I remember sitting nervously in a seminar filled with other pre-medical students hoping to receive the faintest sliver of direction regarding how to tackle the formidable task of the personal statement portion of my application. The first words spoken by any instructor, at any seminar, inevitably fell heavily on most students – “you can’t just say that you want to help people and you like science.” Well duh, I thought to myself. This was immediately followed by the realization that I needed to get creative, and quickly. But that is another conversation. If you ask me today, or at anytime in the past, the reason I wanted to become a physician is because I want to help people and I like science. If you ask any adviser why one needs to go beyond this idea for their personal statement, it is simply because the notion is nearly universal among physicians, and thus lacks individuality. What I have come to conclude is that while this fundamental paradigm is nearly universal, for each individual it does play a unique role in what motivates the rigorous learning required to become a physician.

During the didactic years of medical school, we are so far removed from the actual “helping people” portion of the equation that is becomes very difficult to see the big picture. This is when, for better or worse, additional elements come into play. Another staggering commonality among future physicians is their undeniable competitive nature. There are varying degrees of competitiveness, but it would be ludicrous to deny that we aren’t all extremely competitive. Educators are acutely aware that during the didactic years we are far from actually understanding how to execute what we have learned in order to be effective clinicians, and it becomes frustrating to stay motivated to learn; despite this, we need to learn a lot, and in short order. Capitalizing on competition ensures continuous consumption of information in order to succeed. Exams, class rankings, grades…any measurement to afford us some semblance of success and advancement. It sucks, but it’s effective. In my discussions with classmates I have found that some students choose to look at material and relate it back to the notion that it can be used as a tool to help their patients in the future. They assign value to the material in a different way, it becomes constantly personal. I, myself, would find this terribly exhausting and this was something I had previously felt guilty about. I like science and I want to help people, but these have always remained separate entities.

My personal motivation for learning during the didactic years was, in all honestly, driven by fascination and the simple pursuit of knowledge. I seek a degree of mastery in a subject that both intrigues me and is of massive importance. I have always approached the acquisition of knowledge as a humbling endeavor, and choose to focus on mastering fundamentals before utilizing what I have learned. I waited until I had my degree in human biology until I felt comfortable doing research, simply because I needed to learn how to think before I could even consider making any contribution to science. In my recent reflections I have realized that my subconscious choice to keep science and “helping people” separate was not because I was a terrible future doctor who didn’t constantly consider patient care, but rather because I value the sanctity of medicine as the interplay of science and the human condition. The ability to navigate this delicate balance is granted to those who take the time to invest in the pursuit of knowledge at its most fundamental level. For me, learning material didn’t need to be assigned any more value than it inherently had.

I am just now getting my first glimpse of how lifetime learning and pursuit of medical knowledge is actually translated into making a difference in people’s lives; it’s beautiful, powerful and extremely humbling. While I stand by my motivations to learn during the pre-clinical years, I have abandoned what were my reasons for learning at the beginning of my clinicals. After my first rotation I reflected upon what motivated both myself (and other students) to continue to pursue medical knowledge now that we were out of the classroom. What I experienced was self-serving, ego-driven, and not in the business of helping people. We were all scrambling to essentially avoid humiliation, collecting data not for patient care, but rather to prevent looking clueless during rounds or while being pimped. For me, I felt just as removed as when I was sitting in a classroom the previous year. I made a conscious decision to make my learning patient-centered and whatever embarrassment I felt during rounds, or while being pimpled, was all part of the process. Constantly I now ask myself, what knowledge can I use to help this person? I wish I could say that this immediately fused my previously separate ideas of liking science and wanting to help people, but it has been a slow process…and it should be. The notion that I am finally beginning to see the intersection between the knowledge base I am building, and making a difference in the lives of patients has been extraordinarily motivating. If am I this excited when I see these small advancements in my abilities, I cannot wait for the future. I guess now when people ask me ‘why become a doctor’? I am recently finally able to say, “I like using science to help people”.  Because I a finally am….using science, that is. Sorry pre-med advisers, but this is a big deal.

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