Letters to the Editor  |   October 2009
Personality Types and Performance on Aptitude and Achievement Tests
Author Affiliations
  • Claudia A. Switala, MEd
    Academic Affairs
    Center for Teaching and Learning
    Family Medicine University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford
    Program Development Specialist
Article Information
Medical Education / COMLEX-USA
Letters to the Editor   |   October 2009
Personality Types and Performance on Aptitude and Achievement Tests
The Journal of the American Osteopathic Association, October 2009, Vol. 109, 525-554. doi:
The Journal of the American Osteopathic Association, October 2009, Vol. 109, 525-554. doi:
To the Editor:  
We read with interest the medical education article in the June issue by Donald J. Sefcik, DO, MBA, et al,1 regarding personality types and performance on aptitude and achievement tests. The article caught our attention in light of our recent study on student personalities and Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores at the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine (UMDNJ-SOM), on which we reported at the annual meeting of the American Association of Colleges of Osteopathic Medicine in April.2 
In our study,2 we evaluated the results obtained from 317 osteopathic medical students at UMDNJ-SOM who completed the Myers-Briggs Type Indicator (MBTI) and COMLEX-USA Level 1. We analyzed and correlated 5 years of MBTI data and COMLEX-USA Level 1 results. We used a one-way mixed-model analysis of variance (ANOVA) to control for student sex (0, man; 1, woman), race/ethnicity (0, nonwhite; 1, white), and age (y). We then conducted post hoc mean comparisons and analyzed the data with a comparable mixed-model ANOVA. 
Thirty-nine percent of the students in our study were classified as having the intuitive-feeling (NF) MBTI mental-function pair,2 the type of personality described by Keirsey and Bates3 as “idealist.” Among students who had COMLEX-USA Level 1 scores greater than or equal to 600, those classified as having the intuitive-thinking mental-function pair had the highest adjusted mean COMLEX-USA Level 1 score—followed by those with the mental-function pairs of sensing-feeling, sensing-thinking, and NF.2 All of these results were found to be statistically significant (P≤.05) in two-tailed tests of significance. 
Our finding that NF personalities made up the majority of our study population of osteopathic medical students was similar to data previously reported by O'Donnell.4 
In a study of allopathic medical students taking the National Board of Medical Examiners (NBME) Part 1 examination, O'Donnell4 analyzed the performance of 114 medical students at the University of New Mexico in Albuquerque. He concluded that students with the NF temperament had the most difficulty with the NBME Part 1 examination—with 42% of these students failing the examination on their first attempt. 
According to O'Donnell,4 the focus placed on factual, “memory learning” in standardized examinations rather than theory and “possibilities” makes a high level of achievement in the NBME Part 1 examination especially difficult for students with the NF personality type—though his findings and those of Myers,5 as well as those of Myers and David,6 indicated that NF is exactly the personality type most often attracted to careers in medicine. 
It is also interesting to note that the NF personality type was found to make up the majority of our osteopathic medical student sample despite the fact that this personality type was found by Myers and McCaulley7 to represent only 25% to 35% of the general population. 
Because students with NF personalities tend to focus on possibilities and abstractions, rather than details, while processing information, they are often more responsive to theory than facts, and they typically attend to relationships and patterns of information.8 By contrast, students with intuitive-thinking personalities temper their focus on abstraction and possibilities with logical analysis, thereby helping them make the factual judgments that allow them to achieve success more readily on medical board examinations.4-8 
In their June article, Dr Sefcik et al1 stated that students with the NF mental-function pair “have a preference for the big picture and process data less objectively and therefore tend to select incorrect answers on examinations that are detail-based and analytical by design.” 
However, we found that students with NF personality types initially tend to select the correct answers on “sensor-oriented” examinations, such as COMLEX-USA Level 1, but they then second-guess themselves and change their answers to incorrect options.2 Thus, often their first, intuitive answer is the correct one.2 Myers and McCaulley7 state that intuitive personality types make multiple-choice questions more complex than the examiners intended. 
Given that people have multiple types of intelligence,9,10 there is a need to value and accommodate all types of thinkers in medical schools. Multiple learning formats—incorporating memorization and critical thinking—can be developed with more integrative methodologies of information delivery, making examinations more inclusive of diverse learning styles. 
Our study results,2 as well as the results reported by Dr Sefcik et al,1 and others,4-7 have important implications for osteopathic medical school curriculum development—especially as applied to preparation for COMLEX-USA Level 1. Some suggested curriculum changes may yield a better understanding of the teaching and learning processes. The insights gained might enable educators to enhance instructional effectiveness, counsel students on identifying potential learning problems before matriculation, and address other impediments to educational achievement. 
Finally, knowledge of one's personality type has been found to promote self-awareness,8 which could assist osteopathic medical students in their own self-assessments. Such knowledge could also help students move beyond the limitations of their existing personality types to improve their personal long-term learning methodologies and practice of medicine. 
Sefcik DJ, Prerost FJ, Arbet SE. Personality types and performance on aptitude and achievement tests: implications for osteopathic medical education. J Am Osteopath Assoc. 2009;109:296-301. Accessed September 23, 2009.
Kimmelman M, Giacobbe J, Switala CA. Examining student scores on COMLEX Level 1 examination and possible explanations for performance based on student personalities types as measured by the Myers-Briggs Type Indicator. Paper presented at: Annual Meeting of the American Association of Colleges of Osteopathic Medicine; April(2009). ; North Bethesda, MD.
Keirsey D, Bates M. Please Understand Me: Character & Temperament Types. Del Mar, CA: Prometheus Nemesis Book Co;1978 .
O'Donnell MJ. NBME Part I examination: possible explanations for performance based on personality type. JMed Educ. 1982;57:868-870.
Myers IB. Gifts Differing. Palo Alto, CA: Consulting Psychologists Press; 1980.
Myers IB, David J. Relation of medical students' psychological type to their specialties twelve years later. Paper presented at: Annual Meeting of the American Psychological Association; September 4-9 , 1964; Los Angeles, CA.
Myers IB, McCaulley MH. Gifted Students from Arlington County: A Guide to the Development and Use of the Myers-Briggs Type Indicator. Palo Alto, CA: Consulting Psychologists Press;1985 .
Kroeger O, Thuesen JM. Type Talk: Or How to Determine Your Personality Type and Change Your Life. New York, NY: Delacorte Press; 1988.
Gardner H, Hatch T. Multiple intelligences go to school: educational implications of the theory of multiple intelligences. Educ Res. 1989;18:4-9.
Gardner H. Changing Minds: The Art and Science of Changing Our Own and Other People's Minds. Boston, MA: Harvard Business School Press; 2006.