Medical students must receive regular, structured, and constructive appraisal

Unhappy doctors often underperform,1 and by depressing morale in the workplace, they exert a negative influence on recruitment and retention, which are pressing problems in the NHS.2 Everything we can do to promote contentedness at work is therefore a worthwhile endeavour in the interest of patients.

Much of the difference in the ways that doctors approach work and perceive the climate at the workplace is a reflection of stable long term individual differences in the doctors themselves.3 In a comprehensive questionnaire study, which included measures of approaches to work, workplace climate, stress (general health questionnaire), burnout (Maslach burnout inventory), and satisfaction with medicine as a career as well as the Big Five personality inventories, McManus et al obtained data on 1668 medical graduates, 12 years after they had entered medical school. They were able to relate doctors' present perceptions of the workplace climate to differences in measures of personality and learning style, which were already evident at medical school entry, and remained fairly stable when measured again in the final year at medical school and five years later in working doctors. Stress, burnout, and satisfaction also correlate with trait measures of personality taken five years earlier. Neuroticism …