Identifying Altruism...and Narcissism in the admissions process

[Nietzschelover]

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Much is written here about the importance of demonstrating altruism. Given an applicant pool filled with extremely high achieving individuals with generally large ambitions, and given that one can imagine a large percentage of candidates possess at least, for lack of better words, a "healthy" dose of narcissism, how do (or do they?) adcoms suss out whether candidates have the kind of narcissism that most don't want to see in their physicians? And are there cases where some of those who have racked up impressive displays of apparent altruism on paper are also on the more malignant end of the narcissism scale? And doesn't the focus (obsession?) on accumulating certain numbers of hours in certain categories unwittingly contribute to potential confusion in sussing out what is real altruism vs narcissism vs even just very self-interested efforts to get oneself into medical school? Does the demand for candidates to meet and exceed certain profiles (and fulfill the category areas considered essential for being a competitive candidate) unwittingly contribute to candidates being less like what adcoms say they want...in other words, less genuine, less creative, less spontaneous, less "real"?

 

[MrChance2]

All signs point to you overthinking this.

 

[Goro]

Interviewees who are full of themselves stand out like an erythematous rash. They get rejected immediately. No wait list for them.

 

[MrChance2]

I actually thought of a pretty simple test, though it wouldn't be definitive.

For an admissions interview I had listed some travel stuff on my application, one of the admissions people brought it up and said "Oh, cool, I just got back from there." If I was scoring it I would have given me a point for asking her how she liked it vs talking about my trip. Just a passing thought I had after the interview. I think I said something like "Its awesome right?" so maybe thats worth .5 haha..

But it wouldn't be hard to do with any application. Just pick an aspect and see if they care that you are interested in it or seem to want to say something about it or just continue on talking about themselves. I obviously wouldn't reject anyone for this alone especially with nervousness, different cultures, etc but I think its one way to show who has an interest in others.

 

[gannicus89]

I think the difference between ambitious + sincere and ambitious + cutthroat is quite obvious. I can easily tell within a minute or two of meeting someone whether or not I would be okay being deserted on an island with that person. I don't think adcoms function this crudely, but... I think first instincts are pretty important in this entire process. Most people can judge whether they like a person or not in a few seconds; there's probably a great deal of subconscious crap happening during that, but the outcome is the same. Adcoms, like the rest of us, can tell when someone is abnormally narcissistic.

Sociopaths are a different story.

 

[virtuos locust]

Interviewees who are full of themselves stand out like an erythematous rash. They get rejected immediately. No wait list for them.

Im just curious but would you mind sharing or pointing out some of the characteristics exhibited by these individuals?

 

[XxThaDoggxX]

Interviewees who are full of themselves stand out like an erythematous rash. They get rejected immediately. No wait list for them.

I have always felt like there is such a fine line between confident and cocky!

 

[Goro]

Ever meet a used car salesman?
Or someone who thought they were God's gift to earth?

Im just curious but would you mind sharing or pointing out some of the characteristics exhibited by these individuals?

I have always felt like there is such a fine line between confident and cocky!

 

[XxThaDoggxX]

I did...and I haggled him down for half the price! 😛 My 1995 toyota camry with 307k miles thanks me until this day!! 😛 😛

 

[Cotterpin]

Ever meet a used car salesman?
Or someone who thought they were God's gift to earth?

Lol, I have. I've known one person in my life who was clearly a narcissist and I could tell something was wrong within five minutes of meeting him. And it just got more obvious the longer I knew him. The things he would say about himself, I cannot...

 

[halcyonpage]

Does narcissism include being really concerned with money? Like, maximizing how much you make with as "little" work as a physician as possible? Because one of the doctors I've shadowed definitely seemed to be less concerned about his patients and more about his paycheck/401k. He also tries to tell his students, scribes, shadows, and other impressionable pre-meds that taking any sort of delay when it comes to getting a real physician's job is a huge waste of time and money (think opportunity cost). He even convinced his assistant to go for a Caribbean school this summer. The assistant got in after rejections from all other schools, and he encouraged me to do the same, because "if you're not ready now, then you'll never be" and "no one actually cares if you went to a Caribbean school". Then he sorta threw a fit when I told him I was going for MDPhD...

 

[Cotterpin]

If you're talking about legit narcissistic personality disorder, then no, being overly concerned with money isn't necessarily a criterion. Of course, they could be obsessed with money, but it would be somehow in service of exalting their self-image. Like maybe if, in addition to constant self-aggrandizement, they fantasized about or expected to be making like crazy, Bill Gates-levels of money, then that would be narcissistic.

 

[halcyonpage]

Okay, I guess I was trying to pinpoint why he would be so negative and critical of my life choices just because they wouldn't be *his* choices. Maybe it's not narcissism, it's something else.

 

[Cotterpin]

Okay, I guess I was trying to pinpoint why he would be so negative and critical of my life choices just because they wouldn't be *his* choices. Maybe it's not narcissism, it's something else.

Well, people tend to do that when they aren't totally comfortable with the decisions they've made. Like, maybe this guy subconsciously wants everybody to have the exact same life strategy that he has as a way to validate himself.

