Michael D. Biderman

Is the quality of surgical residency applicants deteriorating

BACKGROUND Among directors of general surgery residencies, there is a concern that the quality of medical students applying to surgical residencies is declining. METHODS Quality of surgical applicants was assessed by several methods including subjective opinions determined by survey and by objective data including student United States Medical Licensing Examination (USMLE) scores of matched candidates. The number of applicants interviewed, total interviews granted, proportion of Alpha Omega Alpha (AOA) students, and the rank order of the candidates matched was obtained by survey. The survey included data on postgraduate year 1 (PGY-1) residents from July 1996 to July 1999. Three mailings were made to 226 US surgical residency programs. RESULTS Data were obtained from 90 programs. Surgery program directors disagreed with a survey statement that overall quality of applicants had declined (P <0.01), but agreed with a statement that activities of medical schools to enroll graduating students into primary care had hurt recruitment (P <0.001). Objective data revealed no change in mean USMLE part I scores of PGY-1 residents over the 4 years (P = 0.265, power = 0.81). There was no change in proportion of matched residents who were AOA over time. The mean score of all new PGY-1 residents, the rank of the first matched resident, the rank of the last ranked resident, and proportion of AOA students was higher in programs with five or more categorical spots when compared with programs of at most four (P <0.001). Across all programs, there was a trend to go lower on the rank list to fill categorical positions over time (P <0.001). CONCLUSIONS There is a perception that medical school policies act to discourage recruitment of quality medical students into general surgery programs, and surgery programs are going deeper into their rank lists to fill categorical positions. However, the average USMLE part I score of applicants to surgical residencies and proportion of AOA applicants has not decreased.

Empathy, sex role orientation, and narcissism

A narcissism model of sex roles was used to examine empathy and other forms of interpersonal reactivity. Questionnaires were administered to 141 males and 232 females sampled from an undergraduate population that was 89% Caucasian and 11% mostly African-American minority. A Peer-Group Dependence measure of narcissistic idealization correlated predictably with femininity, empathy, and a communal orientation; and a Pseudoautonomy measure of narcissistic grandiosity displayed expected linkages with masculinity and Machiavellianism. Multiple regressions confirmed that the self could be defined in terms of both its mature and immature features; and confirmatory factor analyses indicated that the narcissism model was somewhat superior to a sex roles model in describing the often complex interrelationships among measures of sex roles, narcissism, and interpersonal reactivity.

PERSONALITY CORRELATES OF THE REPORT OF MYSTICAL EXPERIENCE

The search for stable personality correlates of mystical experience has been hampered by the use of pathologically oriented personality inventories or those confounded by heavy loadings on mystical experiences. The present research with college students (n = 118) utilizing the Jackson Personality Inventory, a normatively oriented, psychometrically sound inventory, indicated stable personality correlates for scores on Hoods Mysticism Scale. These were conceptually consistent with previous research on mysticism.

Androgyny as synthetic narcissism: Sex role measures and Kohut's psychology of the self

In Kohuts analysis of narcissism, the self emerges as a bipolar structure characterized by grandiosity at one pole and dependency at the other. Through appropriate developmental processes, grandiosity grows into a mature ambitiousness, and early dependencies are converted into a stable system of ideals. The present investigation predicted that sex role constructs essentially measure these two aspects of the self. Expected relationships between masculinity and grandiosity, and between femininity and dependency, were in fact obtained. Based in large part on Westins (Self and Society, Cambridge: Cambridge University Press, 1985) analysis of Kohuts theory, synthetic, internal, external, and archaic narcissistic self styles were hypothesized to exist and to parallel the androgynous, masculine, feminine, and undifferentiated sex roles, respectively. Rough comparabilities were in fact evident between these two typologies. Factor analyses also demonstrated that narcissism and sex role measures load on factors in ways revealing the intimate ties between “pathological” narcissism and the failure to achieve desirable sex role characteristics.

Narcissistic traits scale: validity evidence and sex differences in narcissism

Abstract A previous failure to observe sex differences in the Narcissistic Traits Scale (NTS) was reexamined by assessing both the validity of the NTS and the degree to which it measured maladaptive as opposed to adaptive narcissism. Correlations with age, depression, anxiety, other measures of narcissism and self-immaturity, and emotional and cognitive empathy all supported the validity of the NTS as an index of mostly unhealthy self-functioning. Males in fact proved to be higher in the specifically more maladjusted aspects of narcissism. Most generally, this investigation once again documented the complexity of self-reported narcissism.

