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Abstract Introduction The presence of calling in medicine has been shown to be related to a preponderance of positive outcomes among medical students. However, only a few studies examined the antecedents of calling. Of this group, little is known about how a calling emerges and develops in a crisis situation. This study examines the processes underlying the emergence and development of calling when confronted with COVID-19. Methods Semi-structured interviews were conducted with medical students (N = 28) from China from February to March 2020. Medical students reported their experiences about the emergence of calling, its antecedents, and its outcomes in the context of the COVID-19 pandemic. Interviews were transcribed and analyzed using a thematic analysis approach. Results Four main themes were identified: (1) the definition of calling, (2) the trajectories of calling development, (3) the factors leading to the emergence of calling, and (4) the outcomes of the emergence of calling. Medical students conceptualized calling as both self- and other-oriented regarding serving the common good. Three calling paths were revealed: significantly enhanced, growing out of nothing, and remaining unchanged. Work sense-making and identity formation interact to facilitate the emergence of calling. The emergence of a calling affects career and study-related outcomes. Discussion Our findings advance the concept of how the calling of medical students emerges and develops in response to life events through work sense-making and identity formation. Academic institutions and medical educators could leverage these events to facilitate calling discernment among medical students.

Introduction: The presence of calling in medicine has been shown to be related to a preponderance of positive outcomes among medical students. However, only a few studies examined the antecedents of calling. Of this group, little is known about how a calling emerges and develops in a crisis situation. This study examines the processes underlying the emergence and development of calling when confronted with COVID-19. Methods: Semi-structured interviews were conducted with medical students (N = 28) from China from February to March 2020. Medical students reported their experiences about the emergence of calling, its antecedents, and its outcomes in the context of the COVID-19 pandemic. Interviews were transcribed and analyzed using a thematic analysis approach. Results: Four main themes were identified: (1) the definition of calling, (2) the trajectories of calling development, (3) the factors leading to the emergence of calling, and (4) the outcomes of the emergence of calling. Medical students conceptualized calling as both self- and other-oriented regarding serving the common good. Three calling paths were revealed: significantly enhanced, growing out of nothing, and remaining unchanged. Work sense-making and identity formation interact to facilitate the emergence of calling. The emergence of a calling affects career and study-related outcomes. Discussion: Our findings advance the concept of how the calling of medical students emerges and develops in response to life events through work sense-making and identity formation. Academic institutions and medical educators could leverage these events to facilitate calling discernment among medical students. [ABSTRACT FROM AUTHOR]

Abstract Background Calling within the medical context receives growing academic attention and empirical research has started to demonstrate its beneficial effects. The purpose of this study is to investigate what motivates students to enter medical school and what role calling may play (i), to evaluate if calling influences the way in which they experience their studies (ii), and to compare medical students’ experience of calling with those of physicians. Methods A questionnaire survey was distributed among medical students (N = 1048; response rate above 60%) of the University of Lausanne in Switzerland. It was supplemented by a group discussion between bachelor medical students (N = 8) and senior physicians (N = 4), focusing on different facets of calling. An existing data set of a survey among physicians, addressing calling with the same questionnaire, was used to compare students’ and physicians’ attitudes towards calling. Survey data were analyzed with the habitual statistical procedures for categorical and continuous variables. The group discussion was analyzed with thematic analysis. Results The survey showed that experiencing calling is a motivational factor for study choice and influences positively choice consistency. Students experiencing calling differed from those who did not: they attributed different definitions to calling, indicated more often prosocial motivational factors for entering medical school and perceived the learning context as less burdensome. The analysis of the group discussion revealed that the concept of calling has a fluid definition. It was conceived as having the characteristics of a double-edged sword and as originating from within or outside or from a dialectic interplay between the inner and outer world. Finally, calling is experienced less often by physicians than by medical students, with a decreasing prevalence as the immersion in the clinical years of the study of medicine progresses. Conclusions Calling plays an important role in study choice and consistency of medical students. Given its relevance for medical students and its ramifications with the learning context, calling should become a topic of the reflexive parts of the medical curriculum. We critically discuss the role played by calling for medical students and provide some perspectives on how calling could be integrated in the reflection and teaching on physicianhood.

Background: The medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality. Methods: Medical students completed surveys at the start (1st-year: baseline) and finish (4th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up. Results: The temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak. Conclusions: Most commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors. [ABSTRACT FROM AUTHOR]

Background: Calling within the medical context receives growing academic attention and empirical research has started to demonstrate its beneficial effects. The purpose of this study is to investigate what motivates students to enter medical school and what role calling may play (i), to evaluate if calling influences the way in which they experience their studies (ii), and to compare medical students' experience of calling with those of physicians. Methods: A questionnaire survey was distributed among medical students (N = 1048; response rate above 60%) of the University of Lausanne in Switzerland. It was supplemented by a group discussion between bachelor medical students (N = 8) and senior physicians (N = 4), focusing on different facets of calling. An existing data set of a survey among physicians, addressing calling with the same questionnaire, was used to compare students' and physicians' attitudes towards calling. Survey data were analyzed with the habitual statistical procedures for categorical and continuous variables. The group discussion was analyzed with thematic analysis. Results: The survey showed that experiencing calling is a motivational factor for study choice and influences positively choice consistency. Students experiencing calling differed from those who did not: they attributed different definitions to calling, indicated more often prosocial motivational factors for entering medical school and perceived the learning context as less burdensome. The analysis of the group discussion revealed that the concept of calling has a fluid definition. It was conceived as having the characteristics of a double-edged sword and as originating from within or outside or from a dialectic interplay between the inner and outer world. Finally, calling is experienced less often by physicians than by medical students, with a decreasing prevalence as the immersion in the clinical years of the study of medicine progresses. Conclusions: Calling plays an important role in study choice and consistency of medical students. Given its relevance for medical students and its ramifications with the learning context, calling should become a topic of the reflexive parts of the medical curriculum. We critically discuss the role played by calling for medical students and provide some perspectives on how calling could be integrated in the reflection and teaching on physicianhood. [ABSTRACT FROM AUTHOR]