Predictors of Success and Satisfaction in the Practice of Psychiatry: A Preliminary Follow-up Study|
Paul E Garfinkel, MD1, R Michael Bagby, PhD2, Deborah R Schuller, MD3, Charmaine C Williams, MSW4, Susan E Dickens, MA5, Barbara Dorian, MD6
Background: Few studies have examined the predictors of psychiatrists’ perceived success and personal satisfaction with their careers. The present study examines self-reported success and personal satisfaction with their careers in a cohort of psychiatrists followed for more than 20 years.
Methods: A total of 29 psychiatrists, all of whom had participated in a study during their residency 21 to 24 years earlier, completed a self-report questionnaire. The first set of questions addressed the type and characteristics of their professional practice; the second set assessed aspects of their nonprofessional practice; and the third set assessed aspects of their nonprofessional, personal lifestyles. The personality traits of neuroticism and extraversion were assessed during the residency years and were used as predictors. Composite measures of self-perceived external success and personal satisfaction were computed. Regression models were constructed to determine the best predictors of these composite measures.
Results: Neuroticism proved to be a significant predictor of external success but not of personal satisfaction, with higher scores predicting a lower rating of perceived external success. There were 2 practice characteristics—involvement with research and practising from an orientation other than psychoanalytic—that predicted perception of success. One personal lifestyle characteristic—the perception that one’s nonprofessional life sustained professional life—also predicted perception of success. The best predictor of personal satisfaction was overall satisfaction with nonprofessional aspects of life.
Conclusions: Personality, nonprofessional social support, and engaging in research are associated with greater perceived success and personal satisfaction with a career in psychiatry.
(Can J Psychiatry 2001;835–840)
Key Words: job satisfaction, psychiatrist, personality, lifestyle, work characteristics
Psychiatrists are known to have high rates of mental disorders (1–4), and a higher frequency of both emotional disorders and suicide has been reported more among practising psychiatrists than among other medical practitioners (5,6). One explanation for these high rates is that medical students who are attracted to psychiatry may be prone to mental illness early in life. Thus, it is this vulnerability that contributes to their selecting psychiatry as a career, thereby accounting for the high rates of emotional disturbance. For example, Walton (7) reported that high levels of neuroticism were associated with a positive attitude to psychiatry as a career choice among medical students, although it is an empirically established vulnerability factor for emotional disturbance (8). Another explanation is that the specific stressors associated with psychiatric practice, combined with personality vulverability, lead to emotional dysfunction.
Evidence supports this latter interpretation. In a relatively recent study, Deary and others (3) compared a sample of randomly selected consulting psychiatrists (n = 39), who worked within the National Health Service in Scotland, with a group of 149 physicians and surgeons. Several variables related to the stress process, including personality traits, coping strategies, psychological distress, burnout, job stress, and work demand.
1-6The Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto
Compared with the other physicians and surgeons, psychiatrists reported fewer clinical work demands and, as a group, did not report more work-related stress than did the other physicians and surgeons. There were, however, significant differences in the personality characteristics, with psychiatrists scoring significantly higher than the other physicians on the personality dimensions of neuroticism, openness-to-experience, and agreeableness and lower in conscientiousness. Another explanation is that the specific stressors associated with psychiatric practice, combined with personality vulnerability, lead to emotional dysfunction. Given that work demands were less and reported work-related stress was lower, psychiatrists reported higher work-related emotional exhaustion and depression. This may attribute to a general disposition that experiences negative emotion (neuroticism, including job-related stress), heightened sensitivity to emotional states (openness-to-experience), a need to please others (agreeableness), and an admittedly less self-disciplined, achievement-oriented style. These results suggest that the personality characteristics that might dispose some individuals toward a successful career in psychiatry might be the same factors that make them vulnerable to emotional problems.
The current study aims to examine the relation between personality and job satisfaction in a sample of psychiatrists in Ontario.