Motivações da escolha da profissão médica e suas repercurssões na saúde mental: uma revisão integrativa

Abstract

Introduction: The choice of a medical career is influenced by several factors, such as vocation, family influence, financial stability and social prestige. However, this decision can also have significant impacts on students' mental health, such as stress, anxiety and depression. The high workload, academic pressure and professional expectations contribute to this scenario. Understanding the motivations for choosing a medical career and its consequences is essential to guide educational and health policies. Thus, the research sought to synthesize the available evidence on this topic. Objectives: To conduct an integrative review of the scientific literature on the motivations that influence the choice of a medical career, analyze its impacts on the mental health of those involved, and investigate the individual, social and academic factors associated with this choice. Methods: An integrative review of the literature was conducted using the BVS, PubMed, Web of Science, Embase and Cochrane databases, using descriptors that addressed the choice of profession, medical school and mental health. The selection of studies was performed by two researchers independently and blindly using the online software Rayyan. Information on the type of study, population, instruments used, and main conclusions were extracted. Intrinsic motivations, such as vocation and desire to help, and extrinsic motivations, such as financial stability and social status, were investigated. Results: A total of 1,591 articles were identified, of which 28 were selected for analysis. Most of the studies included were cross-sectional, with populations composed of medical students in different periods of graduation. The main motivational factors for choosing a career were altruism and family influence, assessed by questionnaires and interviews. Regarding the impacts on mental health, 19 studies investigated symptoms such as anxiety, depression, insomnia, and burnout, using specific scales. The analysis of the influence of gender showed an increase in female participation in medicine and the challenges faced, such as balancing professional and personal life. The COVID-19 pandemic has changed perceptions about the profession, increasing altruistic interest, but also stress and academic dropout. Some studies have reported that idealizations about a career can lead to frustration, affecting students' mental health. Intense workloads and academic pressure have been associated with high levels of anxiety, depression, and burnout. It has been found that a competitive environment can aggravate emotional problems, and psychological support is essential to help students deal with these challenges. Conclusions: Motivations for choosing a medical career are influenced by a series of complex and interrelated personal, social, and academic factors, such as altruism, the perception of medicine as a stable and financially rewarding career, and the desire to make a difference in people's lives. Extrinsic factors, such as the search for social status, financial security, and family influences, and previous experience with the medical environment through volunteer work, internships, or even personal experiences, have also been described. The impacts of this choice can affect the mental health of these students. This study reinforces the need for institutional strategies to ensure a healthier academic path. The great methodological diversity, covering different populations and countries, makes generalized conclusions difficult and suggests the need for studies involving different populations.