A cross-sectional study of aggression levels in physicians and orthopaedic surgeons: impact on specialty selection and training?

OBJECTIVES: To determine if current validated psychometric evaluations could determine a difference in basic behavioural characteristics between surgical and medical specialties. DESIGN: Cross-sectional study. SETTING: Two district general hospitals and one University teaching hospital in England, UK. PARTICIPANTS: Internal medicine (16) and trauma and orthopaedic (20) consultants. MAIN OUTCOME MEASURES: Aggression levels as assessed by the Buss and Warren questionnaire. The self-administered questionnaire assesses aggression in terms of physical, verbal, anger, hostility, indirect hostility and an overall assessment of aggression. RESULTS: All participants had aggression scores below the population average. We found a significant difference (P < 0.01) in total level of aggression, with orthopaedic consultants scoring a mean of 61.1 (standard deviation [SD] 9.2) and physicians 51.3 (SD 9.5). When analysis of the five different subtypes of aggression was carried out, orthopaedic surgeons scored significantly higher in terms of verbal aggression (P = 0.005), hostility (P = 0.002) and indirect hostility (P = 0.03). CONCLUSION: This study joins a growing evidence base for aspects of behaviour indicative of a given specialty. Aggression is a relatively stable behavioural characteristic from adolescence, and as such this is the first study of its type to suggest that the differences in behavioural characteristics seen between specialties are inherent, rather than learned. It is unclear if the differences observed represent an attraction of that specialty to the personality type or is required for success within the given specialty. Whether this can be used in terms of selection into higher specialty training, or influence training within specialties, requires further work.