Charisma and career pathways: how specialty choice reflects personal charisma among medical residents

Charisma is a relational construct that may shape communication, leadership behavior, and team dynamics in healthcare settings. It remains unclear whether charisma profiles differ across residents' intended medical specialties.

This study examined the association between intended specialty choice and charisma profiles among Japanese postgraduate residents using a cross-sectional, nationwide, web-based survey conducted between 18 January and 31 March 2024 after a national in-training examination. Of the 9179 postgraduate year one and two residents invited, 5808 (63.3%) were included in the analysis. Charisma was assessed using a modified General Charisma Inventory with binary items. The primary outcome was the total modified inventory score and its association with the intended specialty was estimated using multivariate linear regression adjusted for age, sex, and hospital type (including university hospital affiliation).

Among participants, aspirations for surgical-oriented specialties were associated with higher total charisma scores compared with internal medicine (Surgery: β = 0.26, P < .001; Neurosurgery: β = 0.37, P = .001). In contrast, aspirations for diagnostic specialties were associated with lower total charisma scores (Radiology: β = -0.25, P = .022; Pathology: β = -0.48, P = .011). Male sex (β = 0.20, P < .001) and university hospital affiliation (β = 0.14, P = .008) were also independently associated with higher total charisma scores.

Charisma profiles among Japanese residents varied according to their intended specialty, consistent with a potential person-environment fit mechanism in early career preferences. Sex and institutional affiliation were also independently associated with charisma scores, suggesting socio-cultural and environmental influences. These findings can inform leadership development and career support strategies for residency training. Key messages • What is already known on this topic - charisma is a relational construct that can influence communication, leadership behavior, and team dynamics in healthcare settings. • What this study adds - in a nationwide cross-sectional web survey of 5808 residents, surgically oriented specialties were associated with higher total charisma scores, whereas diagnostic specialties were associated with lower scores (vs. internal medicine). Male sex and university hospital affiliations were independently associated with higher scores. • How this study might affect research, practice, or policy - charisma profiles may differ according to the intended specialty, person-environment fit, leadership development, and career support strategies in residency training.