It’s no secret that residency, introduced to the U.S. at Johns Hopkins in the late 19th century, is a vital part of a physician’s medical training. But what makes a particular resident successful enough to attain competency over time is more of a mystery. For surgical fields, such as otolaryngology–head and neck surgery, being able to attain competency involves having the aptitude to learn intricate surgical maneuvers and attaining a base knowledge of the field, among other skills. But it’s much more than that, say EunMi Park and Young Kim.

To help figure out why some residents more readily attain competency while others struggle, the researchers and their colleagues recently performed a study to examine whether personal characteristics might predict competency improvement.

After recruiting a longitudinal cohort of 16 residents spanning the spectrum of first to seventh year, the study team had each take two different questionnaires: one designed to measure trait emotional intelligence (which assessed factors including well-being, self-control, emotionality, and sociability), and the other to measure learner autonomy (which assessed the profile of learning desire, resourcefulness, initiative, and persistence). For the next year, the study team monitored changes in the residents’ competency scores every three months, assessed by faculty mentors.

When the researchers analyzed the data, they found a striking correlation between certain personal characteristics of the residents and their likelihood of achieving competency improvement. Those who demonstrated larger improvement of competency also had higher scores in their learner autonomy profile as well as in their emotionality score, one of factors in trait emotional intelligence.

“There’s more to learning to be a good surgeon than just reading more books and taking care of more patients,” says otolaryngologist–head and neck surgeon Kim. “There’s something to be said for coming prepared to learn and having the right mindset.”

In order to increase the chances that all residents could succeed in attaining competency, the research team suggests offering self-assessments and targeted coaching that emphasizes residents’ learner autonomy and emotionality.

“I believe it’s possible to change, although some might need less or more willful efforts for making a difference in their personal habits,” Park says. Nevertheless, she says, such efforts are critical for residents as they complete their training and practice medicine elsewhere.

“Our residents not only serve patients at Johns Hopkins but will serve patients throughout the world,” she says. “We owe it to them and future patients to do everything we can do to have them receive the best possible experiences for learning and improvement.”