Being introverted--a negative?

[ari202]

Hey everyone,

I was advising some of the MS3's about auditions and applications for the next year. One of them brought a concern to my attention, apparently one of his attending evaluators for an Internal Medicine rotation thought he was an introvert but did a great job otherwise. It is going to be an uphill battle for the student to get it changed as I had a bad evaluation from one of my preceptors and the school still put in my MSPE.

But, really, is being introverted bad in psychiatry? I think it helps prevent any transference that happens during encounters with patients if anything. I had always known several psychiatrists to be introverts. I told him to just ignore it because a lot of the other evaluations talked positively about the student and his confidence with patients.

From a recruitment standpoint, is this a big issue? I don't want to misguide him, though, knowing my school, its going to be a challenge to get anything on the MSPE changed anyways.

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[wolfvgang22]

If it shows up on the MSPE, good advice is to just be honest and explain what was learned in the rotation and show that you do, in fact, have good social skills.

Ok, now I rant:
Why would a med school put anything that can be perceived as negative in a MSPE? That's bizarre at best, hateful at worst. Do they think they come across as more honest by being jerks and including such immature drivel?
I would have trouble taking some random doctor's evaluation that a person is an "introvert" seriously if I was reading an MSPE. What kind of passive aggressive a-hole writes that about a med student? It tells me more about the writer than it does the student. What the hell does saying the student is an "introvert" mean? If the writer thinks a student needs to build confidence, or lacks in social skills, knowledge, or work ethic, the writer should just say that, and indicate if the student worked to improve or not.

 

[ari202]

If it shows up on the MSPE, good advice is to just be honest and explain what was learned in the rotation and show that you do, in fact, have good social skills.

Ok, now I rant:
Why would a med school put anything that can be perceived as negative in a MSPE? That's bizarre at best, hateful at worst. Do they think they come across as more honest by being jerks and including such immature drivel?
I would have trouble taking some random doctor's evaluation that a person is an "introvert" seriously if I was reading an MSPE. What kind of passive aggressive a-hole writes that about a med student? It tells me more about the writer than it does the student. What the hell does saying the student is an "introvert" mean? If the writer thinks a student needs to build confidence, or lacks in social skills, knowledge, or work ethic, the writer should just say that, and indicate if the student worked to improve or not.

I honestly think our medical school's administration is completely unprepared and understaffed to look into this type of stuff. They have such a huge class size and its up to the students to take this stuff up. They are so afraid of ruining relationships with preceptors and they just like to blame us if we fail to match, or fail to meet preceptor expectations.

Our tution is insane, and I think a lot of us have just decided to accept that somethings we won't be able to win

 

[Ceke2002]

But, really, is being introverted bad in psychiatry? I think it helps prevent any transference that happens during encounters with patients if anything. I had always known several psychiatrists to be introverts. I told him to just ignore it because a lot of the other evaluations talked positively about the student and his confidence with patients.

Not being a medical practitioner of any description I cannot comment on the rest of your post, but as a Psych patient I can at least comment on what you've written here. I personally don't think being an introvert is bad for a Psychiatrist, as a matter of fact I personally find a Psychiatrist having an introverted personality as their base or dominant personality trait can actually provide a good balance within the therapeutic process if they can also harness a certain level of extroversion as well. My own Psychiatrist, by his own admission, is predominantly an introvert, but as we discussed in session one time (where interestingly enough it turned out we both had the same introversion/extroversion type profile) he is able to switch into a more extroverted mode when a situation calls for it. Like I said in session I find that provides a really nice balance, because he can be very directive and talkative as the flow of the session dictates, but at the same time he can also pull back into a more introspective mode and just allow the discussion to process/unfold as it will. So for me a Psychiatrist being an introvert is a positive, with the caveat that introversion does need to be balanced alongside at least some degree of extroversion as well.

 

[splik]

But, really, is being introverted bad in psychiatry? I think it helps prevent any transference that happens during encounters with patients if anything. I had always known several psychiatrists to be introverts. I told him to just ignore it because a lot of the other evaluations talked positively about the student and his confidence with patients.

no being introverted isn't a bad thing. being quiet may be positive as a resident to a degree. it just isn't valued in our society. read Quiet by Susan Cain. She aims to redeem the introvert as a powerful if quiet force to be reckoned with. btw most people dont spend much time looking at the comments on the MSPE unless they are really egregious, its mainly looking at your core clerkship grades, and even that's worthless if you went to a questionable school.

