Intended for healthcare professionals

Career Focus

Extraversion and introversion

BMJ 2004; 329 doi: (Published 06 November 2004) Cite this as: BMJ 2004;329:s191
  1. Anita Houghton, careers counsellor and coach
  1. Londonanita.houghton{at}


In the second article in our series, Understanding Personality Type, Anita Houghton asks you to consider where you focus your attention—inside or out

Over the next four weeks I will be examining in some detail each of the four pairs of preferences (extraversion-introversion, sensing-intuition, thinking-feeling, judging-perceiving) measured by the Myers Briggs Type Indicator (MBTI) instrument. It's important to remember that in practice these preferences coexist, and any examples given will inevitably include expression of more than one preference.

Picture this...

You are arriving early for the first day of a new job. When you enter the department, you notice a quiet man collecting a pile of notes and making for one of the rooms off the reception area. His eyes alight on you briefly as he does so; he nods, and there is a brief smile. Long enough to be polite, but not to encourage. He vanishes. You look around for someone who might help you, and you notice a woman behind the reception desk. You move towards her, and before you can speak she beams at you, and asks if she can help. You explain who you are and she beams another welcome, and proceeds to tell you who you should see, when they are likely to arrive, where the toilets are, how to get lunch, who your secretary will be, what the boss is like, and where she went for her holidays.

Box 1: Character preferences


  • Outgoing and sociable

  • Prefer action to reading and reflection

  • Tend to speak as thoughts are forming

  • Wide circle of friends/contacts

  • May find it hard to focus


  • Quiet and reflective

  • Prefer reading and reflection to action

  • Tend to think carefully before speaking

  • Small circle of close friends

  • Work alone contentedly

Introvert and extravert

These are caricatures of the first two preferences measured by the MBTI, introversion and extraversion, and the behaviours are indications of where these two people like to focus their attention. When you're ambling along deep in thought, not noticing the people you pass, or the noise of the traffic—when nothing short of a cloudburst would draw your attention to what is around you—you are focusing on your internal world (introversion). When you are chatting with people, watching events, engaging in a group activity, or noticing your environment, you are focusing on your external world (extraversion).

We all focus attention in both places, many times a day, but we have a preference for one or the other, and we tend to be energised by that place, and drained by the other. Box 1 lists the main preferences of each type.


People who prefer introversion (the I personality type) tend to be reserved, reflective people who like to think things through before they speak or act, who prefer to spend time with small numbers of people they know, and who find it easy to concentrate on solitary tasks. Their best work often takes place in their heads, and they feel energised by periods of solitary concentration, and drained by multiple activities and meeting new people. After a day of extraverting, which they may well enjoy if it doesn't happen too frequently, their idea of relaxation is likely to include solitude.

People who prefer extraversion (the E personality type) tend to be the outgoing, action-oriented people in life; the ones who take the initiative in groups and at work, who are at ease with new people, and who verbalise thoughts as they are forming in their minds. Their best work is most often done in their external world, and they are energised by active, people-filled days, and drained by days sitting at a desk, studying, or writing a report. After a day of introverting, their idea of relaxation is likely to involve people or activities.

Extraversion and introversion in the workplace

Like any job or profession, medicine requires all preferences, but some jobs will contain more of certain kinds of activities than others, and it is the balance between these, and how they match with your own preferences, that play a huge part in your effectiveness and happiness at work (box 2).

Box 2: Activities that require extraversion or introversion


  • Seeing a lot of patients

  • Networking with colleagues

  • Public speaking, teaching

  • Committee work

  • Team working


  • Focusing on individual patients

  • Thinking through clinical problems

  • Examining data and specimens

  • Writing reports, papers, or letters

  • Private study, reading

Where differences cause problems

We're all different, and while variety is what makes life so interesting and exciting, there are times when differences can cause problems. This is especially so when people don't understand personality type, and every preference has the potential to bemuse and infuriate someone of a different type. You only have to look at the negative connotations that extraversion and introversion have acquired over the past hundred years to understand that.

An extravert's view of an introvert

To an extravert, introverts may be totally unfathomable. Why on earth do they not speak? Why do I feel like a gabbling idiot when they're around? What are they thinking? In particular, what are they thinking about me? You spend a bit of time with them, and at the end you realise they now know everything about you, and you know as little about them as when you first met.

Box 3: Tips on how to cope with things you don't enjoy

Get help from someone who does

If you're an E and have done a piece of research with an I, they'll be only too delighted to analyse the data and write it up, especially if you did all the wheeling and dealing to get it off the ground, and if you offer to tout it round the journals

Do your worst tasks (for example, phone calls for introverts, report writing for extraverts) at the times of the day you feel strongest

The temptation is to put them off until you're tired, and the result is that they never get done

Do the difficult things regularly, but in small doses

If you put them off they accumulate, and there's nothing more offputting than having to face a mountain of tasks you find difficult. If you have a thesis to write, you'll find that writing for just half an hour a day will result in a huge amount of text over time. If you need to network, you'll find that making just one contact a day is not too daunting, but can result in an astounding numbers of contacts in just a few weeks

Think carefully about applying for jobs that are ill-suited to your preference, and prepare yourself if you do

If you're an E, beware of jobs that involve large amounts of time concentrating on solitary tasks, and if you're an I, you may want to reconsider before applying for a job that involves nothing but committees, public speaking, and travelling to conferences. Everyone can do these jobs, and if you do decide to go for it, you need to prepare yourself, using the tips above

For introverts in E jobs, schedule regular “I” time at work

Spend time in the library, take breaks in clinics, work from home, or go for a solitary walk at lunchtime

For extraverts in I jobs, schedule regular periods of extraverting

Meet colleagues at lunchtime, join committees and working groups, go “walkabout” during breaks

Perhaps partly because of this discomfort, the word “introverted” has gained all manner of negative connotations over the years, and is sometimes associated with personality disorders and other forms of mental illness. Psychiatrists, who are interested in pathology, have tended to measure levels of extraversion and introversion on a scale of “sociability.” In other words, being sociable (that is, extravert) is good, while being unsociable (that is, introvert) is bad.

An introvert's view of an extravert

To an introvert, on the other hand, extraverts can be maddeningly noisy. They come out with half-baked ideas, take up all the “air-time,” and seem to have difficulty sitting still. “If they would only shut up for two seconds,” introverts think, “I might have a chance to give them the solution/idea/insight I've worked out.”

When an extravert says something, they are sometimes just thinking aloud, but introverts find this difficult to understand and use the same quality criteria as they would to assess something they themselves have taken hours, days, or even months to think through. Similarly, extraverts tend to ascribe the weight to the utterances of an introvert that they would to their own, unaware of how long the introvert's thoughts have been incubating. As with introversion, extraversion has suffered from negative associations—noisiness, brashness, and an inability to listen—over the years (probably at the hands of introverts).

How personality type can help

One of the main strengths of the MBTI is that it is not concerned with pathology, but with normality in the most positive sense, and when you understand type some very helpful things begin to happen. The first is that you realise the other person is not difficult, they're just different. They're not being deliberately annoying, that's just what they're like. Next you realise that you might be just as annoying to them. Finally you realise that their annoying habits may actually be quite useful.

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