The Calling‐Cost Paradox: When Identity‐Driven Motivation Becomes a Risk in Medical Training.
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| Title: | The Calling‐Cost Paradox: When Identity‐Driven Motivation Becomes a Risk in Medical Training. |
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| Authors: | Neufeld, Adam1 (AUTHOR) adam.neufeld@ucalgary.ca |
| Source: | Clinical Teacher. Oct2025, Vol. 22 Issue 5, p1-4. 4p. |
| Subject Terms: | *Psychological burnout, *Motivation (Psychology), *Intrinsic motivation, *Medical personnel training, Self-determination theory, Social support |
| Abstract: | Physicians are often fueled by more than external rewards or professional mastery; many experience a deeply internalised sense that being a doctor is central to who they are. Self‐determination theory (SDT) labels this identity‐level drive 'integrated regulation'—a form of autonomous motivation typically viewed as protective and performance‐enhancing. This viewpoint introduces the Calling‐Cost Paradox: the proposition that the very physicians and trainees who appear most autonomously motivated may be uniquely vulnerable to burnout when learning and practice environments lack clear boundaries, reciprocal support, or psychologically need‐nurturing cultures. Drawing on empirical work in motivational profiling, need‐sacrifice and work–family conflict, as well as the author's dual perspective as an SDT scholar and practicing family physician, this article traces how integrated motivation can blur boundaries, amplify perfectionistic norms and lead high performers to self‐sacrificial overextension. It argues that simply moving learners along the SDT continuum is insufficient. Medical programmes must also implement structural safeguards, such as duty‐hour limits, reflective mentoring, team‐based scheduling and boundary‐setting norms, to 'protect the purposeful.' By naming and unpacking the Calling‐Cost Paradox, this paper invites further research and urges educators to recognise that high engagement does not necessarily equate to low risk. [ABSTRACT FROM AUTHOR] |
| Copyright of Clinical Teacher is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Education Research Complete |
| FullText | Text: Availability: 0 |
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| Header | DbId: ehh DbLabel: Education Research Complete An: 188120951 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: The Calling‐Cost Paradox: When Identity‐Driven Motivation Becomes a Risk in Medical Training. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Neufeld%2C+Adam%22">Neufeld, Adam</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> adam.neufeld@ucalgary.ca</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Clinical+Teacher%22">Clinical Teacher</searchLink>. Oct2025, Vol. 22 Issue 5, p1-4. 4p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22Psychological+burnout%22">Psychological burnout</searchLink><br />*<searchLink fieldCode="DE" term="%22Motivation+%28Psychology%29%22">Motivation (Psychology)</searchLink><br />*<searchLink fieldCode="DE" term="%22Intrinsic+motivation%22">Intrinsic motivation</searchLink><br />*<searchLink fieldCode="DE" term="%22Medical+personnel+training%22">Medical personnel training</searchLink><br /><searchLink fieldCode="DE" term="%22Self-determination+theory%22">Self-determination theory</searchLink><br /><searchLink fieldCode="DE" term="%22Social+support%22">Social support</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Physicians are often fueled by more than external rewards or professional mastery; many experience a deeply internalised sense that being a doctor is central to who they are. Self‐determination theory (SDT) labels this identity‐level drive 'integrated regulation'—a form of autonomous motivation typically viewed as protective and performance‐enhancing. This viewpoint introduces the Calling‐Cost Paradox: the proposition that the very physicians and trainees who appear most autonomously motivated may be uniquely vulnerable to burnout when learning and practice environments lack clear boundaries, reciprocal support, or psychologically need‐nurturing cultures. Drawing on empirical work in motivational profiling, need‐sacrifice and work–family conflict, as well as the author's dual perspective as an SDT scholar and practicing family physician, this article traces how integrated motivation can blur boundaries, amplify perfectionistic norms and lead high performers to self‐sacrificial overextension. It argues that simply moving learners along the SDT continuum is insufficient. Medical programmes must also implement structural safeguards, such as duty‐hour limits, reflective mentoring, team‐based scheduling and boundary‐setting norms, to 'protect the purposeful.' By naming and unpacking the Calling‐Cost Paradox, this paper invites further research and urges educators to recognise that high engagement does not necessarily equate to low risk. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Clinical Teacher is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/tct.70187 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 4 StartPage: 1 Subjects: – SubjectFull: Psychological burnout Type: general – SubjectFull: Motivation (Psychology) Type: general – SubjectFull: Intrinsic motivation Type: general – SubjectFull: Medical personnel training Type: general – SubjectFull: Self-determination theory Type: general – SubjectFull: Social support Type: general Titles: – TitleFull: The Calling‐Cost Paradox: When Identity‐Driven Motivation Becomes a Risk in Medical Training. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Neufeld, Adam IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Text: Oct2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 17434971 Numbering: – Type: volume Value: 22 – Type: issue Value: 5 Titles: – TitleFull: Clinical Teacher Type: main |
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