Sick doctors.

Abstract

SIR,-Like others before him,' 2 Dr Clive Richards has drawn attention to the stress problems, emotional difficulties, and preventive care needs of general practitioners.' A national counselling service for sick doctors already exists,4 but Dr Richards rightly pointed out that coping includes "trying to prevent problems before they occur." Risk factors have been identified. For example, Walton recently noted, "it is commonly accepted that achievement-oriented compulsive people are attracted to medicine" and that this preselection of vulnerable individuals may contribute to the high incidence of mental illness, stress, and drug dependence.' Student selection methods should therefore be reconsidered as part of primary prevention. Current student selection procedures have been criticised6 and contrasted with the thorough personality assessment and psychological testing used by organisations such as IBM.7 In 1988 the World Federation of Medical Education recommended that medical schools should "use selection methods for medical students which 'go beyond intellectual ability and academic achievement to include the evaluation of personal qualities.' "" Including personality assessment in student selection might therefore provide effective primary prevention to help reduce long term unhappiness, stress, and mental illness in the profession.