'Same traits' in killer doctors and top medics

The arrogance, aloofness and narcissism displayed by many rogue medics can also be an indicator of the advanced problem-solving skills found in the best doctors.

The finding was made by a team examining ways of weeding out potentially dangerous doctors from Scotland’s medical schools.

They tested about 1,000 candidates for signs of extreme personalities which can make some doctors act in a callous and overbearing fashion without regard for their patients’ health.

But it soon emerged that if they excluded all the candidates with extreme personalities they would also deprive Scotland’s hospitals of some of the most talented medics.

Researchers at Glasgow University’s medical school devised the tests as a way not only of removing potentially dangerous candidates but also weeding out excessively "autocratic" medics in the mould of the pompous Sir Lancelot Spratt, the fictional consultant in the film Doctor in the House and its sequels.

The psychometric tests were introduced two years ago following the murder of 15 patients by Manchester GP Harold Shipman and the heart surgery scandal in Bristol, where doctors continued to operate on babies in spite of alarmingly high death rates.

Candidates were asked to complete logical tasks designed to identify those best suited to tackling problems such as complex diagnoses or treatment decisions. They also completed questions which revealed their personalities.

Although about one in five applicants tested in the Glasgow study were found to have personality defects such as extreme overconfidence, aloofness and narcissism, the same group also tended to score well on problem-solving.

Dr Mary-Ann Lumsden, associate dean for admissions at Glasgow University medical school, said: "We’re getting some suggestion that some of those with what one might call an extreme personality also have extremely high problem-solving ability.

"All the applicants were very bright, but there was a clear distribution of problem-solving ability and the results were remarkably consistent across the two years."

Lumsden said the results suggested the tests might be too crude and that medical schools would have to go further than just rejecting students with "extreme" personalities.

She suggested using the tests as a guide to be followed up with further work to establish whether the prospective students might be talented doctors. Some could be steered towards careers in biochemistry or pathology where the risk to patients is low. Alternatively, the psychometric tests could be ditched altogether.

Martin Pippard, professor of medicine at Dundee University, said: "It’s a problem. We may be able to weed out some personalities, including psychopaths, but that may also mean weeding people out who could fit an essential niche in medicine."

About 800 graduates each year pass out of Scotland’s five medical schools - in Edinburgh, Glasgow, Aberdeen, Dundee and St Andrews - but there are no procedures in place designed to identify prospective doctors with potentially dangerous personalities.

Nobody was refused entry as a result of the test in Glasgow, and further research is to be carried out before it is decided whether to introduce psychometric testing as part of the selection process. The researchers are about to submit a paper on their findings to the British Medical Journal.

Shipman, who is suspected of being responsible for the deaths of hundreds of patients, is seen by many in the medical profession as a "one in a million" case.

Nevertheless, there have been several high-profile cases of doctors harming their patients as a result of arrogant and aloof behaviour.

Two doctors were struck off the medical register in 1998 after they were found to have allowed operations on infants at Bristol Royal Infirmary to continue, despite death rates which were far higher than in other hospitals.

Dr John Garner, chairman of the Scottish Council of the British Medical Association, said psychological tests could be a welcome addition to current selection procedure, which focuses heavily on results in Higher and A Level exams.

But he added: "They may not be helpful as a tool to actually determine entry to medical school."