Abstract
Background Personality traits may play a role in the likelihood of success in training and careers. Identifying personality characteristics associated with a preference for community-oriented medicine, defined as medical practice that integrates clinical care with the public health needs of a local area, may help reduce mismatches in regional quota programs (RQPs) during medical school admissions. Few studies have examined the relationship between personality traits and medical students' intentions to engage in community health care. Moreover, no studies have examined this relationship under the RQPs, which account for a considerable proportion of medical school enrollment in Japan. The objective of this study was to examine the personality characteristics associated with medical students' aspirations toward community-oriented medicine. Methods This study analyzed the personality tendencies of community medicine-oriented students. All medical students in a medical school in Japan (n=750), who were selected into the RQP, RQP without loan (RQPWL), or standard program, were asked to complete the validated psychometric questionnaire (the shortened Japanese version of the 'big five' personality traits) to investigate the five major personality traits of neuroticism, extraversion, openness, conscientiousness, and agreeableness. A multivariable logistic regression was performed to assess the association between personality traits and willingness to engage in community health care. We also assessed the association between personality traits and admissions programs. Results In total, 591 students completed the questionnaire. The RQPWL was associated with grade (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.63-0.94, p=0.011) and gender (OR 2.94, 95% CI 1.48-5.96, p=0.002). The RQP was associated with gender (OR 1.76, 95% CI 1.06-2.92, p=0.028), extraversion (OR 0.91, 95% CI 0.85-0.98, p=0.012), and conscientiousness (OR 1.05, 95% CI 1.00-1.10, p=0.0496). There were differences in the willingness to engage in community health care concerning gender (OR 1.57, 95% CI 1.04-2.36, p=0.031), admission programs (OR 4.32, 95% CI 2.16-8.90, p<0.001 for the RQPWL; OR 20.69, 95% CI 10.65-44.38, p<0.001 for the RQP). Higher openness to experience was associated with increased willingness to engage in community health care (OR 1.06, 95% CI 1.01-1.11, p=0.027), whereas higher extraversion was inversely associated (OR 0.94, 95% CI 0.89-1.00, p=0.046). A significant gender-by-RQPWL interaction was detected; compared to the general admission program (GAP), women admitted through RQPWL showed markedly higher odds of willingness to engage in community health care (OR 17.66, 95% CI 3.83-81.5, p<0.001). Conclusion Female students tended to be willing to engage in community-oriented medicine, and gender diversity can improve medical staff recruitment in rural areas. Fundamental differences were observed between the RQP and community medicine-oriented groups, demonstrating that the RQP may not adequately select students who want to engage in community-oriented medicine. A solution can be found by adjusting admissions to accept applicants with lower extraversion scores and enhancing openness to experience and agreeableness by providing cooperative learning education in medical schools.