Abstract
Physician burnout remains a pervasive challenge in medical education, with significant implications for both physician well-being and the quality and safety of patient care. Despite growing awareness and interventions, medical educators often lack a cohesive theoretical framework that explains how learning environments can contribute to both burnout and clinical performance. This article highlights Self-Determination Theory (SDT) as a robust, evidence-based lens through which to understand and address these challenges by emphasizing the fulfillment of three basic psychological needs: autonomy, competence, and relatedness. Drawing on foundational and contemporary research across health professions education and healthcare, the authors argue that supporting these needs within clinical learning environments not only enhances learner motivation, engagement, and resilience, but also reduces burnout and its downstream effects on empathy, decision-making, teamwork, and patient outcomes. The authors recommend integrating SDT principles into the structure of medical training through curricular design, assessment strategies, faculty development, and institutional policies that support high-quality motivation. They propose that psychological need support should be regarded as a patient best practice and position SDT not only as a wellness framework, but as a clinical quality framework for strengthening learner development, reducing harm, and promoting safe, compassionate, and effective care. Ongoing research, collaboration, and faculty development will be essential to advancing this work across medical education systems.