A comment published in The Lancet in June 2026, awarded the Wakley–Wu Lien Teh Prize, poses two deceptively simple questions: why do people choose medicine, and why do they remain in it? The essay, written in the tradition of the prize, does not treat these as abstract philosophical puzzles. Instead, it frames them as questions with immediate, practical weight for newly qualified doctors navigating the realities of clinical life.
The Lived Experience of Early-Career Medicine
The essay draws attention to the conditions that define the early years of medical practice—long working hours, persistent uncertainty, and the weight of clinical responsibility. These are not presented as incidental features of the job but as central to understanding why the question of commitment arises at all. For those entering the profession, the gap between the ideals that drew them to medicine and the day-to-day demands of the work can be considerable.
The piece does not offer a single answer to why people enter medicine, nor does it claim that any one factor sustains them. Rather, it situates the question within a broader interrogation of what the profession has become—and what it asks of those who are newest to it.
A Challenge to Modern Medical Professionalism
Central to the essay's argument is a pointed quotation, cited from a prior source, that challenges the adequacy of contemporary thinking about medical professionalism:
Our modern vision for 21st-century medical professionalism meant little if we were ignoring the circumstances and feelings of these newly qualified colleagues. What kind of profession had we created?
The citation, attributed with a footnote in the original text, functions as more than rhetorical flourish. It signals a concern that formal frameworks for professional identity and conduct may be poorly matched to the actual experience of those entering the field. If the profession's self-image does not account for what early-career doctors feel and face, the essay implies, that image is incomplete at best.
Why the Questions Matter
The framing of the essay—why medicine, and why stay?—reflects a recognition that entry into the profession and sustained engagement with it are distinct phenomena. Choosing medicine involves a set of motivations formed before clinical training begins. Remaining in medicine, by contrast, is a decision that is tested repeatedly against the realities of the work itself.
The essay, as published in The Lancet, does not resolve this tension so much as name it. By foregrounding the circumstances and feelings of newly qualified colleagues, it argues implicitly that any serious account of medical professionalism must begin there—with the people doing the work, under the conditions in which they actually do it.
The Prize and Its Context
The Wakley–Wu Lien Teh Prize Essay is a recognised feature of The Lancet's publishing programme. The 2026 winning essay appears as a Comment in the journal, a format typically reserved for opinion and analysis that engages directly with questions of policy, practice, or professional life. Its publication signals that the questions it raises—about motivation, commitment, and the shape of modern medical culture—are considered timely and substantive by the journal's editors.
The essay does not present new empirical data. Its contribution is analytical and reflective, drawing on the author's engagement with the experience of early-career doctors to ask whether the profession is attending adequately to those it is training and retaining. In that sense, it functions as a form of professional self-examination, conducted in public and addressed to a readership of clinicians, educators, and policymakers.
Whether the questions it raises prompt broader discussion within medical institutions remains to be seen. The essay, as it stands, is a contribution to an ongoing conversation about what medicine demands of its practitioners—and what, in turn, it owes them.