Religion, sense of calling, and the practice of medicine: findings from a national survey of primary care physicians and psychiatrists.

The notion of a “sense of calling” has been attracting increasing empirical and theological interest, with calling increasingly recognized as an intrinsic motivating factor that can help medical students and physicians sustain meaning and purpose in their work. Those who view work more as a calling than as a job tend to ascribe intrinsic or transcendent purpose and life meaning through their work.1–3 A few studies have found that seeking meaning in one’s work may be the key mediating variable in the relation between a sense of calling and work satisfaction; researchers in the fields of work motivation and positive psychology have found calling to be positively associated with measures of professional well-being, including work satisfaction, commitment, and performance.4,5 Studies of medical students have found that students who endorsed a stronger sense of calling were more likely to express an interest in primary care6 and endorse a higher commitment to their specialty.7 Few studies, however, have explored the issue of a calling among practicing US physicians. One study of primary care physicians (PCPs) found an association between a sense of calling and experiencing satisfaction treating smoking, alcoholism, and obesity.8 Another study of practicing US physicians across various specialties, however, found no significant association between a sense of calling and practicing among underserved populations, although the latter study did find that physicians who considered themselves religious were more likely to view their practice of medicine as a calling.9 The notion of a calling shares the same Latin root as the word vocation (“voco, vocare, vocatus”), meaning “to summon, to call, to name, to call upon, to invite, to challenge.”10 In early Christianity, “calling” was used to describe a decision initiated by God, referring primarily to the calling one would receive to enter the ministry or religious work. In the 16th century, the idea of vocation or calling was explicitly extended from the clergy to all people,11 as the Protestant reformers Martin Luther and John Calvin began attaching more spiritual significance to “earthly” work.12 The concept of calling has evolved into a broader reference to any strong sense of purpose that keeps motivation alive; nourishes a proper sense of self-fulfillment; and enables one to work with a vision, namely that the impact of one’s work extends beyond the individual realm to benefit others, society, or a transcendent figure.13 Qualitative research has further specified a sense of calling as either a guiding force (eg, God’s will, a driving feeling), a sense of personal fit (eg, ability, personal enjoyment), or altruistic motivation.14 Most research, however, leaves the definition of calling open to interpretation by the individual. The present study did not specify calling as a specifically religious concept, despite its religious and theological roots. Even so, we hypothesized that physicians who considered themselves religious would endorse a stronger sense of calling to their work than physicians who did not consider themselves religious, suggesting that the concept has particular resonance for those who are religious, even though “calling” is a familiar concept across diverse moral communities. In the present study, we examined the association between religion and calling among a national sample of practicing PCPs and psychiatrists.