you seem not to understand what transference is. transference and countertransference occur in EVERY clinical encounter. it is a truism that we have feelings about patients and they have feelings about us (though of course you may be forbidden from using terms like transference and countertransferece if you trainers are staunchly anti-psychoanalytic). this is not something that can be, or should be prevented. in fact much of the healing that occurs happens through the transference, much of the exploration of affect happens through the transference, and the most effective interpretations (so-called mutative interpretations) happen through the transference affect. much of what we do is to encourage the development of transference, and recognize our own countertransference which we can use both diagnostically and therapeutically. in more contemporary (intersubjectivity) theory, the idea is that therapeutic change occurs through "implicit relational knowing" that kind of a-ha factor where the patient feels understood and that the therapist "gets" them. none of this has anything to do with whether the therapist is an introvert or extrovert, but of course the kinds of transference you get may be influenced by that.

regardless, the transferences will develop no matter who you are. I had a chinese patient who was initially referred to a female chinese resident and it didn't stick. she said "i guess i reminded him too much of his mother". Well, he sees me (not female, not chinese) and in the transference I become the cold, witholding critical mother, he says "you're just like my mother, always criticizing me!" (I hadn't said a word...)

 

[mgdsh]

Relevant:

http://www.businessinsider.com/personality-types-that-make-the-most-money-2015-4

 

[MacDonaldTriad]

Just a counter point about Dean’s letters and requests to edit them. With all of the pass fail grading and everybody wins culture, I would be very disturbed if I learned that my school was editing my evaluation comments. I think dean’s letters should be verbatim. Sure some attendings will be unfair, and some will be subjective and critical, but most are not. Who gets to decide what to take out and what to leave in? If anything negative gets taken out, they will all look the same.

We like to make up our own minds about what to believe or not believe. My favorite comment was on an OB/GYN eval. “He was very enthusiastic about performing pelvic examinations.”

 

[Jorje286]

Just a counter point about Dean’s letters and requests to edit them. With all of the pass fail grading and everybody wins culture, I would be very disturbed if I learned that my school was editing my evaluation comments. I think dean’s letters should be verbatim. Sure some attendings will be unfair, and some will be subjective and critical, but most are not. Who gets to decide what to take out and what to leave in? If anything negative gets taken out, they will all look the same.

We like to make up our own minds about what to believe or not believe. My favorite comment was on an OB/GYN eval. “He was very enthusiastic about performing pelvic examinations.”

Well, the whole idea of quoting evaluations in a dean's letter seems ridiculous in the first place. There's certain cherry picking going on regardless of how you look at it. If you're going do that, at least try to look at the positive side.

I would have trouble taking some random doctor's evaluation that a person is an "introvert" seriously if I was reading an MSPE. What kind of passive aggressive a-hole writes that about a med student? It tells me more about the writer than it does the student. What the hell does saying the student is an "introvert" mean?

There's a lot of stigma with introversion in society, but even more so in medical culture. I don't think the attending was being passive-aggressive or an a-hole; he probably really meant that as an honest criticism. Introversion is most likely quite an irrelevant factor when it comes to actual patient care, but not so when it has to do with socialization with medical staff.

 

[Doctor Bagel]

Just a counter point about Dean’s letters and requests to edit them. With all of the pass fail grading and everybody wins culture, I would be very disturbed if I learned that my school was editing my evaluation comments. I think dean’s letters should be verbatim. Sure some attendings will be unfair, and some will be subjective and critical, but most are not. Who gets to decide what to take out and what to leave in? If anything negative gets taken out, they will all look the same.

We like to make up our own minds about what to believe or not believe. My favorite comment was on an OB/GYN eval. “He was very enthusiastic about performing pelvic examinations.”

The problem now is that the comments are so uniformly positive that everyone tries to read between the lines in ways and determine the secret code of what the evaluator is really saying, which makes medical students all the more paranoid. It also makes it harder when you have an attending who doesn't know this and writes what they think is a positive review that is then deemed to be negative because it's not sufficiently effusive.

I had a PD grill me when I was interviewing for a comment from an evaluator for a 2 week pass fail rotation who said something like "Doctor Bagel did a good job on this rotation." Apparently that meant I sucked on that rotation (actually not true) to this PD. But apparently good = bad, excellent = OK and best medical student ever = maybe kinda good. Any mention of anything remotely not clearly positive (like even neutral stuff) is often seen as a negative. No wonder medical students are so neurotic. Also, jeez, glad I dodged the bullet on going to that program.

 

[Shikima]

Just a counter point about Dean’s letters and requests to edit them. With all of the pass fail grading and everybody wins culture, I would be very disturbed if I learned that my school was editing my evaluation comments. I think dean’s letters should be verbatim. Sure some attendings will be unfair, and some will be subjective and critical, but most are not. Who gets to decide what to take out and what to leave in? If anything negative gets taken out, they will all look the same.

