‘Why do you want to be a doctor’ is a common question asked to medical students – so much so it can be met with an eye roll, if asked too often. Understanding the ‘why’ can help uncover someone’s motivation for a career in medicine.
A recent publication discovered that ‘helping people’ was the most important reason as to why residents chose a career in medicine, followed by ‘interest in the human body’ and ‘job/financial security’. Other reasons cited included an interesting/challenging job, respected profession, problem solving, and family influence. There can be variations based on location or culture, as they found ‘interest in the human body’ was more common amongst Dutch doctors compared to Lithuania and Indonesia which had ‘helping people’ as the top reason. It is recognised that there can also be more than one reason, with many people having a main reason and additional ones.
It was proposed in the discussion that understanding personal motivation for a career in medicine could help address the declining vitality of doctors in medicine and the burnout crisis by facilitating a better match between motives and the realities of a career in medicine. “Specific motivational profiles of medical students could align with specific medical specialties.” A tall ask perhaps, given the narrow range of motives and wide range of jobs within medicine and would certainly require a more detailed assessment of each individual and their more expanded reasons for a career in medicine.
But what if there is a simpler approach that could both explain why so many are suffering burnout and the seeming mismatch between career aspiration and the subsequent reality?
Whilst recognising the contributing factors to burnout are multifactorial and include both systemic and personal factors, it is the latter I wish to focus on here. Before doing so, it is important to state that I am very aware of the systemic issues of lack of resources, high expectations and demands, lack of staff, non-compliant rotas, moral injury by not being able to deliver the quality of care we want to and know we can due to under resourcing, and many other factors that can contribute to burnout and do not dismiss their importance.
However, what if there is one distinction that can make a huge difference to how we approach our work and career in medicine and our ability to thrive in it rather than just survive?
And that distinction with respect to ‘why’ is….
Am I going into a career in medicine for me and what I can get out of it?
Or
Am I going into a career in medicine for what I can offer to others and the profession as a whole?
The first is me-centric (focused on a separated part) and the second is other-centric (inclusive of the whole). Each has a different focus and emphasis and ultimately a different outcome also.
Let me expand further as it is not always as it seems on face value. For example, the most common reason given in the cited paper was to help others. On first glance this might appear to be other-centric – but often it is not. Frequently it can be rooted in reasons that are actually about the individual – by helping others I will feel better or good about myself, I will be seen to be a good person, I will be respected for what I do, are examples of reasons behind the reason of helping others that are actually about meeting a need within ourselves. There can be an underlying or unconscious feeling of not being good enough, that we seek to resolve by doing a job that gives us validation and recognition for helping others and assuaging that inner discontent of not being good enough. The ‘helping others’ is in this instance a ruse for actually assuaging a discontent or dis-ease within ourselves.
I know this well as my reason for doing medicine and surgery was also ‘helping others’ and I thought it was just that. I went the extra mile, I worked long hours, I did whatever was necessary as a trainee to be seen to be a ‘good doctor’, a hardworking doctor, a caring surgeon – and ended up exhausted, demotivated and on the verge of walking away from it all. In the process of looking after others, I neglected myself, indeed I abused my body with lack of sleep, unhealthy food, too much alcohol and was easily given to expressing frustration or anger at work situations that did not go as I expected – all in the name of providing ‘good quality care’ I hasten to add – not realising at that time just how harming such behaviour truly is. But it was a toxic mix. No wonder I ended up exhausted, demotivated and looking for the exit.
However, once these underlying reasons were identified and addressed by recognising that my worth is not dependent on my job or what I do – but that who I am is inherently worthy and more than good enough without doing anything, then I can go to work not for me, myself and I, but to bring what I am – the love, joy, fun, lightness of being, playfulness, (as well as all the medical and surgical skills) to all my interactions – accepting that none of us are perfect and we can all have our off moments or days!
When we resolve the need for validation and recognition from the outside, by reconnecting with our innate worth and glory of being, we feel naturally full, loving and joyful, and we are then able to truly attend work to serve others and to do what is needed for the benefit of our patients, the team and the organisation as a whole, without need or demand for me, myself and I.
When we are truly focused on the whole, which includes ourself and all others, we become more responsible in maintaining the quality of our own health and wellbeing as we recognise that impacts the quality of care I can give to others. If I run with late nights, and not enough sleep, I will not perform at my best. If I eat food that makes me feel sleepy, heavy or dull – I will not be as present and ON as if I eat light and ensure I am well hydrated. If I neglect exercise I will lack the physical fitness to work hard and deal with the various forces that come at us in a busy, demanding job like surgery. We realise we have a duty and a responsibility to care for ourselves deeply, so that we can care for others deeply. The purpose of self-care is then not for self – but for all – and we of course are part of that all.
In the current climate, entitlement is off the Richter scale, the ‘what’s in it for me’ is rampant, and self-care corrupted to make it about me, myself and I, void of the all. A recipe for burnout and dissatisfaction in a career that is, or can be, demanding and stressful. If we want to thrive and not just survive, we have to shift our alignment and focus to make it about the all and everyone, of which we are an integral part – so that nothing is just me, myself and I for everything we do and say, impacts the whole.
To be truly selfless, does not mean we run ourselves ragged, exhausted and overburdened and neglecting the needs of the body, but instead it is where our care for others is so grand that we look after our bodies to the max so we can look after others more deeply. A win-win all round.
Reference
- De Jong CAJ, Wang L, van Rijn LC, Iskandar S, Jokubonis D, van der Laan MJ. Is the desire to help people the main motivation for entering a medical profession? A cross-cultural phenomenological study. Academia Mental Health and Wellbeing. Vol 2 issue 1. https://www.academia.edu/2997-9196/2/1/10.20935/MHealthWellB7531
1 Comment
Bernadette Glass
23rd July 2025 at 8:45 pmI loved this article – so honest and no hiding behind the prestige and often elevated position of being a doctor. Blows to smithereens the false notion that helping people is always altruistic. So often our own needs for recognition really come first and we are not even aware of it, so ingrained this is.
Thank you Soulful Doctor for sharing this gem of a reflection for us all, whatever our work.