COMMITMENT TO SCHOLARSHIPS: Generous alumni and friends were recognized for supporting aspiring physicians at a luncheon during Alumni Weekend.

Up for Debate: IQ Versus EQ

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There’s a great quote from well-known golf champion Lee Trevino: “The older I get, the better I used to be.” After many years as a technical specialist in a surgical subspecialty, I could easily do a highlight tour of simple or complex procedures where an excellent technical operation resulted in a good outcome. But, I recognize that I do have selective memory loss when it comes to the occasional negative outcome as a result of an unforeseen problem arising intraoperatively, usually in an emergency situation in which a technical approach did not foster a good outcome. And hence, I can always fall back on Lee Trevino’s famous phrase.

I recently read an article in the February 20th issue of the Journal of the American Medical Association (Vol 319, Number 7, pp 651-653) by Ezekiel Emanuel, MD, PhD, and Emily Gudbranson, both from the University of Pennsylvania’s Perelman School of Medicine titled “Does Medicine Overemphasize IQ?” They discuss how everyone wants the best and smartest physician who attended the best medical school and trained in the best hospital system. Many times, these physicians had very high GPAs and MCAT scores in college. But, do these very intelligent students truly make the best physicians? The authors suggest that success in these metrics has little to do with social-emotional intelligence, which correlates much better with being an excellent clinical physician.

As GPAs and MCAT scores have risen over the past two decades, the identification of factors such as self-awareness and the ability to manage emotions and interact with others has helped fill out the equation of what constitutes a successful physician. Picture an oncologist’s interaction with a critically ill patient or an ICU intensivist leading a multidisciplinary team of nurse practitioners, students and fellow MDs in a morbidity and mortality conference as two examples of the need for that “other intelligence” to expeditiously solve problems.

Where I disagree with the article is the discussion of how to enhance emotional intelligence (EQ) in medicine. The authors espouse asking admissions committees to deemphasize cognitive IQ and increase the emphasis on EQ in the selection of medical students. They mention eliminating “irrelevant” science requirements and emphasizing humanities-oriented programs in the selection process. Part of this admissions process would be evaluation of EQ by using a relevant scored exam.

I think that much of what the medical community values in self-awareness and EQ can be taught and learned at the medical student level.

EQ at Feinberg

Feinberg students participate in a four-year longitudinal course called Personal Transitions to the Profession, where they discuss the challenges of careers in medicine and how it may affect them personally and professionally. In small groups facilitated by a trained faculty member, they talk about topics such as perfectionism and dealing with failure and life balance. Students also engage in a mentored assessment portfolio review to reflect on their own performance data and identify areas of strength and self-improvement in competencies including effective communication and interpersonal skills. Students who leave Feinberg are equipped with the knowledge and skills to become outstanding reflective practitioners of medicine.

I do think that basic course work in these areas can be explicitly taught at the medical school and GME level with reasonable expectations of understanding and progressing through the material. Maybe even a series of webinars on the seven factors making up EQ — emotional stability, conscientiousness, extraversion, ability emotional intelligence, cognitive ability, general self-efficiency and self-rated job performance — could be a requirement for students advancing from M2 to M3 in all medical schools.

Medicine at its highest level of performance requires both IQ and EQ. While we can do some things to raise general intelligence, I think we can do more to raise the level of emotional intelligence in our medical schools, thus avoiding the deselection of high-IQ students at the post-college level because they don’t score well on a basic screening EQ test.