Is medicine an occupation or a calling?

“There are significant generational differences in learners now,” says Jennifer Imsande, Ph.D., director of the M-Home learning community at the Medical School. She says Gen Z expects autonomy, flexibility, and individuality in their workplaces. 

Ahab Chopra is entering his fourth year as an M.D./Ph.D. student. In his rotations at the hospital, he’s seeing a shift where students want a more level playing field and opportunities for collaboration. 

“The teams I’ve been on, there’s much more the sense that everyone is caring for the patient as the top priority and not that one person has the right answer and everyone has to follow suit,” he says. “Although [some team members] may have more experience dealing with certain diseases, anyone can have a good idea that can change the patient’s outcome, and we can all be good stewards for patients.” 

Gen Z also cares about mental health and work-life balance. 

“For older generations, there was a ‘suck it up’ mentality. It was a badge of honor not to sleep for days or not to eat,” says Deirdre Conroy, Ph.D., professor of psychiatry. “That level of workmanship involved grit and stoicism. … But if we want a healthy, balanced mindset as providers, we need to [take care of ourselves] and have the psychological safety to communicate [our needs] at work.” 

Deb Weinstein, M.D., executive vice dean for academic affairs, agrees, and she doesn’t see this as a conflict with patient care. “We’ve been thinking more deliberately about what are the bounds on somebody’s job description and expectation of work hours, but I don’t think that diminishes the commitment that people feel to their patients.” 

This generation is better at self-care, according to Michele Carney, M.D., associate professor of emergency medicine and of pediatrics. But she still sees the old mentality in some of her students. She spoke with a resident recently whose finger was swollen and seemed infected. “They told me they’d go to the emergency department after their shift,” she says. “I told them, ‘You’re going right now.’ … I remind the residents and my colleagues, ‘You have to take care of you first, so that you can take care of others.’” 

On the other hand, some specialties require a lot of self-sacrifice. “Our transplant surgeons have the hardest lifestyle of anybody I’ve ever encountered in my life,” says Justin Dimick, M.D., MPH (Residency 2007), the Frederick A. Coller Distinguished Professor of Surgery and chair of the department. “You almost have to consider it a calling, to get up on Christmas Eve, for example, and do a liver transplant for eight hours. I don’t think we need to criticize them for not putting boundaries around that.” 

Dimick says self-reflection can help learners discern whether they see their work as a calling or occupation, and that can have implications for what branch of medicine they choose. “Don’t be afraid to make choices that reflect your values,” he advises. 

Chopra sees medicine as a calling, but he acknowledges that some aspects of the job don’t inspire passion. “When you ask people who aren’t in the medical field, ‘What does it look like to be a doctor?’ they think, ‘Doctors save lives.’ But what a lot of us see when we enter medicine is that a lot of the work is on the computer — ordering, clicking. … That does feel more like a job, and some people have lost a sense of calling.”