Psychological Profile of Cardiothoracic Surgery Trainees: Prevalence of Anxiety and The Big 5 Personality Traits

J. Cyr¹, S. Cardozo¹, L. Bougioukas², P. Callas¹, M. Polomsky^3
1University of Vermont, BURLINGTON, Vermont ²Hofstra University, Hempstead, New York ³SUNY Upstate Medical University, Syracuse, New York

Purpose: Identification of personality traits enhances performance and education efficacy in medical training[1,2]. While personality traits of surgeons differ from other medical specialties, personality characteristics of cardiothoracic surgery (CTS) trainees have not been examined[3]. We aim to identify and compare CTS trainee personality and anxiety traits at various stages of training.

Methods: An electronic survey collecting personality and demographic data was distributed to 549 trainees in Accreditation Council for Graduate Medical Education accredited United States CTS training programs via the Thoracic Surgery Director Association’s e-mailing list. Two validated inventories were used: (1) The Big Five Inventory (BFI-44), a 44-item measure of the five-factor personality model (Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness) using a 1-5 Likert scale (scored 1-5)[4]; (2) the State-Trait Anxiety Inventory form Y-1 (STAI-Y1), a 20-item measure of anxiety using a 1-4 Likert scale (scored 20-80)[5]. The BFI-44 and STAI-Y1 were scored against validated, age-adjusted, population norms and manual-defined classifications respectively[5,6]. Demographic data collected included age, gender identity, postgraduate year, program type (Integraded-6-year, 4+3-year, traditional 5+2-year), program location, subspecialty interest, and preferred institution type (academic, non-academic). A two-sample pooled t-test was used for categorical comparisons and a Pearson’s correlation was used for continuous comparisons. All results are reported as mean±standard deviation.

Results: Seventy-three trainees (age 33±4, male:female 41:32) completed the BFI-44 (13.2% response rate), and 71 trainees (age 33±4, male:female 40:31) completed the STAI-Y1 (12.9% response rate). CTS trainees obtained a significantly greater score for Conscientiousness (4.2±0.4), and significantly lower scores for Openness (3.5±0.6) and Neuroticism (2.4±0.7) compared with population norms (all p< 0.0001). Extraversion (3.4±0.8) and Agreeableness (3.9±0.6) were not distinct from population norms (all p>0.1) (Figure-1A). CTS trainees obtained an anxiety score of 37±11; at the border of low and moderate anxiety classifications (Figure-1B).

While CTS trainees’ personality and anxiety patterns were independent of age, postgraduate year, program type, and program location (all p>0.1), CTS trainees interested in academic institutions had significantly higher anxiety levels compared to those interested in non-academic institutions (p=0.048). Additionally, CTS trainees aspiring to specialize in cardiac surgery trended toward significantly increased Conscientiousness and Extraversion scores relative to their peers interested in general CTS or thoracic surgery (p=0.060 and p=0.064 respectively), and female CTS trainees trended toward higher levels of Neuroticism relative to their male counterparts (p=0.088).

Conclusion: Personality profiles of CTS trainees consist of high Conscientiousness, low-moderate anxiety, and low Neuroticism and Openness. These traits are constant across age, postgraduate year, and training program type. Identification of personality traits within CTS trainees could help inform trainees and training programs to optimize career advising and educational performance strategies.

Identify the source of the funding for this research project: The University of Vermont department of surgery