by Robert Nagle
A high school senior wanting to study medicine was attending a special magnet school for the sciences and had grades near the top of his class. In our testing, he scored high on Inductive Reasoning and was "nonspatial" in his visualization style (not high on structural visualization, the ability to visualize in three dimensions). The career examples for his pattern of aptitudes included law, psychology, sociology, and diplomatic work. But the young man, expecting to hear medicine, was disappointed. After all, several colleges had already accepted him into their premed program. His parents confirmed that he liked to read medical books and assist at his father's medical office. Was the Foundation really saying not to pursue medicine?
Of course not. Our purpose is simply to make the individual aware of fields most likely to use one's strengths. Follow-up studies have consistently identified two distinguishing traits that tend to predict success and satisfaction as a physician. The first is a high aptitude score on Inductive Reasoning, the knack for quickly seeing connections between unlike phenomena. Inductive Reasoning helps in isolating the cause of an ailment or quickly arriving at a theory to explain the relationship between various symptoms. The second is a high aptitude score on Structural Visualization, the knack for working with three dimensional concepts easily and quickly. It helps in visualizing the spatial relations between organs or understanding the effects of molecular chemical processes on the human anatomy. As it happens, the student's high score on Inductive Reasoning did indicate an aptitude for diagnosing, making it no surprise he would find medical problems so interesting. His low structural score, though, suggested caution: it could spell difficulty with the long sequence of anatomy and physiology courses necessary for completing a medical degree.
Other fields, however, could use his diagnostic ability without necessarily entailing a lot of three-dimensional visualizing. The social sciences, for instance, involve recognizing behavioral patterns, making hypotheses, finding underlying causes behind social problems, and prescribing appropriate remedies. In some cases, the abstract nature of the problem might prove less elusive to those less spatially-oriented. Sigmund Freud once wrote, "I have an infamously low capability for visualizing spatial relationships which made the study of geometry and all subjects derived from it impossible to me." Though he started in neuroanatomical research, he is best known for his theories about human psychology and techniques for treating hysteria. The diseases of interest to Freud and later psychologists were those invisible to a microscope, but visible through words and behavior.
Inductive Reasoning, Ideaphoria and Objectivity
Consider the case of another high school student interested in medicine. His aptitudes included Inductive Reasoning, Ideaphoria, and Objective personality, but not Structural Visualization. In addition to the non-spatial fields mentioned above, he received career examples in fields such as marketing, journalism, and teaching. He ignored these suggested fields and enrolled in college as a premed. In his junior year he returned for a follow-up conference, complaining that all his classes seemed so much harder than they used to be. Instead of A's and B's, he was getting B's and C's though he felt he was working twice as hard as his classmates. Another career path in health care, one relating to his communication style, would provide him with an outlet for his natural abilities while keeping him engaged in his prime interest.
These sentiments were echoed in another case involving a high school student scoring low in Structural Visualization, average Inductive Reasoning, high Ideaphoria, and high scores on all three musical aptitudes. He received advertising, journalism, music education and music performance as career examples. Indeed, he went on to double major in music composition and premed. After completing medical school and starting his residency, he began to feel uneasy and scheduled a follow-up conference.
It would be extreme to suggest that this man abandon his medical training and embark on a precarious career in music. He admitted that music was his true love, but it wasn't practical. Medicine offered job security and adequate support for raising a family. It garnered respect and allowed him to help others. His concern was not that he couldn't perform the physician's duties-he had already come this far through hard work and determination. He worried, nonetheless, that medical work would crowd out time for music. How could someone raise a family, work long hours in the doctor's office, and then devote full energy to musical activities?
Although the musical aptitudes might conceivably be used in music therapy or in understanding auditory disorders, it seemed unlikely they would be used regularly for someone whose aim was to be a general practitioner. A partial solution might involve finding outlets for Ideaphoria. This student had already tried his hand at leading study groups at medical school and knew it to be something he could do easily and well. Perhaps he could write books, give seminars or make instructional videos. One home medical guide estimated that the typical patient carries out less than one-half of the instructions given by a physician. Often a doctor's effectiveness may hinge less on scientific expertise than the ability to teach and motivate patients about the value of diet, exercise and good hygiene.
