1: Control.  One must have control of day to day, week to week and have decision making ability.  We all have constraints, but within their confines we need to be able to make meaningful decisions to be happy

2: Meaning: whether one lays brick, cleans floors, or does surgery, one must have the feeling that what they do has meaning and importance in the broader sense of life, to feel as though you will have left a positive mark, and that one's time here on Earth was not wasted.  One must feel as if their work is critical to the success of their organization's mission, whatever that role maybe.  

3: Respect: one must feel as though peers feel positively about your career and skills and that such skills are valued above and beyond a paycheck.  One must feel that their patients respect them as well.  Skills ought to cultivated and nourished.  

4: Academics: medicine demands a decades long learning process.   When a physician no longer finds learning fun, professional and personal happiness will suffer. 

5: Compensation: once basic needs are met, happiness is not increased by absolute W2 income levels.  While important, W2 is not everything.  Compensation ought to be linked to effort but without the other 4 elements to satisfaction, professional satisfaction and happiness will always remain elusive.