A winding road representing medical school, with lanterns symbolizing student motivation.

Med School Motivation Crisis: Why Students Lose Steam (and How to Reignite It)

Soraya Malik in Mind & Education August 2025 • 4 min read.

"Discover the surprising motivation slumps in medical school, and learn strategies to help students stay driven and avoid burnout."

The journey through medical school is often portrayed as a relentless pursuit of knowledge and skill, fueled by an unwavering passion for healing. However, the reality for many students is a rollercoaster of motivation, with peaks of excitement and valleys of disillusionment. Understanding these motivational shifts is crucial for educators and students alike, paving the way for strategies that keep the flame of passion burning bright.

Motivation is the engine that drives effective learning, high-quality study habits, and overall well-being in medical education. Highly motivated students typically demonstrate better performance and are more likely to develop into competent and compassionate professionals. But what happens when that initial spark begins to fade?

New research sheds light on the changing levels of student motivation throughout medical school, pinpointing specific phases where enthusiasm wanes and offering insights into how to combat this decline. By understanding these trends, medical schools can implement targeted interventions to foster a more engaging and supportive learning environment.

The Motivation Rollercoaster: Mapping the Highs and Lows

A winding road representing medical school, with lanterns symbolizing student motivation.

A recent study published in the Revista da Associação Médica Brasileira investigated the motivation levels of 710 medical students at a Brazilian public university. The researchers used the Academic Motivation Scale (AMS) to assess different types of motivation—from intrinsic (enjoyment of learning) to extrinsic (pursuit of rewards) and even amotivation (lack of purpose).

The study revealed a fascinating trend: motivation levels fluctuate significantly depending on where students are in their medical education.

Preclinical Years (1st-2nd year): Students in this phase reported higher levels of integrated regulation (seeing education as a privilege), introjected regulation (feeling obligated to meet expectations), and intrinsic motivation (finding school a pleasure).
Clinical Years (3rd-4th year): A shift occurred during the clinical years, with students showing increased amotivation (feeling like they're wasting time) and external regulation (focusing on earning a degree).
Clerkship Years (5th-6th year): Compared to preclinical students, clerkship students had differing levels of external, introjected, and integrated regulation.
The Start vs. The Finish: Incoming students began with higher levels of integrated regulation and lower levels of amotivation and external regulation compared to those nearing graduation.

These findings suggest that the initial enthusiasm that propels students into medical school can wane as they progress through their studies, highlighting the need for interventions to sustain motivation.

Reigniting the Flame: Strategies for Sustaining Motivation

The study underscores the importance of addressing motivational changes throughout medical school. By understanding the specific challenges students face at each phase, educators can tailor their approaches to create a more supportive and engaging learning environment, ultimately fostering a new generation of passionate and dedicated healthcare professionals.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1590/1806-9282.64.10.902, Alternate LINK

Title: Comparison Of Students’ Motivation At Different Phases Of Medical School

Subject: General Medicine

Journal: Revista da Associação Médica Brasileira

Publisher: FapUNIFESP (SciELO)

Authors: Gabriel Mendes Corrêa Da Silva, Amanda Ribeiro Borges, Oscarina Da Silva Ezequiel, Alessandra Lamas Granero Lucchetti, Giancarlo Lucchetti

Published: 2018-10-01

Everything You Need To Know

What is the Academic Motivation Scale (AMS) and how was it used in the study?

The Academic Motivation Scale (AMS) is a tool used to assess different types of motivation in students. The study used the AMS to evaluate the motivation levels of 710 medical students at a Brazilian public university. The AMS helped researchers differentiate between intrinsic motivation (enjoyment of learning), extrinsic motivation (pursuit of rewards), and amotivation (lack of purpose), providing a detailed view of the students' motivational states throughout their medical education.

How does motivation change from the Preclinical Years to the Clinical Years in medical school?

During the Preclinical Years (1st-2nd year), students reported higher levels of integrated regulation, introjected regulation, and intrinsic motivation. In contrast, the Clinical Years (3rd-4th year) saw a shift. Students in this phase showed increased amotivation and external regulation. This suggests that the initial enjoyment and sense of privilege can diminish as students progress, replaced by feelings of obligation and a focus on external rewards like earning a degree.

What is the difference between intrinsic and extrinsic motivation in the context of medical school?

In medical school, intrinsic motivation refers to the enjoyment of learning and the inherent satisfaction students get from studying medicine. Extrinsic motivation, on the other hand, involves pursuing rewards or avoiding punishments, such as earning a degree or meeting external expectations. The study highlights the shift from intrinsic to extrinsic motivation as students progress, which can impact their overall engagement and well-being.

What were the key differences in motivation between incoming students and those nearing graduation, according to the study?

Incoming students began with higher levels of integrated regulation and lower levels of amotivation and external regulation compared to those nearing graduation. This contrast highlights the erosion of initial enthusiasm. The study suggests that strategies are needed to help students maintain a strong sense of purpose and enjoyment throughout their medical education, counteracting the trend towards decreased motivation as they approach the end of their studies.

Why is it important to understand the changes in motivation throughout medical school, and what can be done about it?

Understanding the shifts in motivation throughout medical school is crucial because motivation drives effective learning, study habits, and overall well-being. By recognizing specific phases where enthusiasm wanes, educators can tailor interventions to create a more supportive and engaging learning environment. This could include strategies to reignite intrinsic motivation, foster a sense of purpose, and address the challenges that contribute to amotivation and a reliance on external rewards. The goal is to cultivate a new generation of passionate and dedicated healthcare professionals.