After leaving bedside medicine, my life became less stressful and more enjoyable, but something was missing: I longed for the mental stimulation, discipline, and physical exhaustion following a harrowing day of taking care of sick patients. 

I’ve been a runner my entire life, but I only started running marathons and ultramarathons once I left my job. I craved a passion that was physically exhausting and required constant rigor and discipline—something that could fill the new gap in my life—and I found it in training for long-distance races.

 

Why we're endurance junkies

 

Long-distance training has set a new standard for what my mind and body can do. I can endure endless miles, horrendous weather, painful blisters, and almost constant discomfort. You learn to “embrace the suck,” one step at a time.

I believe the amount of time, commitment, and discipline it takes to be an endurance runner or cyclist is akin to what it takes to be a good physician.

The volume of information you must absorb and retain during the early years of medical school is astronomical. I believe the long nights studying, the grueling hours of residency, the physical exhaustion from being on your feet all day, and the stamina required to navigate the mental and emotional trauma that can come with caring for patients parallels training for a marathon.

A study on the psychology of ultramarathoner runners revealed that the most critical factor motivating them to run, to push beyond their limits, was the desire to achieve personal goals.

Roebuck GS, Fitzgerald PB, Urquhart DM, et al. The psychology of ultra-marathon runners: a systematic review. Psychol Sport Exercise. 2018:37:43–58.

 

 

 

We have always pushed ourselves physically and mentally, all in the name of career success and personal fulfillment. We have no choice—it’s just part of what it means to pursue a career as a physician.

Like ultrarunners, we must demand the most out of ourselves, physically and mentally, to do the job right.

However, it’s not a totally selfless pursuit.

 

We 'earn' our dopamine

 

“Earned dopamine” refers to obtaining dopamine through effort—anything that requires time, patience, sacrifice, and energy that cannot be bought or derived from substances. 

Effortful rewards such as career advancement (being a physician) and personal fitness (endurance running) that encourage ongoing learning and personal growth are healthy ways to “earn” dopamine. 

 

Here are some other similarities between endurance athletes and physicians:

We hit plateaus or walls

Training for endurance races means, at some point, you’ll hit a plateau. Even when it feels like you’ve given it your all, you’ll have to keep going and dig deep to work through the psychological and physical exhaustion. 

In medicine, we also hit plateaus. We are faced with challenging cases where we need to think “outside the box,” go back to the drawing board, and consult other specialists; we have to push through long surgeries or overnight shifts, and find ways to manage the emotional effects of being faced with death and dying.

Endurance athletes and physicians are problem solvers; we have no choice but to figure out how to get to the other side.

We’re obsessed with numbers

For runners, numbers are everything—the number of miles and calories consumed, our split times and pace. For physicians, numbers are just as important. Our GPA and class rank in medical school, our board scores, our patient’s lab results, patient satisfaction scores, RVUs—the list goes on. 

As much as we may not realize it, endurance athletes and physicians are always focused on numbers; they are our bottom line.

 

Being a role model for our patients

 

At the end of the day, physicians who are active themselves have more of an impact on patients when providing education and feedback on the importance of being physically active.

Lobelo F, de Quevedo IG. The evidence in support of physicians and health care providers as physical activity role models. Am J Lifestyle Med. 2016 Jan;10(1):36–52.

 

Research has also shown that these physicians feel more confident in having conversations about the importance of physical activity, while having a better understanding of its impact to their patients’ mental well-being.

Lee AK, Muhamad RB, Tan VPS. Physically active primary care physicians consult more on physical activity and exercise for patients: a public teaching-hospital study. Sports Med Health Sci. 2024;6(1):82–88.

 

 

Ultimately, the joy derived from both crossing the finish line of a marathon and positively impacting patients' lives underscores the profound connections between endurance athletes and those who become physicians.