 

[halcyonpage]

Much insight. Very impress. Are you a psych major?

Just realized that question can be taken the wrong way. PLEASE DON'T TAKE IT THE WRONG WAY.

 

[Cotterpin]

Much insight. Very impress. Are you a psych major?

No, I'm just old.

 

[CaliforniaDreamer]

No, I'm just old.

Same thing right?

 

[efle]

A lot of people volunteer and get good grades and do tons of research just for the MD accept, and do a great job of passing it off as altruism and a love of learning and a love of research. I think I know a couple people like Goro is talking about...but many more who are competitive, have high opinions of themselves and their abilities, but know better than to behave like an arrogant ass in an interview. I certainly would guess there's a lot of false humility presented to adcoms.

The research one is especially true. I'd have to say more than half of my friends in labs are 100% certain they will not have careers in research and will 100% pretend to be very interested in incorporating research in MD school and beyond. It's essentially a requirement for the most selective med schools so yeah...there's gonna be some fibbing. I haven't had many similar frank discussions about whether people actually enjoy volunteerism, but I'd bet there's fibbing for the same reasons there.

I can at least say after seeing how much of this process is a box checking game...if I'm ever an adcom, I'm going to be a damn cynical one.

 

[Pusheen]

If someone says that they always enjoy volunteerism and loved every single minute of it, I wouldn't trust them.
If someone can objectively talk about the ups and downs of an experience, and demonstrate a mature attitude about it and personal growth, I would trust them more than someone who describes every volunteer experience in glowing terms.
I personally think the right kind of volunteering is challenging and hard at times. That's what makes it rewarding.

 

[Nietzschelover]

Tend to agree with @efle. Who said narcissists can't be savvy?

On the other hand, do I care if a surgeon carving around my heart is a narcissist? No, I don't. I just want him or her to get it right.

I grew up with physicians and played tennis with a bunch of them every week from age 10 or so until going off to college at age 18. There are more than a few narcissists out there.

 

[efle]

Tend to agree with @efle. Who said narcissists can't be savvy?

On the other hand, do I care if a surgeon carving around my heart is a narcissist? No, I don't. I just want him or her to get it right.

I grew up with physicians and played tennis with a bunch of them every week from age 10 or so until going off to college at age 18. There are more than a few narcissists out there.

Makes you wonder how many go in that way vs become narcissistic from being put in a god role, making lots of money etc.

 

[DokterMom]

I recall reading recently that if you want to know whether someone is a narcissist, just ask them flat-out. That they usually know, and will usually tell you, simply because they don't think there's anything wrong with being that way.

Not sure though that a medium-high dose of narcissism is necessarily a bad thing in a doctor, so long as the degree of narcissism is not so extreme that they can no longer feel any genuine empathy.

 

[ChillDawg]

The way I heard one surgeon say it, you basically have to be a bit cocky/narcissistic in order to think that you could see a problem with somebody and believe that you can cut them open and make them better. A bit tongue in cheek im sure, but still an interesting thought.

 

[DokterMom]

The way I heard one surgeon say it, you basically have to be a bit cocky/narcissistic in order to think that you could see a problem with somebody and believe that you can cut them open and make them better. A bit tongue in cheek im sure, but still an interesting thought.

As a profession, surgeons reportedly have among the highest narcissism scores -- probably for just that reason.

 

[Spector1]

There's a fine line between being willing to toot your own horn and being an ass

 

[efle]

Something something toot your own ass

 

[Nietzschelover]

As a profession, surgeons reportedly have among the highest narcissism scores -- probably for just that reason.

My father was a surgeon. Age 64, still practicing, thought he was ill, ordered tests on himself, all negative, and 3 weeks later inoperable cancer. 2 months later, and after spinal block, 2 cordotomies, and loads of morphine failed to curb his pain, dead.

 

[DokterMom]

I'm sorry for your loss --
Interesting that he knew (and would have been right, of course), but that tests couldn't find anything.

 

[Nietzschelover]

I'm sorry for your loss --
Interesting that he knew (and would have been right, of course), but that tests couldn't find anything.

Thanks. I wasn't expecting to go there, but you mentioned surgeons, and even though I didn't consider my father to be a narcissist (at least not a malignant one), I still naturally thought of him. He died 15+ years ago.

One of the most interesting things was observing how different physicians (oncologists, surgeons, etc) at a top 15 university medical center handled treating a colleague who had a dreadful prognosis. A couple were steadfast and heroic to the bitter end, and a few bailed out, apparently struggling to handle dealing with the futility of a case where nothing could be done. My father actually learned a great deal during that time, especially with respect to how even a colleague can become a patient and ultimately just "a case." He was able to share some of his insights with a few of the doctors dealing with him.

In regard to the thread, the first responder probably was right about my "overthinking it," but then again, he or she may not be leaning towards psychiatry. Narcissism is clinically fascinating and very relevant to certain personality disorders, paranoid disorders, and some forms of depression. Distinguishing between "healthy" narcissistic equilibrium, clinical narcissism, and how narcissism interplays with the most socially desirable traits, like altruism, also is clinically fascinating.