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What keeps medical students motivated, and what causes them to disengage? A six-year study at Radboud university medical center sheds new light on this question. The researchers show that motivation and engagement are not fixed traits, but evolve over time. While students are initially driven mainly by external factors, their intrinsic motivation grows as they become more familiar with the medical profession. At the same time, the need for a healthy work-life balance increases, especially toward graduation. The call to action: build sustainable motivation together and keep the conversation going.
What truly drives medical students, and what makes them sometimes step away? New research at Radboud university medical center reveals that student engagement is not a straight path, but a journey full of shifts, doubts, and renewed insights. Motivations change, as does their vision of the future. That’s precisely why it’s important for students and educators to stay in dialogue.
In a six-year longitudinal study, now published in Academic Medicine, researchers followed a group of ten medical students at three key moments in their education. While motivation in the early bachelor phase often stems from external stimuli, such as passing exams, it gradually shifts toward a more personal, intrinsic drive. Students increasingly connect their learning process to what they themselves find meaningful and interesting in the medical profession.
Illustration: Merel van Gils.
Work-life balance
At the same time, master’s students show a growing need for balance. Their increased engagement leads to dedication, but also raises questions about the sustainability of that commitment. One quote from a group discussion stands out: “I function better as a doctor when I have more time for myself.” Students weigh their options: does the workload of their dream job still fit the life they envision? Or might an alternative path offer more peace of mind? These considerations are often not shared with educators and remain confined to conversations among peers.
The study shows that many students prefer part-time work, manageable hours, and a varied set of tasks. Interest in general practice is increasing, partly due to the perceived opportunities for more autonomy and balance. Some students are considering a plan B: a career that may align less with their personal interests or original ambitions, but offers better working conditions.
Plan B
The researchers raise the question of how sustainable such a choice is in the long run. Does plan B truly offer peace and satisfaction, or will motivation fade there too, if it’s not nourished by personal values and joy in work? They emphasize that good self-care doesn’t necessarily come at the expense of ambition—perhaps the two can go hand in hand.
That’s why the researchers advocate for creating space throughout medical education for reflection on values, motivation, and visions of the future. Not only to prevent dropout, but also to support students in making conscious and sustainable choices. By keeping the dialogue open, we prevent talent from quietly disappearing, and create room for growth, rooted in trust and connection.
About the publication
This research was published in Academic Medicine: From Quiet Quitting to Open Dialogue in Medical Education: Longitudinal Student Perspectives on the Factors Shaping Student Engagement. Smeets, Annemieke G.J.M.; van Ede, Annelies E.; Vorstenbosch, Marc A.T.M.; van Gurp, Petra J. Academic Medicine 100(8): p. 931–939, August 2025. DOI: 10.1097/ACM.0000000000006059
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