We like to make up our own minds about what to believe or not believe. My favorite comment was on an OB/GYN eval. “He was very enthusiastic about performing pelvic examinations.”

You have to find something you love about your job.

 

[ari202]

I told him he could try and beef with the admin. But it ain't gonna fly so much with our deans office. so I further advised that he should just try and be more balanced and friendly to the staff he works with when he auditions. Also, make an active effort to participate in conversations during interviews. It's so akward when you have a quiet person at lunch with residents. I even faked interest in cooking recipes with a few residents.

 

[ari202]

also, on a related note, for men during interviews: please make sure your wife, mom, significnat other etc chooses your tie color. And if you are going to wear a zip on /clip on tie, make sure you zip it up all the way. I saw some sloppy sap, who was wearing a shirt under his dress shirt, you could see the shirt and his tie was unzipped, it was really sloppy and I had to actively supress my maternal instinct to fix it. Also make sure that your sleeves come out of your coat.

Honestly, medical students don't know much about fashion. end of my rant! haha

 

[Doctor Bagel]

I told him he could try and beef with the admin. But it ain't gonna fly so much with our deans office. so I further advised that he should just try and be more balanced and friendly to the staff he works with when he auditions. Also, make an active effort to participate in conversations during interviews. It's so akward when you have a quiet person at lunch with residents. I even faked interest in cooking recipes with a few residents.

Based on this and on previous posts, you seem really caught up with the notion that being perceived as an introvert or as quiet is a huge negative. I'm curious where that's coming from.

 

[MacDonaldTriad]

Well played Dr. Bagel. Don’t worry ari202, if there is anything worse than being an introvert, it is being a boring extravert.

This reminds me of something. I remember telling my therapy supervisor about a patient who point blank told me that I wasn’t helping her. He became real excited and said “now I know we are getting somewhere”. I thought this was strange, but low and behold, the patient took a leap into health that was one of the most impressive things I have ever seen. Yes can mean no and no is often yes, and an all out affective denial means that your interpretation was too close to the mark. Isn’t psychiatry fun?

 

[ari202]

Based on this and on previous posts, you seem really caught up with the notion that being perceived as an introvert or as quiet is a huge negative. I'm curious where that's coming from.

I don't think it's a big deal and I think it may work to someone's advantage in some respeccts. A lot of these things do need to account for someone's culture as well tho.

 

[ICUBlue]

no being introverted isn't a bad thing. being quiet may be positive as a resident to a degree. it just isn't valued in our society. read Quiet by Susan Cain. She aims to redeem the introvert as a powerful if quiet force to be reckoned with. btw most people dont spend much time looking at the comments on the MSPE unless they are really egregious, its mainly looking at your core clerkship grades, and even that's worthless if you went to a questionable school.

you seem not to understand what transference is. transference and countertransference occur in EVERY clinical encounter. it is a truism that we have feelings about patients and they have feelings about us (though of course you may be forbidden from using terms like transference and countertransferece if you trainers are staunchly anti-psychoanalytic). this is not something that can be, or should be prevented. in fact much of the healing that occurs happens through the transference, much of the exploration of affect happens through the transference, and the most effective interpretations (so-called mutative interpretations) happen through the transference affect. much of what we do is to encourage the development of transference, and recognize our own countertransference which we can use both diagnostically and therapeutically. in more contemporary (intersubjectivity) theory, the idea is that therapeutic change occurs through "implicit relational knowing" that kind of a-ha factor where the patient feels understood and that the therapist "gets" them. none of this has anything to do with whether the therapist is an introvert or extrovert, but of course the kinds of transference you get may be influenced by that.

regardless, the transferences will develop no matter who you are. I had a chinese patient who was initially referred to a female chinese resident and it didn't stick. she said "i guess i reminded him too much of his mother". Well, he sees me (not female, not chinese) and in the transference I become the cold, witholding critical mother, he says "you're just like my mother, always criticizing me!" (I hadn't said a word...)

Reading this book right now... So insightful. I highly recommend!

 

[675015]

also, on a related note, for men during interviews: please make sure your wife, mom, significnat other etc chooses your tie color. And if you are going to wear a zip on /clip on tie, make sure you zip it up all the way. I saw some sloppy sap, who was wearing a shirt under his dress shirt, you could see the shirt and his tie was unzipped, it was really sloppy and I had to actively supress my maternal instinct to fix it. Also make sure that your sleeves come out of your coat.

Honestly, medical students don't know much about fashion. end of my rant! haha

Who would wear a zip up or clip on tie to a professional interview... :-(

 

[Psychobabbling]

Introversion/Extraversion, who cares. The sad thing is, and I agree with the comment above, is that it says a LOT about the person who wrote that down (probably out of some sort of jealousy). The scarier thing will be if someone who reads that allows that to affect their judgment.