Aggression, sex role measures, and Kohut's psychology of the self

Recent controversies concerning the relationship between aggression and sex role development were evaluated in light of Heinz Kohuts psychoanalytic psychology of the self. Masculinity roughly corresponded to grandiose elements of Kohuts bipolar self while femininity was linked to its idealizing sector. As predicted, self-reported aggressiveness reflected an immature grandiosity; and associations of assertiveness with both masculine and grandiose personality styles supported Kohuts claim that adjustment can evolve out of more aggressive forms of self-functioning. Socially desirable forms of femininity had the advantage of being incompatible with aggressiveness, but they also failed to promote assertiveness. Androgynous, masculine, feminine, and undifferentiated sex roles displayed largely predictable parallels with synthetic, internal, external, and archaic narcissistic styles. As in previous research, therefore, Kohuts theory proved useful in examining the mental health implications of traditional sex roles.

Empirically derived job characteristics measures and the motivating potential score

The relationship of job satisfaction to empirically derived measures of job perceptions originally investigated by Zaccaro and Stone (1988) and to measures of the job from the Job Diagnostic Survey (JDS: Hackman & Old-ham, 1975) was investigated. The multiplicative nature of the JDS scales forming the Motivating Potential Score (MPS) was tested. The extent to which job satisfaction mediated the relationship between job perceptions and intent to leave was explored using a path analysis. The empirically derived measures of Zacarro and Stone were found to account for a significant increment in variance in the case of satisfaction with work itself, but not with overall satisfaction or satisfaction with other job facets. No evidence for the multiplicative formulation of the MPS was found. Both perception of job danger and a linear composite motivating potential scale exhibited direct effects on intent to leave not mediated by job satisfaction.

The Relationship of Reliability and Validity of Personality Tests to Frame-of-Reference Instructions and Within-Person Inconsistency

The efficacy of both frame-of-reference (FOR) instructions and a measure of within-person inconsistency in predicting grade point average was investigated. The IPIP Big Five personality questionnaire was given to 329 students with generic instructions and at school FOR instructions. The Wonderlic Personnel Test was also administered. A measure of within-person inconsistency was created based on the standard deviations of responses to items within the same Big Five dimension. The validity of conscientiousness was greater when FOR instructions were given. The measure of within-person inconsistency provided incremental validity over that of conscientiousness and cognitive ability. Additionally, within-person inconsistency moderated the relationship between conscientiousness and performance for the participants without the FOR instructions. Practical implications are discussed.

A Validation Study of the Cross-Cultural Adaptability Inventory

Despite the claims made about the effectiveness of cross-cultural training programs, few studies have examined the reliability and validity of the instruments used in these training programs. In this study, the authors examined the factor structure of the Cross-Cultural Adaptability Inventory (CCAI) via a confirmatory factor analytic approach. A series of confirmatory factor analytic models was tested and applied at the item level to both the CCAI and Goldbergs Big Five Inventory. A confirmatory factor analysis (CFA) model in which a method factor was estimated fits the data significantly better than a model without such a method effect. Further, the method factor suppressed substantive relationships such that the two CCAI factors of Emotional Resilience and Personal Autonomy became significant correlates with self-reported number of international job assignments after accounting for method variance. Implications for research and practice are discussed.

Failure of rats deprived of water to increase food intake during glucoprivation induced by 2-deoxy-D-glucose ☆

Thirsty rats denied access to water did not significantly increase their food intake following the glucoprivic stimulus provided by 750 mg/kg 2-deoxy-D-glucose (2-DG). In a second study, subjects were made hypodipsic through adulteration of their water supply with 0.2% w/v quinine hydrochloride; and they too displayed glucoprivic feeding deficits at 250 mg/kg, 500 mg/kg, and 750 mg/kg dosages. A reduced ability to ingest fluids therefore can inhibit 2-DG-induced eating when rats are examined after experience with water restriction schedules. These data consequently suggest that caution may be necessary in interpreting post-lesion disruptions of 2-DG glucoprivic feeding when severe water intake deficits are also observed.