Motivational State of Japanese Medical Students at the Time of Admission and Factors Influencing Intrinsic Motivation: a Cross-sectional Study

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold>Medical schools should select students with clear intentions to become doctors because motivated students are better pupils and become better doctors. However, there are no studies directly asking medical students whether they intend to become doctors at the time of medical school admission. The aim of this study was to explore the motivational aspirations of medical students and the factors impacting motivation upon entering medical school.<jats:bold>Methods</jats:bold>We conducted a cross-sectional study at a Japanese national medical school from April 2019 to March 2021. We used a questionnaire asking medical students whether they had clear intentions to become doctors when applying to medical school. Students who answered affirmatively were classified as “intrinsically motivated,” whereas those without this intention were classified as “extrinsically motivated.” We compared these two groups and analyzed the factors influencing intrinsic motivation with multinomial logistic regression analysis.<jats:bold>Results</jats:bold>Out of 531 medical students who completed the questionnaire, 378 (71.2%) had clear intentions to become doctors at the time of admission (intrinsically motivated), and the remaining students did not (extrinsically motivated). Factors influencing intrinsically motivated students were doctors in the students’ family other than their parents (OR = 1.645, <jats:italic>P </jats:italic>= 0.041), doctors as role models (OR = 2.836, <jats:italic>P </jats:italic>< 0.001), and having the personality characteristic of empathy (OR = 1.940, <jats:italic>P </jats:italic>= 0.008). Parental (OR = 0.391, <jats:italic>P </jats:italic>< 0.001) and peer (OR = 0.284, <jats:italic>P </jats:italic>= 0.008) influences on their career choice had negative effects on intrinsic motivation.<jats:bold>Conclusions</jats:bold>This study revealed that not all medical students intended to become doctors upon entering medical school, and their motivational status and reasons for being motivated varied. In conducting motivational research on medical students, it may be necessary to keep in mind that the target students who aspire to become doctors are not necessarily a homogenous group. These findings may lay the groundwork for additional medical student motivational research. Additional research on motivation after admission through prospective surveys and developing curricula based on motivation should also be studied in the future.</jats:p>