 

[Doctor Bagel]

A bit of a hijack but for introverted folks, what was your least favorite part of medical school? For me, it was being the OR with all the incessant, inane small talk. Total nightmare.

 

[Doctor Bagel]

Introversion/Extraversion, who cares. The sad thing is, and I agree with the comment above, is that it says a LOT about the person who wrote that down (probably out of some sort of jealousy). The scarier thing will be if someone who reads that allows that to affect their judgment.

Or they were just clueless and didn't get the rule noted above -- anything not excessively positive is negative in an MSPE. Of course I'm again not sure being an introvert would be perceived of as a negative.

 

[JohnBender]

Ugh. I had a comment like this on my mspe but it was eventually edited out, and I was told it would have only been left in "if it were a pattern". As a previous poster mentioned, these types of comments are so passive aggressive and unnecessary.

The comment was something along the lines of "student is reserved, but the things he contributes are very insightful and knowledgable". This being relative to the extremely verbose classmates I was with on this brief rotation who would shout out anything and everything that came to mind. If I did the same, my batting average for "insightful, knowledgable" comments would be a hell of a lot lower. Is that what the reviewer would have preferred?

For the record, if I one day have the opportunity to review applications, I would see this as a positive in psych. Introverts, in my experience, are some of the more thoughtful and empathic people, and are less inclined to spew out the first thing which pops into their head with a patient.

 

[Jorje286]

Ugh. I had a comment like this on my mspe but it was eventually edited out, and I was told it would have only been left in "if it were a pattern". As a previous poster mentioned, these types of comments are so passive aggressive and unnecessary.

The comment was something along the lines of "student is reserved, but the things he contributes are very insightful and knowledgable". This being relative to the extremely verbose classmates I was with on this brief rotation who would shout out anything and everything that came to mind. If I did the same, my batting average for "insightful, knowledgable" comments would be a hell of a lot lower. Is that what the reviewer would have preferred?

For the record, if I one day have the opportunity to review applications, I would see this as a positive in psych. Introverts, in my experience, are some of the more thoughtful and empathic people, and are less inclined to spew out the first thing which pops into their head with a patient.

.

 

[Armadillos]

Ugh. I had a comment like this on my mspe but it was eventually edited out, and I was told it would have only been left in "if it were a pattern". As a previous poster mentioned, these types of comments are so passive aggressive and unnecessary.

The comment was something along the lines of "student is reserved, but the things he contributes are very insightful and knowledgable". This being relative to the extremely verbose classmates I was with on this brief rotation who would shout out anything and everything that came to mind. If I did the same, my batting average for "insightful, knowledgable" comments would be a hell of a lot lower. Is that what the reviewer would have preferred?

For the record, if I one day have the opportunity to review applications, I would see this as a positive in psych. Introverts, in my experience, are some of the more thoughtful and empathic people, and are less inclined to spew out the first thing which pops into their head with a patient.

I'm not sure why someone would take the comment in your eval as a negative?

Unrelated to your eval comment which seems completelybenign.

I could see how a program would want to avoid extroversion and introversion when they are taken to the extreme. We have all seen or heard of the occasional medstudent/resident who keeps to themselves so much that nobody in the program knows anything about them. If you get a couple people like that in any workplace it can put a damper on morale. (Before people freak out, I'm not talking about someone being shy, I'm shy. I'm talking it's so obvious they are acting completely out of the range of normal social behavior that nurses/staff/patients/visiting students/ will be like "what's up with them?")

 

[Doctor Bagel]

I'm not sure why someone would take the comment in your eval as a negative?

Unrelated to your eval comment which seems completelybenign.

I could see how a program would want to avoid extroversion and introversion when they are taken to the extreme. We have all seen or heard of the occasional medstudent/resident who keeps to themselves so much that nobody in the program knows anything about them. If you get a couple people like that in any workplace it can put a damper on morale. (Before people freak out, I'm not talking about someone being shy, I'm shy. I'm talking it's so obvious they are acting completely out of the range of normal social behavior that nurses/staff/patients/visiting students/ will be like "what's up with them?")

And for extroversion, the people who interrupt and dominate everything and don't give others a chance to talk, likely including their patients. I feel like the totally keeping to yourself is something different than introversion. It could be suggestive of paranoia or of active (almost hostile) disengagement in things.

 

[JohnBender]

I'm not sure why someone would take the comment in your eval as a negative?

Unrelated to your eval comment which seems completelybenign.

I think it was mostly the phrasing. I forget exactly, but it was presented in a manner that seemed to say "despite this negative quality, here are some positives..." It was questionable enough that it was taken out.