Many community health problems are not the result of medical incompetence but of ignorance and the medical community's failure to educate people. The recent resurgence of tuberculosis, for instance, can be attributed not to ineffective drugs or bad diagnoses, but the failure of at-risk patients to be informed of the need to take medication for the full duration of the disease. In the long run, a successful smoking cessation program or an effective anti-smoking ad may do more to fight lung cancer than any discovery in the laboratory. Whatever happens to health care reform, jobs in public health or corporate jobs stressing prevention-nutritionist, health educators and "wellness" experts-is expected to soar in the upcoming decade, and so will medical opportunities for the high ideaphoria person.
Often an interest in medicine can later translate into careers within marketing or public relations. One college freshman wanting to study premed tested Subjective, non-spatial, high Inductive Reasoning and high Ideaphoria. Although happy with her results, she decided to switch majors only after poring over the shelves at the college bookstore and realizing that the books for English classes interested her much more than her chemistry books. She graduated with an English degree and found work she loves with a public relations firm. Most of her clients are medical firms, and she now spends most of her time writing articles and press releases on medical topics. In addition to doing volunteer publicity work for a non-profit medical association, she recently became involved in an effort to design a city anti-smoking ordinance. She attributes her success partly to her longstanding interest in medicine.
A medical student came in wanting to know if he should stay in medicine. He scored low in Inductive Reasoning, low Structural Visualization, Objective personality, high Graphoria and all the numerical aptitudes. He had stellar SAT scores and graduated with honors in biology at a prestigious southern university under a full tuition scholarship. But at medical school he began to flounder. Doing medical rounds was a horror for him because it required applying classroom work into real life situations, and feeling himself slow at diagnostic work might have causes indecisiveness in situations where these diagnoses needed to be made promptly. His 99th percentile vocabulary score indicated he had already acquired a vast body of knowledge which helped him do well in classroom work.
This man had a classic aptitude pattern for management, enhanced by his top-notch vocabulary. Management and health care administration seemed a better fit. Fortunately, this is a growth field. A recent Fortune article predicted healthy job growth "...for broad-based executives who can put together the newly emerging health care networks made up of hospitals, rehabilitation clinics, HMO's and home care services...." The med student left the summary evaluation of his aptitudes pleased and eager to explore MBA and graduate programs in health care administration programs before making a final decision.
A physician's work might demand spatial thinking, but the question of access and affordability of medical treatment does not. According to a recent U.S. News article on medical careers, "quality audits, physician report cards and other features of the Clinton reform proposals promise to expand niches for a variety of number crunchers..." How does one determine the cost-effectiveness or one treatment over another? How does an HMO find ways to trim costs without compromising the quality of service? These are tasks that seem more likely to use the quantitative aptitudes (Number Series, Number Facility) or administrative aptitude (Graphoria) than the Structural Visualization aptitude. How does one draft insurance policies or legislation that address the issues of fair distribution of costs or equality of care? How does one mediate the ethical obligations of the Hippocratic oath with the real need to control the growth of medical expenditures? These are knotty problems that surely would challenge any high inductive person. As with any large industry, there will always be a need in health care for qualified managers, administrators, consultants and accountants who bring their own individual talents to the insurmountable task of delivering a quality service at the best possible price.
Nursing is another option for the non-spatial person wishing to enter medicine. Nurses in past studies have not necessarily tended to score high in Structural Visualization. Indeed, high scores on Tweezer Dexterity and Graphoria seem to be better predictors of success in this field. Tweezer Dexterity helps in using medical instruments, administering injections and dressing wounds, while Graphoria assists in collecting accurate medical information and tracking a patient's progress over time. Although nursing students are expected to take a fair number of courses in structural-visualizing subjects such as microbiology and physiology, these subjects are useful mainly as background for their work. For a nurse in a cancer ward, it is less important to understand the biological mechanisms of cancer than to know the right way to administer a chemotherapy drug and make the patient feel as comfortable as possible.
Nursing, though, has become such a broad and diverse field that it now seems to offer opportunities to use aptitudes not traditionally associated with the nursing aptitude pattern. The escalation of health care costs and the shortage of qualified medical workers make it inevitable that nurses will be increasingly relied upon to perform many of the functions once performed by physicians. As nurses become more experienced and learn to master many complex medical procedures, some will choose to seek advanced training for positions involving more responsibility. Many mid-level healthcare providers (nurse practitioners, physician assistants, etc.) work independently or in association with physicians in diagnosing and treating ailments; for those tasks inductive reasoning should prove helpful. Nurse anesthetists and other advanced positions are more likely to use Structural Visualization for their work with high-tech equipment. Nurses specializing in public health, on the other hand, are more likely to use Ideaphoria (flow of ideas) in teaching roles for community health education programs.