By Andrew Wang
The fourth years counted down the days. Braced ourselves for the worst.
But nobody could have prepared us for what happened when the day came.
They packed, tight, into the common room, still excited about their day’s learning at 5pm in the afternoon. Their endless chatter of cannulas and pneumonia and heart murmurs filled what was, for a week, a space that had been solely ours.
The third years had arrived, and the common room was already theirs.
It was hard to believe that little over a year ago I was no different. Hopelessly entranced by that first set of lungs I had auscultated. And actually auscultated, free at last of the need to recite that dirty laundry list which becomes the annual mantra of the second year come OSCE season.
It is not long before their enthusiasm starts to wane. Because a sleep-in is a beautiful luxury (P<0.05) and because some meetings are better spent sleeping in than sleeping through.
Nevertheless, the liveliness of such fresh faced, stethoscope-wearing, notepad-bearing third year medical students on their first day of placement hit me with a pang of nostalgia.
Where did our excitement go?
Some days roll past in routine monotony. Monotony, punctuated by the adrenaline of an occasional MCR or mid semester exam, that shifts us into autopilot as we face just what needs to be learnt, memorised and regurgitated. Where the process of study often feels like I’ve hitched a ride on the Prochaska-DiClemente cycle and forgotten just where to hop off.
I understand that looking into the past through the rose tinted lenses of nostalgia is a dangerous thing.
But there was once a time where some lofty aspiration buoyed us through long solitary nights, straining our eyes to pick the middle of five very subtly different clipart shapes in preparation for the UMAT.
Did we ever think it would be like this? That instead of saving lives or removing appendices, we’d sometimes find ourselves trapped in a sequence of bleary eyed mornings, coming to terms with my addiction to caffeine and my propensity for procrastination. Perhaps not.
When it comes to the issue of burnout, we’ve already been given the answers. The 7 pillars of wellbeing are our commandments. The recorded lecture run at double speed in first year about stress management and the ‘E-word’ becomes more important than ever.
Go for a run, take up life drawing or marathon running; do anything to make sure your study of medicine doesn’t take over your life.
A study published in 2013, discovered via a quick Google search (without employing relevant MeSH terms and having not been critically appraised), suggests the importance of ‘intrinsic motivation’, or genuine interest, in leading to higher achievement and greater creativity in our medical studies. 
But the perfect student with an endless supply of ‘intrinsic motivation’ is few and far between. There’s a large, grey area between the intrinsically driven Hermione Granger and those spurred on by extrinsic factors, such as a desire for power or profit.
For the rest of us that fall somewhere on this continuum, our interest in medicine can be tarnished following repeated and traumatic exposure to entities such as Turnitin and the generous feedback we’re provided on our exams or OSCEs. Additionally, the emotional and physical pressures of studying medicine may result in us losing focus of our initial goals.
And there is no easy way out. Articles acknowledging the importance of motivation have made suggestions ranging from finding a mentor to witnessing the miracle of childbirth. 
But sometimes it may be the simple and small things might remind us of the passion for studying medicine when we’re being too busy being medical students. The joy of nailing your first cannula. The emotions of your patients. And even, god forbid, that fleetingly boundless enthusiasm of a bunch of rowdy third year medical students on their first day of clinical rotations.
Featured image is The Night Before the Exam by Leonid Pasternak (1935)