Letters to the Editor
In Reply to Kwatra and Rimoin:
Burnout in medicine is a problem. At some career stages, it can be traced to overwork and excessive work-related anxiety. Homogenization in medical education is another contributor that prevents many physicians from developing their distinctive abilities and contributing as much as they could, and it is certainly desirable, as Kwatra and Rimoin propose, that medical schools help physicians-in-training achieve a better fit between their innate interests and the specific career paths they pursue. Medical education and practice need to be less one-size-fits-all and more tailor-made.
As we probe further into reasons for burnout, however, the problem turns out to be still more deeply rooted in a lack of clarity of purpose. Too many physicians are pursuing their careers as businesspeople, and not responding to a deep sense of vocation or calling. Properly understood, medicine is not a career but a profession, and the most promising deterrent to burnout is rich and sustained vocational reflection and conversation.
We in academic medicine need to provide medical students, residents, and practicing physicians opportunities to think about the deep social, psychological, and spiritual needs that drew them to careers in medicine in the first place and that constitute the wellsprings of resilience and inspiration from which they all need to be drawing throughout their lives. Only when physicians deeply understand why they are physicians and how they contribute to the lives of others will they find full fulfillment in medicine and life.
Richard Gunderman, MD, PhD
Professor, Schools of Medicine and Liberal Arts, Indiana University, Indianapolis, Indiana; firstname.lastname@example.org.