86 – Embracing Yarigai: Achieving Fulfilment at Work with Professor Hiroshi Nishigori

What makes work fulfilling?

For some, work becomes a lifelong dedication. While it may seem extraordinary to others, discovering work that holds meaning transforms it from mere labour into a profound sense of purpose, invoking a feeling of yarigai.

In this episode of the Ikigai Podcast, Nick discusses with Professor Hiroshi Nishigori how individuals can uncover meaning and fulfilment in their professional lives.

Podcast Highlights

Hiroshi Nishigori

Hiroshi Nishigori

Professor Hiroshi Nishigori graduated from Nagoya University School of Medicine in 1998 and became a Fellow of the Japanese Society of Internal Medicine (2004) and a Diplomate in Primary Care of the Japan Primary Care Association (2011). He obtained a Master’s Degree in Medical Education from the University of Dundee in 2008 and completed PhD in Health Professions Education at Maastricht University in 2020. 

His research interests include culture and medical professionalism (especially work ethic), Hypothesis-Driven Physical Examination (HDPE), and teaching and assessing behavioural and social sciences. He is working as an editor of the Journal of Medical Education Japan and a core member of the Asian Pacific Medical Education Network (APME-Net).

Writing a paper on yarigai

Hiroshi recently published a paper titled 'Exploring yarigai: The meaning of working as a physician in teaching medical professionalism.' When he was a PhD student at Nagoya University’s Graduate School of Medicine, Hiroshi had the opportunity to visit the UK as a research fellow. During his time there, he observed significant differences between Japanese and British doctors, notably that Japanese doctors tend to work longer hours.

Intrigued by the dedication of Japanese doctors to their work, Hiroshi realised that they find their work particularly worthwhile—an idea encapsulated by the concept of yarigai. This sparked his research interest in yarigai, leading him to decide to write a research paper focused on this concept.

Delving into yarigai

In his paper, Hiroshi defined yarigai as the fulfilment and sense of satisfaction that comes from intrinsic motivation derived from engaging in meaningful work. When individuals find yarigai, work becomes more than just a means of earning a living; it becomes a source of fulfilment, personal growth, and a way to contribute to something greater than themselves.

Why doctors work for their patients

Hiroshi has long been interested in why doctors work for patients and believes that the concept of yarigai offers the best theoretical framework for exploring this question. He aims to uncover what doctors gain from working directly for their patients beyond monetary compensation—what intrinsic value they derive from their work. 

This exploration is particularly relevant today, as many doctors experience burnout. Understanding yarigai may help them find greater satisfaction and meaning in their profession.

“One aspect of yarigai and ikigai is the idea of overcoming a challenge or going through some tension to achieve a goal. So in some ways, working hard and having some stress gives us that sense of fulfilment, because it's challenging, and we're using our skills to the best of our abilities. But if we do that too often, and too intensely, then it becomes a problem and we burn out and maybe we start getting mental health issues. So there's a balance that we need to find and maintain.” - Nicholas Kemp

Overcome Challenges

Methods used for the study

To examine the question of why doctors work for patients, Hiroshi selected interviewees recognized for their commitment to patient-centred care and their demonstrated yarigai in treating patients. He employed narrative inquiry as his methodology, a qualitative approach frequently used in healthcare professions, education, and research.

Difference between yarigai and Ikigai

While writing his paper, Hiroshi explored both the concepts of yarigai and Ikigai. Although both share the suffix 'gai' (value or worth), they differ in their application in life. To Hiroshi, Ikigai is more philosophical, while yarigai is related to meaningful work and practicality.

Relevance of role in yarigai

yarigai is felt when individuals find alignment between their personal values, skills, aspirations, and their work, turning their profession into more than just a livelihood. Drawing from his experience as a doctor and his strong sense of yarigai, Hiroshi emphasises the importance of finding a role that resonates with one's passions. This alignment enables individuals to make a meaningful impact within their chosen profession.

“I am very happy to work as a doctor. I feel a strong sense of yarigai working as a doctor. So that's the starting point for me, and that's why I highlight the importance of the role in yarigai in this paper.” - Professor Hiroshi Nishigori


Themes from narratives with doctors

Hiroshi’s paper examines four narratives from daily clinical practices. Many doctors find a sense of yarigai when they confront challenges such as witnessing patients nearing death or handling medical errors that demand detailed explanations and apologies. Overcoming these hurdles fosters a profound sense of achievement and deepens the doctor-patient relationship, illustrating a typical pathway to experiencing yarigai.

