Twenty-nine students voluntarily joined the MBSR class and attended the first session. 62% were undergraduate (beginning, n = 4(15%); Clerkship, n = 12(41%)), 45%(n = 13) were residents (n = 13), 65% (n = 20) were women. Mean age was 25.9 years old. 3(10%) students have already meditated. Participant characteristics are shown in Table 1.

Table 1 Characteristics of 29 participants to the MBSR program

We identified three overarching themes based on views shared by students on their motivations to participate in the mindfulness-based class. These themes varied on their nature of politically correctness, as well as their personal nature. The first theme gathers motivations relevant to medical training and the professional role of the physician. The second theme gathers codes pertaining to the need to take care of one’s own health. The third theme gathers reports on searching meaning in medical practice and life in general. Themes and subthemes are summarized in Fig. 1. A detailed account of codes is available in Appendix 2.

Fig. 1

Themes and subthemes of the analyses of medical students’ motivation to participate in a MBSR class

Medical education and physician’s role

First, participants reported motivations related to medical education in line with their commitment to their studies. Participants wished to improve their skills. Within this theme, we were able to identify four subthemes.

Improving interpersonal skills

Participants expressed a need to develop interpersonal skills allowing them to develop more meaningful relationships with their patients. They mentioned the lack of resources related to the communication skills they had access previously, before engaging in the MBSR program.

“I thought I liked being in a relationship, a real relationship with the patients and the people we were talking to(E7)”.

“I hope to be able to find the right words a little more and to have a sympathetic ear(E24)”.

They wanted to learn how to develop a relationship being more centered on the patient’s needs. At the same time, they wished to acquire skills allowing them to step back from the overwhelming emotions they reported in the healthcare relationship. Some shared experiences of conflict, unpleasantness, or emotional contagion during care. The need to better control one’s own emotion, such as aggressiveness or emotional variability, was also underlined.

“Why I’m really really here, I thought it might teach me to understand my emotions(E4)”.

Learning complementary skills oriented towards a more integrative medicine

Some participants would like to learn more holistic dimensions of care. They wished to participate in the MBSR program to learn about meditation as an element of a more integrative medicine that takes into account the body-mind connection. They also emphasized the desire to integrate meditation into their care activities, and therefore the need for training.

“I like to test everything I offer my patients so I find it interesting to know what we’re talking about, so that was the primary reason(E21)”.

Attracted by an other educational approach

Some participants reported the too theoretical, perhaps too serious learning methods they experienced in their medical studies. Attending such a program seemed also a way to enjoy a new experiential learning experience. They wished to experience joy, desire, and enthusiasm and discover a new activity.

“So there you go, as I was saying to M…, I was excited to do this (laughs)(E1)”.

They also reported the desire to be in a group and learn with and from others. Indeed, they looked for group training, insisting on fostering social bonds.

“I wanted to __ not just to learn something but that __ or to learn things but to learn different things and that __for example we have time for exchanges. Finally, to have a__ a different pedagogy and to study in a way that is perhaps a little more interesting” (E11)”.

Being more productive

Finally, participants mentioned aspects of productivity in one’s work. Medical students expected to improve their performance. Indeed, with humor and authenticity, some of them underlined their need to get better in order to be more productive. The challenge of medica studies and the competition was evoked, and some reported doubts to be able to do it. Meditation training could then represent a mean to enhance personal productivity.

“and actually what I was really interested in was the productivity (laughs) (…) __ I don’t know. I thought you’re able to multitask and be a better doctor(E5)”.

Caring for my health

If the motivation turned towards others, echoing their function as future doctors, was often the first one mentioned by students, the motivation turned towards their own health was also rapidly put forward. Respondents produced a higher quantity of verbal material relating to this theme. It includes three sub themes: stress reduction and well-being improvement, taking time for oneself, and improving self-compassion.

Stress reduction, emotion regulation and well-being improvement

Participants reported being motivated by stress reduction. They spoke about their anxiety and reported sometimes it had a strong impact on their daily life. Fatigue, lack of sleep or concentration issues were mentioned as elements related to stress, they wished to mitigate with mindfulness practice.

“I told myself that I was also doing it for myself. Because I realized not long ago that when it’s time to go to sleep, well, for me it’s more of an ordeal than anything else. And so I don’t sleep much and so I want to live it as a good moment and sleep well like everybody else. Yeah, to spend some good moments alone with myself(E26)”.

Participants also mentioned the difficulty managing emotions, as an element often invading and impacting the quality of life but also the care relationship.

I wanted to be able to better manage my emotions, to better take stock of them in order to be able to finally (speeding up of the voice) better take care of the patients(E3)”.

At this stage of the program, they evoked the reciprocal link between their health and their role as caregiver. Participants spontaneously linked their responsibility to take care of themselves with their duty to take care of their patient.

“If I can understand myself better, I can understand my patients better (E27)”.

Take time for oneself

Another element of motivation seems to be simply the need to take some time without having a specific goal. Thus, enjoying time during the week to do something for themselves seemed to be an important motivator. Again, they recall the intense academic routine and a need to slow down. Participants expressed their wish to cultivate another relation with time, learn to anticipate less, and live more intensely in the present moment.

“to take the time to do things more slowly, to settle down, not to chain actions, thinking about what we were going to do afterwards etc. That’s what came to me first (E1)”.

Improving self-compassion

Taking care of oneself was evoked by some participants as an act of love, tenderness, and friendship. The evocation of this motivation emerged as a “surprising” need, giving way to emotions underlined in the non-verbal language “voice trembling(E28)”. In response to the demanding nature of medical education, participants spoke of the need to learn to be more tolerant toward themselves. They thus reported a need to cultivate self-compassion. Some of the students had already been exposed to mindfulness practice and knew they would find in meditation.

“… a moment where I find I can allow myself to feel love for myself, it feels good(E28)”.

A quest for meaning

The content of the last theme underlies both previously presented themes, namely the care of self and others. This theme describes the need to find a greater engagement to continue learning, living, and caring along the medical studies and career. To train in mindfulness would support this quest, provide meaning to care and to life in general.

Cultivate mindfulness

In fact, many students had already heard of meditation, sometimes even had been meditating through yoga or other mind-body practices such as apps. They expressed a wish to deepen and pursue their experience. The desire to continue and integrate this practice into daily life as is proposed in MBSR practice was important.

“Because I knew that I had done meditation before and it felt good and I wanted to include it in my life in general and I couldn’t do it on my own so__ having some help is good(E9)”.

Meaning of care

Through this quest for meaning, the quest for the meaning of the nursing profession is put forward. Indeed, as if the motivation to be there was to find an answer to the fundamental question of why I become a doctor, and how I wish to heal?

I also wonder if the fact that I take care of others is not purely selfish, to avoid thinking about myself. And so I want to help others because I want to help them and not only to escape from my head to head with myself(E27).

I’ve always had a goal, always succeeded, to do this, that, that, so I move forward with a goal every time I’m given one and in fact I’m coming to the end of my studies... And so I think it’s important to sit down and say to myself what I want(E22).

Meaning of life

For others, the questions raised were even more profound and dealt with the meaning of life itself. Participants mentioned a need to enrich their spiritual life. It seemed that in mindfulness practice they wished to develop a form of secular spirituality. They made connections between concrete aspects of training and some religious activities: using silence, fostering community, and developing goodness and non-judgment, and underlined their desire to cultivate it outside religion.

“This question of doing actions that are right; so a need to have this guidance to really help me(E26)”.

“I heard the word conviction that spoke to me, it’s more, I know it a little bit from experience that it feels good and there was a kind of certainty actually that surprised me(E26)”.