Articles and Case Studies

Finding your niche in medicine

30 Sep 2022

Dr Lily Vrtik

by Dr Lily Vrtik

koi fish

Ikigai was my first step in creating a career map for myself. It didn’t give me specific answers, but it helped me rediscover the meaning in my work and guided me in finding my niche.

There were times during my surgical training when I developed doubts as to whether I was on the right career path. I wondered if surgery was really for me, or vice versa. That seed of doubt sprouted again later in my career. I had lost my direction and questioned myself as to whether I enjoyed my work. That was when I came across ‘Ikigai’.

The concept of Ikigai

For those who aren’t familiar with Ikigai, it literally means ‘a reason for living.’ It’s a principle practised in Okinawa – where the world’s longest-living people reside – a way of achieving a longer and more fulfilled life. I decided to apply this concept to one specific part of my life: medicine. And to see if I too could prolong and enjoy my medical career.

The key to finding Ikigai in one’s career is to find the right balance between interests, remuneration, skills and ego. The perfect balance will change a ‘Job’ (something one turns up for because one gets paid) into a ‘Niche’ (a comfortable or suitable position in life and employment).

The search for answers

We often search for answers throughout our medical career, amongst many other self-finding conundrums:

  • What do I want to do?
  • What would I like to specialise or sub-specialise in?
  • What do I not want to do?
  • What level of income and wealth would I want to achieve?
  • What interests and reputation would I like to establish?

Personal attributes to help with Ikigai

Obviously, in preparation for finding an answer, we need adequate exposure to the options of our individual interests, through avenues available during the early years of medical studies and training. However, personal maturity with insight is paramount in being able to use the Ikigai model with meaning.

It’s essential for one to be truly honest with one’s own feelings, desires, weaknesses and ambitions to be able to negotiate an authentic decision-making process. Being truthful can be a difficult and emotional process. It takes courage to admit to one’s own limitations in capabilities, personality and life circumstances. To recognise them when making life-choices also requires utmost maturity.

Other personal criteria important in seeking Ikigai

  • Satisfaction of various desires including ego, fulfilment, joy, wealth and any others: The priority and quantity of these desires are unique to each individual.
  • Positive encounters with others: It’s through positive experiences that we form ambitions and find out what makes us happy.
  • Realisation in the value of our own lives: It’s only when we value our own physical and psychological wellbeing that we’re able to acknowledge the importance of the choices we make.
  • A life with love and happiness: This is essential to foster self-realisation. Without unconditional love from others and experiences of true happiness, we won’t develop enough inner strength to satisfy our own Ikigai; instead, we will be enticed to fulfilling another’s agenda in exchange for external validation.

Ask yourself some practical questions

Once armoured with all of the above attributes, it’s time to ask yourself some practical questions.

Consider the four contributors to Ikigai – the four circles in the diagram below:

  1.   What are the things you’d love to do in your career?
  2.   What are the things you’re good at?
  3.   What are the things in your career which you’re well remunerated for?
  4.   What medical services are in demand in the current market and community?

By filling each circle, it becomes clearer as to what aspects of your career will fulfil different components of Ikigai – Passion, Mission, Profession and Vocation.


Exclusivity of one circle can also result in a negative impact, such as uselessness, uncertainty (self-doubt), emptiness and lack of wealth – reiterating that satisfaction of various desires is essential to achieve this fine balance.

It’s only when all components are fulfilled that you’re able to find Ikigai and develop your specific niche in medicine. This is an anchoring concept that may help you find purpose and direction in your work, prolonging an enjoyable career.

Dr Lily Vrtik (MDA National member)
Plastic & Reconstructive Surgeon

Anaesthesia, Dermatology, Emergency Medicine, General Practice, Intensive Care Medicine, Obstetrics and Gynaecology, Ophthalmology, Pathology, Practice Manager Or Owner, Psychiatry, Radiology, Sports Medicine, Surgery, Physician, Geriatric Medicine, Cardiology, Plastic And Reconstructive Surgery, Radiation Oncology, Paediatrics, Independent Medical Assessor - IME


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