Appendix 8 - Machiavellianism

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

One study found evidence that students become significantly less inhibited and more self-indulgent in medical school.[120] Other studies have noted personality changes that are more worrisome.

"Emotional detachment is the underlying requirement to be Machiavellian."[121]

Machiavellian tactics have been found to be associated with success in college athletes. In the world of business, Machiavellianism is said to facilitate acquisition of prestige and wealth. What about in medical school? From an article in the American Journal of the Medical Sciences: "Results showed that 15% of all [medical] students scored positively on the Machiavellianism score." One study compared medical and law students:

The authoritarian personality was originally defined as a personality type with dogmatic beliefs, a hierarchical orientation in interpersonal relationships, with significantly greater distrust and suspicion, manipulative in relationships with others and seeking material rather than social values.... The observations of a trend towards greater authoritarianism in medical than law students is consistent with a previous study comparing these faculties.[122]

From the American Journal of the Medical Science article "Machiavellianism in Medical Students": "The more students prized devious behavior and flattery as a means of 'getting ahead,' the higher they scored on authoritarianism by devaluing homosexuals, persons with low IQ's, patients with self-inflicted problems such as intravenous drug abuse, and noncontributors to society."[123] In an article called "The Effect of Medical Training on Attitudes Toward Alcoholics," three groups of medical students and residents were surveyed. The results indicated that all three groups differed significantly in their ratings of the alcoholic. The more medical school, the more negative the views.[124]

"If nothing else is accomplished," a researcher asserts in an Academic Medicine article, "I hope that people come to understand that we are not dealing with a few bad apples spoiling a good bushel but a bad bushel spoiling many good apples."[125]


[120] Whittemote, PB, et al. Journal of Medical Education 60(1985):404-405.

[121] Merril, JM, et al. American Journal of the Medical Sciences 305(1993):285-288.

[122] Pestell, R and JRB Ball. Australian and New Zealand Journal of Psychiatry 25(1991):265-269.

[123] Merril, JM, et al. American Journal of the Medical Sciences 305(1993):285-288.

[124] Journal of Studies of Alcoholism 36:949.

[125] Hundert, EM. Academic Medicine 71(1996):624-640.

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