Background: Undergraduate medical education relies on physicians who balance their clinical responsibilities with teaching, which requires motivated teachers and institutional initiatives that foster a satisfactory environment. To inform the development of effective strategies, this study aims to study the association between the motivation and satisfaction to teach.

Methods: In this cross-sectional study, 414 physicians involved in clinical teaching at the School of Medicine and Biomedical Sciences Abel Salazar of University of Porto were invited to complete a digital questionnaire. 179 teachers (43.2%) responded. The survey collected demographic and professional data, assessed teaching satisfaction using a scale developed by M.J.M. Verhees et al, and evaluated motivation using the Physician Teaching Motivation Questionnaire (PTMQ). Principal component analysis (PCA) was performed, and internal consistency was assessed using Cronbach’s alpha.

Results: PCA identified one construct for the satisfaction scale and four domains for motivation, with good internal consistency (α > 0.70). General satisfaction was low (median 8.6/20, IQR 4.3), as were scores for career-oriented motivation (7.5/20, IQR 6.2) and introjected and external motivation (5.0/20, IQR 5.0). In contrast, intrinsic motivation (14.1/20, IQR 5.0) and identified motivation (16.7/20, IQR 5.0) scored higher. Satisfaction was significantly associated with all motivation domains (crude association), after adjusting intrinsic motivation demonstrating the strongest associations with higher levels of satisfaction compared to other factors (β=1.8, p<0.001). Additionally, older age (p=0.016), higher academic rank (p=0.015), and higher medical category (p=0.026) were significantly associated with greater satisfaction.

Conclusion: Despite reporting low overall satisfaction, clinical teachers demonstrate high motivation to teach, driven primarily by an altruistic commitment to educating the next generation. Our findings highlight that teaching satisfaction is significantly associated with multiple motivation domains, particularly intrinsic factors. This research provides institutions with a framework to design initiatives that improve the academic environment and encourage clinicians to pursue teaching roles.