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Partha Kar: Is being a doctor a vocation?

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m227 (Published 03 March 2020) Cite this as: BMJ 2020;368:m227
  1. Partha Kar, consultant in diabetes and endocrinology
  1. Portsmouth Hospitals NHS Trust
  1. drparthakar{at}gmail.com
    Follow Partha on Twitter: @parthaskar

Is there some sort of higher calling to join the medical profession, or is it simply a highly skilled job? This age old debate generates more heat than light, and it’s not clear why the two need to be mutually exclusive.

Did some form of vision appear to me and drive me to be a doctor? No—I grew up in a family of doctors, in the heart of Kolkata, before the economic boom. My choice was pretty much made for me by my parents: I can’t think of a time when I didn’t want to be a doctor or thought of a different career. In the hubbub of Kolkata the job came with prestige and respect, and it was important for my parents. Plus, I grew up seeing my parents working long hours, seven days a week—yet always finding time for me and my sister, for holidays, and for everything important to family life. For me it was never a vocation, then, but more of a natural progression.

To me, being a doctor will always be a job. I trained for it, I worked long hours, and I had lots of fun along the way. I try to do it to the best of my ability. But many doctors, particularly on social media, are clear that they regard medicine as a vocation and see themselves as part of a noble profession.

This sits in stark contrast with some posts on the same forums on social media, where doctors show that they’re human beings with the same failings and weaknesses as anyone else. Doctors’ foibles are the same as those of any nurse, teacher, or pilot: all trained individuals, mostly doing their job to the best of their ability. They’re trying their best in trying circumstances—nothing more, nothing less, and no more special than anyone else.

Maybe that’s where a rethink is needed. Do we as doctors perpetuate the myth by allowing ourselves to be portrayed as selfless heroes? When doctors say that they have a vocation and are special, is it much of a surprise when people then expect you to work more for nothing? After all, it’s a vocation, right? You signed up to help others, no matter what your personal consequences, and surely a bit more isn’t a big deal. The saintly element makes any fall from “hero” status even harder.

The current issues with doctors’ pensions, or indeed with our job contracts more generally, are perhaps a crystallisation of the tension created when we think of our role as a vocation rather than a job, the two being mutually exclusive. On one hand (seeing what we do as a job), we’re rightly indignant at the tax implications; on the other (a vocation), the system either tries to find us more money or promises to review the system solely for senior medics. Is separate treatment of this sort because we’re special, indispensable, money minded, or just asking for recognition for the work done and services provided?

Perhaps we’re all better served by reminding the public that our job is tough and uncompromising—but, in the end, a job from which we need to take a break, time out, and a deep breath. Heroes rise, only to fall. It’s even worse when we self-create those myths too.

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