My former pediatrician always had the brightest smile. She was an effervescent “people-person.” Between her and episodes of Grey’s Anatomy, I always thought that all physicians were outgoing butterflies flapping back and forth between patients and their vibrant social lives. Physicians are usually depicted as extroverts, and medicine a profession of the people.
And then, there is me. If I am ever at a party, one will find me with my back pressed against the wall hoping to skip the small talk and waiting to find one person who might be willing to do the same. Similarly, I hang back in large group conversations and prefer to listen rather than share. A few years ago, I read Susan Cain’s book entitled Quiet and realized I was not only different from my party-loving friends, but I was also the textbook definition of an introvert: someone who gains energy from alone time, prefers being thought-oriented rather than action-oriented and enjoys creating deeper relationships.
Although I have been learning to embrace introversion in my personal life, I still question how well introversion fits into the field of medicine. I question whether I should pretend to be an extrovert in front of patients and my teachers. Is it possible for introverts to succeed (and thrive) in medicine?
Recent studies have demonstrated that extroverts perform better than introverts during years three and four of medical school, which consist of clinical rotations. Medical school and residency interviewers may even favor extroverts, thus making these interviewees more likely to be accepted.
In group cases and rounds, extroverts have the edge as they tend to be more comfortable answering questions with limited information and processing time. For all of these reasons, evaluators may rate extroverts more favorably on evaluations than introverts.
While extroverts may perform better during clinical rotations, the skills in question may be narrow in scope. The traditional structure of monthly rotations can make it more difficult for introverts to have time to become familiar with staff, patients and the facility’s atmosphere. The introverted tendency for reticence may be mistaken for lack of engagement or interest. In small groups, introverts, even though they may be thinking deeply about a conversation, may be less likely to be “engaged” in the talkative sense.
Extroverted physicians are viewed as more personable, warm and assertive while introverted physicians are sometimes thought to be like real life versions of Dr. House: people lacking the ability to follow basic social norms and only having super-intelligence as a redeeming quality.
Cain, the author of Quiet, argues that society has an “extroversion bias” and also asserts that introversion is both undervalued and misunderstood. She elaborates by stating that introversion is not the same as social anxiety, lack of social skills or even a need to be around other people. Cain encourages all individuals to embrace their natural personalities and argues that introversion confers its own unique benefits.
Despite the popular culture portrayals of gregarious and outgoing physicians, there are actually more self-described introverted physicians than extroverted ones. A Medscape report surveying over 15,000 physicians found that thirty-five percent self-identified as introverts, and only twenty-eight percent identified as extroverts with the remaining respondents reporting to be somewhere in between.
Additionally, there is increasing pressure to evaluate prospective medical students based not only on standardized examination scores and GPA, but also on personality test results. While these changing admission standards are well-intentioned, medical school acceptance committees should not conflate introversion with a lack of interpersonal skills.
Despite these potential disadvantages of being an introvert, I am uncomfortable portraying a false extroverted persona. At the same time, I recognize my introverted tendencies leave room for growth.
As I try to reflect on and constructively review my behavior and responses, I have become committed to maintaining this self-awareness. Constantly, I remind myself to introduce myself to other hospital staff members even though it has never felt natural to go out of my way to speak with passersby. I now contribute more to small group cases by thinking aloud and answering more questions. I am working on filtering and synthesizing information to give confident oral presentations in stimuli-saturated environments.
Even though extroverts may feel more comfortable in group-settings, I find my introverted leanings to be most useful in front of one person: the patient. While there is always a little small-talk, we usually dive right into the important topics. After all, these conversations often involve matters of life and death.
Sometimes, I feel as though I should be more like my witty, charming pediatrician who I grew to admire. However, I also feel as if my introverted instincts such as careful processing and leaving space in conversations for my patients to speak have been critical for building rapport with patients. While extroverts may make their patients comfortable through humor and warmth, introverts may instill the same level of comfort to their patients through active listening, reflective thinking and compassion.
Whether introverted or extroverted, everyone finds some actions and behaviors more natural than others. I am still finding my individual path and appreciate that medicine provides moments of both unfamiliarity and comfort. For better or worse, introversion is and will always be a part of me and my practice as a future physician.