The question that was asked to everyone who ever applied for medical school. Every interviewee is sat down by strangers and asked – why do you want to be a doctor?

Eight years later a senior doctor asked me this question, and it left me at a loss for words. After so many years of “doing”, I hadn’t stopped to think for a long time.

Back when I was applying for medical school I had a prepared answer ready to go. What is your reason?

When our situations become difficult, like 100-hour weeks and challenging shifts, it’s important to reconnect with our “why”.

After years of working as a doctor I finally stopped to reflect on if I this is what I really wanted. Is this my “why”?

The influences

Originally, when I was very young, I wanted to be a veterinarian. I’ve always loved animals, of all kinds. There are photos of me as a four year old playing vet, and bandaging up my plush dog toy.

As I became a teenager I was quite studious, and an overachiever (I’m sure other medical people can relate). Then I got to the age when people kept asking “what do you want to be when you grow up?”

I wanted to be a vet, but some adults around me felt that I really should not be a vet. That it was a terrible idea. I was gently persuaded to consider medicine, as being a vet would only bring me heartache and cow’s bums. Apparently you have to keep sticking your arm up cow’s behinds? (Little did this adult know all the manual evacuations interns are left to do). On top of this, I had good marks, so becoming a doctor made sense.

If I’m being truthful, I also enjoyed the reaction I got. When I told my parents, grandparents, teachers, classmates and extended family my decision to become a doctor it was widely applauded and supported. I liked having my choices approved of, and the external validation felt great.

Winning is another thing that felt awesome. I was addicted to it. The high of achieving and having reward for it. I strived to achieve in everything in life. Getting into medical school was an extension of this. I was going to win at life.

Self-reflection

My final years of high school weren’t spent on wondering what my strengths and interests were. In fact, I largely ignored them and focused on my flaws (maths, chemistry and abstract reasoning). Which you kind of need for getting into med school. So I studied, got tutoring and revised and revised. My sole focus was getting accepted into medical school at all costs. The only beauty of this goal oriented living is the simplicity, you don’t stop to think or question. Yet after so many years of doing that it took me a long time to realise I was working for a dream that wasn’t really my own.

My grandmother always wanted to be a doctor and she came to Australia in search for a better life for her family. Leaving behind the military dictatorship of Chile, she wanted us to have an education and success. She’s very proud of me being a doctor, and will mention it to anyone who will listen. My teenage self wanted to please, and choosing medicine seemed to please everyone.

I am sure there are more than a few people out there who were gently nudged towards choosing medicine as a career by well-meaning elders.

Lack of decision-making practice

On top of this, I think there’s pressure to know your career choice young. To have your life and future figured out. It’s scary not knowing, having not a single clue. Committing to medicine is a lot more comfortable as the path is neatly set out for you. First you get into medical school, then you work as a junior doctor (they give you a guaranteed job), then you become a specialist and you’re done!

You only need to focus on the next step ahead. This means you can go years without making a big decision about your life. For example, I decided to be a doctor at 15. I didn’t need to make any further career choices until I turned 26! High school was spent studying for med school entrance exams, med school was spent studying to graduate, junior doc years were spent surviving the shifts. Then at 26 I was lost.

What was I doing? Why did I become a doctor? Do I like what I’m doing? What do I do now?

When my supervisor asked me one ward round why I wanted to be a doctor (this was at the end of internship) I was speechless. It’d been a rough year to put it lightly, and actually most mornings were spent with me asking myself the same question.

Why was I doing this?

The only thing I could say to my senior was, “I wanted to be a vet”.

Though a lot of my life was based around pleasing those around me and achieving to feel good about myself, there’s only so far that could take me. Medicine is hard. It’s a calling. When you’re working your 100th hour that week, exhausted, the motivation to fight on is next to nothing if you don’t have a deeper purpose.

Intrinsic motivation vs extrinsic motivation

“He who has a why to live for can bear almost any how.”

Friedrich Nietzsche 

My original decision to be a doctor (at 15) was largely based on external motivators, not intrinsic factors. My grandma wasn’t doing the after hour shifts. None of my family were. No one but myself would be doing the training program. So why was I letting others make my own life decisions?

External motivation is primarily doing activities to earn a reward or avoid punishment. This type of motivation means you will do things that aren’t enjoyable if it means you will get a reward such as praise, wages, and fame. An example is getting good grades to earn praise from your family.

Intrinsic motivation is when you do something for the pure joy of doing it. The activity itself is its own reward. Often these types of activities lead to the “flow state”. E.g. studying a subject because you find it interesting.

While extrinsic motivation isn’t bad in itself, it can be hard to self-motivate if your primary reasons for doing something are based on external factors.

Connecting challenging situations back to your “why” can reconnect you to your values. And that motivation can come from within.

What now?

At 26, I finally admitted to myself that I was unhappy in my career and needed change.

At 27, I finally did something about it.

Balanced Medics was born to promote doctors’ and med student health. But also it was created to show we are more than what we think we are. Every person has their own unique life story, interests and skills. You’re more than a doctor, and can shape your life how you want it.

I hope to explore all the different possibilities available, so that more medics can find their “why” and create more fulfilment in their careers.

Some starting points that helped me:

• Pause
• Reflect – are you happy?
• Review – what are your values?
• How can you make a small change today to live a life more aligned with these values?