The four case studies

Here are the four specific representative narratives about yarigai mentioned in Hiroshi’s paper:

Dr Mishima - Finding positive meaning in difficult situations

The first theme is finding meaning in difficult situations. The story is about Dr. Mishima and a case of medical malpractice where a patient developed aspiration pneumonia due to a medication error. Despite the mistake, Dr. Mishima worked tirelessly to apologise and care for the patient. 

Initially, the patient's family was angry but eventually appreciated the doctor's dedication. Dr. Mishima expressed that he felt a sense of yarigai from this challenging interaction, showcasing a unique perspective on finding purpose in difficult circumstances.

Dr Kaneko - Receiving gifts embodying ikigai

The second story is about Dr. Kaneko. She performed a gastrectomy differently from her supervisor's method to preserve the patient's gastric function. Her approach was successful, allowing the patient to continue farming and eating normally. Grateful patients often bring her gifts, like vegetables. 

This story highlights surgeons' efforts to preserve patients' living functions and the appreciation they receive. Dr. Kaneko finds a sense of yarigai through her work, feeling a sense of purpose in society as a doctor. This is similar to having an ibasho, a place where a person feels a sense of belonging.

Dr Kawabata - Cultivating relationships that transcend temporal boundaries

The third story involves an internal medicine doctor, Dr. Kawabata, who helped a patient with type 1 diabetes who wanted to have a baby, despite her obstetrician advising against it. Dr. Kawabata negotiated with the obstetrician, and the patient was eventually able to have a child. Years later, Dr. Kawabata received a letter from the patient, expressing gratitude. This long-term appreciation gave him a deep sense of yarigai.


Dr Murakami - Witnessing strength in a seemingly powerless human being

Dr. Murakami's story revolves around the theme of dealing with dying patients, a challenging aspect for doctors who are typically focused on diagnosis and treatment. This experience can evoke feelings of helplessness and inadequacy since it isn't thoroughly covered in medical training. However, interactions with dying patients and their families can reveal the profound impact a doctor can have on a human level. 

The story highlights a young, inexperienced doctor who, despite feeling powerless, stayed with her dying patients, talked with their families, and provided emotional support. This experience gave her a sense of yarigai, illustrating the meaningful connections formed in such difficult times.

“In all four stories on yarigai, presented in this paper, the interviewees managed to relate their medical practice to their own positive feelings; medical practice was presented as a source of gratification, joy and satisfaction or sense of approval, belonging, esteem, reward and fulfillment. This gave intrinsic meaning to their occupational lives, which in turn became a source of motivation and commitment.” - Professor Hiroshi Nishigori

Instrinsic Meaning

Mieko Kamiya’s contribution to ikigai literature

Hiroshi referenced ikigai’s pioneering researcher, Mieko Kamiya, in his work. Kamiya, a psychiatrist, explored the concept of ikigai in the Japanese context. She wrote a book on ikigai not as an academic paper but to highlight its presence in daily life without scientific thinking. This approach influenced Hiroshi’s choice of a qualitative methodology for his paper.

Experiencing yarigai personally 

More than 20 years ago, Hiroshi cared for a patient with heart and kidney problems who often needed hospitalisation. Hiroshi visited him at home frequently towards the end of his life. After the patient passed away, Hiroshi asked his wife for permission to do an autopsy, which she agreed to. 

When Hiroshi asked why she took care of the patient so devotedly, she said he had done the same for her during her own health issues. This deeply touched Hiroshi and showed him the strong bonds between patients and their families. This experience made Hiroshi feel a strong sense of purpose and yarigai as a doctor.

Hiroshi’s ikigai

Hiroshi considers his wife and son as one of the sources of his ikigai. Recently, he shifted from focusing solely on work to also enjoying activities like skiing and reading. His current sense of yarigai and ikigai revolves around teaching and nurturing the creativity and abilities of younger generations. Education has become a significant source of fulfilment and purpose for him.

“My recent source of yarigai and ikigai is to teach and develop the younger generation’s creativity and capabilities.” - Professor Hiroshi Nishigori

Younger Generation


Once you find meaning in your work, no matter how challenging it may be, you'll always have the motivation to persevere. This principle applies not only to work but to life in general when you have a sense of yarigai—something worth doing that propels you forward despite life's challenges.