Choosing a career is one of the most important decisions any of us will make in our lives. For medical students, the decision to pursue a career in medicine often comes with a complex mix of motivations.

A recent study published in IJME investigated the different motivations behind medical students’ career choices and how these motivations related to their academic interests and performance in the United States.

The researchers surveyed 207 medical students at a private university in Korea. The survey asked students about their motivations for pursuing medicine and their level of academic interest and collected data on their academic performance. Students’ motivations were categorized into “intrinsic” reasons – related to personal interest in medicine – or “extrinsic” reasons – related to external factors like status, job security, or parent expectations.

The results showed some clear differences between intrinsically and extrinsically motivated students. About 74% of students surveyed had primarily intrinsic motivations, while 22% had mainly extrinsic motivations. Intrinsically motivated students significantly outperformed their extrinsically motivated peers academically. They had higher GPAs and showed higher levels of academic interest overall.

These findings highlight the importance of internal motivations in driving academic engagement and achievement in medical training. For intrinsically motivated students, the inherent interest and meaning they find in medicine sustains their focus and energy for rigorous coursework. Extrinsically motivated students, on the other hand, may struggle more to stay engaged when the academic demands get tough.

What are some of the key intrinsic and extrinsic motivations behind medical students’ career choices?

Intrinsic Motivations

• Desire to help others. Many students pursue medicine because they are passionate about caring for patients and making a difference in people’s health and well-being. Their altruistic nature draws them strongly to the field.
• Fascination with science. For some, it’s the intellectual challenge and scientific problem-solving aspects of medicine that spark their interest. They are driven by curiosity and discovery.
• Personal or family health experiences. Students often become interested in medicine after seeing illnesses or medical issues up close with their own family. These experiences give them a personal connection to the field.
• Sense of calling. Some students simply feel an inner conviction that medical practice aligns with their values, interests, and abilities. They feel naturally drawn to this career path.

Extrinsic Motivations

• Financial security. Medicine is seen as a financially stable career with good earning potential. The prospect of a high salary can be a major factor.
• Job stability. The demand for doctors and medical professionals remains high. Job security is an understandable extrinsic motivator.
• Prestige and status. There is an undeniable prestige associated with being a doctor. For some, respect and status are big appeals.
• Pressure from family. Many medical students have family members (often parents) who strongly encourage or expect them to pursue medicine. Familial pressure can drive the decision.

Of course, for most students, there is a combination of intrinsic and extrinsic factors behind their choice to enter medicine. However, the findings from this study suggest students who are primarily driven by their innate fascination and passion for medicine have an advantage. These intrinsic motivations fuel their learning and achievement.

This raises important questions for medical school admissions committees as they evaluate applicants. How can they best assess a prospective student’s motivations to determine fit for their program? Here are some considerations:

• Look closely at their personal statement. Applicants should communicate genuine intrinsic interest in medicine rather than just extrinsic motivations. Compelling personal stories can set them apart.
• Ask about motivations during interviews. Interview questions that probe an applicant’s reasons for pursuing medicine can reveal much about their internal vs. external motivations.
• Assess prerequisites holistically. Strong performance in pre-med science courses is essential, but humanities electives also indicate broader intellectual curiosities.
• Gauge community service and healthcare exposure. Applicants who go above and beyond minimum healthcare hours and take on meaningful experiences demonstrate intrinsic motivation.
• Consider research participation. Research projects for credit alone check a box; intensive research driven by a fascination with a topic suggests authentic engagement.

Of course, extrinsic motivations like financial security are understandable, and a mix of internal and external motivations is normal. But applicants who can compellingly convey their innate passion and a calling to medicine should rise to the top.

As medical students embark on their rigorous training, their mix of motivations continues to shape their experience. Intrinsically driven students retain an advantage, but what about students lacking internal motivations? Here are some ways educators can support them:

• Encourage intellectual curiosity. Design projects, assignments, and learning activities that stimulate fascination and problem-solving.
• Provide inspiration through role models. Exposure to passionate, humanistic mentors helps students connect with medicine’s intrinsic rewards.
• Offer diverse clinical experiences early on. Volunteering in various specialties allows students to discover their passions.
• Emphasize team-based learning. Small groups build community and reinforce medicine’s collaborative nature.
• Share patient perspectives. Direct interaction with patients through panels, interviews, and hospital visits reminds students of the human impact.
• Promote reflection. Journaling, reflective essays, and small group discussions help students process their motivations and experiences.
• Support student wellness. With counseling, mentoring, and work-life balance policies to manage stress.

Medical schools owe it to students to help them uncover, or in some cases recover, the intrinsic motivations that initially drew them to medicine. By ensuring students stay connected to their passions, medical educators can equip the next generation of doctors to provide compassionate, outstanding care.