels. To ensure the generalisability of the results, criterion data are not restricted to the first year of medical training but to the first 3 years. In addition, these data have been gathered in all five universities providing medical studies in the Flemish community. On the basis of prior research in the medical,20 occupational21 and educational fields,22 we hypothesise that the second-order factor conscientiousness in general and the facets associated with conscientiousness (i.e. competence, order, dutifulness, achievement, self- discipline and deliberation) in particular will be con- sistent predictors of medical student performance across the pre-clinical years. Methods Participants In 1997, a total of 785 students entered medical studies courses at the five Flemish universities. All of these students had successfully passed the Flemish admission examination in Medical and Dental Studies. This admission examination, which was organised by the Flemish government, included cognitive ability meas- ures (e.g. reasoning tests) and video-based situational tests (e.g. videotaped interaction between doctor and patient). During classes at the start of the first academic year of medical studies, a personality inventory was admin- istered to the medical students at all Flemish univer- sities. Students were informed about the purpose of the study and were told they would receive individual Key learning points Medical studies are in a group of majors that score highest on extraversion and agreeableness. Medical students scoring high on conscientiousness (i.e. ��self-achievement�� and ��self-discipline��) are more likely to succeed in the pre-clinical years. Students scoring low on conscientiousness and high on both ��gregariousness�� and ��excitement-seeking�� are significantly less likely to successfully pass the preclinical years. Personality assessment may be a useful tool for medical student guidance and counselling rather than for medical student selection per se. Table 1 Domains and facets of the Five-Factor Model of Personality Factor ��� domain Facets 1 Neuroticism (N) N1: Anxiety N2: Angry hostility N3: Depression N4: Self-consciousness N5: Impulsiveness N6: Vulnerability 2 Extraversion (E) E1: Warmth E2: Gregariousness E3: Assertiveness E4: Activity E5: Excitement-seeking E6: Positive emotions 3 Openness to experience (O) O1: Fantasy O2: Aesthetics O3: Feelings O4: Actions O5: Ideas O6: Values 4 Agreeableness (A) A1: Trust A2: Straightforwardness A3: Altruism A4: Compliance A5: Modesty A6: Tender-mindedness 5 Conscientiousness (C) C1: Competence C2: Order C3: Dutifulness C4: Achievement striving C5: Self-discipline C6: Deliberation Medical students��� personality characteristics ��� F Lievens et al. 1051 �� Blackwell Science Ltd MEDICAL EDUCATION 2002 36:1050���1056