5 Problems Many Students Have With Time Management & How To Solve Them

So, I wanted to answer the questions I have received since my enthusiastic involvement on the island with my seemingly endless extracurriculars: How do you find time for a family, extracurriculars, and medical school? My answer is always time management. When you have to prioritize your time constantly to ensure you're developing yourself in medical education while still nurturing relationships with family and friends then you have to be efficient in how you use your time. This post is particularly useful to those of you balancing family needs and school needs, but does have overarching themes applicable to anyone regardless of profession. 

1. Sacrificing Sleep and Personal Time - Um, no. That's not an option for someone who is going to be a physician. Sleep is my favorite activity, and remains the core for my schedule. Personal time is essential to prevent you from losing your sanity, and you really do need regular breaks from medicine so you do not burn out from it and you're able to keep your passion. I love medicine and I love being a workaholic, so I have to remember to set boundaries because I have other relationships I care about and should nourish. I prefer to sleep 8 hours a night, but I know that I can function well with 6-7 hours if I have extra things going on in life. 

First, I look at my "outside of the home" requirements for the week whether it be didactics, clinic, grand rounds, doctor's appointments, school meetings, etc. I get a good sense for when I MUST be out of the house every day to get somewhere on time and then I start by planning backwards. So, if I have to be at clinic at 8:00AM  then I know I must leave by 7:00 AM. Therefore, I will wake up at 5:00 AM. If I am waking up at 5 AM, then my goal is to be in bed at 9:00 PM since it takes me roughly 20 minutes to fall asleep. Therefore, I pull out my digital calendar and block out sleep from 9 PM to 5 AM every night of the week (EVEN WEEKENDS!). I know it's tempting to sleep in on the weekend but it wrecks your good sleep hygiene so keep it constant. You'll be surprised how refreshed you feel when you stick to a consistent schedule in an inconsistent world. Once that's scheduled, I am then able to portion the rest of my time. 

Why do I wake up at 5 AM you say? Well, the kids aren't awake that early so I'm able to enjoy a cup of coffee, stretch, meditate, or exercise. I generally do not look at my phone until I've been awake for an hour and feel like I am done with personal time designated to allow for reflection. This is when I might think about goals I have for myself for the day, or just sit and think about how amazing my cup of coffee is in silence. Whatever it is, just take that hour for you in the morning and you'll be surprised how great it can jump you'll feel the rest of the day. I will then spend from 6:00-6:45 getting myself ready, getting Ethan ready (since Danielle usually takes the boys to school), and making breakfast. And then we usually walk out of the house together so I can help put the boys into my wife's car, and we wish each other a good day. Having this morning routine helps me feel connected to my family and as though I am setting myself up for a successful day.

2. Time wasting activities - I am not suggesting that you take your smart phone into the restroom by any means because that's just gross.... What I am suggesting is that you take advantage of downtime, during clinical semesters. If you find 20-30 minutes while you're waiting for something to start, patients to arrive, or dinner to be served then read or study something. That time adds up quickly. 

This is also true in the evenings and making time for responsibilities like housework or grooming, or whatever you do at home. If I ask myself "should I put up the dishes tonight?", then the answer is yes because I obviously had time to think the thought so take the 10 minutes to do the chore. Do laundry regularly throughout the week so it doesn't build up. My wife and I also have specific things we prefer to clean, so we divide the labor. However, we also willingly pick up the slack when one of us have a busier schedule one week for whatever reason. The point is to communicate with your spouse if you have one, and to not take advantage of that person. Danielle doesn't like dishes and I hate laundry but we both do our share of the two if we need to step in and help each other. So, if you're fortunate enough to have a spouse then work together to efficiently take care of household responsibilities. If you don't have a spouse, outsource things you can pay someone to do like a maid to clean up your place. Instead of stressing about things piling up like laundry, think of whether you can pay someone else to do the work for you. Some might judge and say it's lazy or entitled, but I think it's smart business management because you're investing in yourself by making more time for education. 

I am currently enjoying a very busy practice that yields little time for studying during the working day, however I was able to find an extra hour and fifteen minutes today between arriving earlier than our lecture started and finishing lunch 40 minutes before afternoon clinic started. So, be aware of your time and ask yourself if there's something you could be studying (especially if you have time to think random thoughts as such because you're not running around tending to patients). However, if clinic is busy but you're not then you might want to find out what someone else on the team needs. You might not be advancing yourself towards exam preparation but you're helping ease the burden someone else is enduring and you may gain some knowledge through practice in the process. 

A huge time-waste example I found on my drive to and from clinic. I used to listen to music and sing at the top of my lungs, and really enjoy those two hours of my day (hour to and from generally). One day, I realized that I was wasting 10 hours a day in a car. That's not going to help me maximize my time efficiently. So, I took my Apple iPhone and opened up the Podcast app I downloaded before so I could listen to comedy podcasts. I typed in the clerkship I was in at the time (OBGYN), and found that I could listen to Clinical Pearls in OBGYN by Dr. Chapa who would give lectures on commonly tested items on the shelf. It was great because I am an auditory learner and I was getting exposure to material in a different forum which was good. I did not find a good podcast for Psychiatry but used that time to listen to the OnlineMedEd videos for psych during my drives. For Family Medicine, I am currently enjoying The Curbsiders podcast series which consists of internal medicine doctors who interview experts in various fields of medicine and address best practices for treating common conditions (I never thought I would understand vertigo as well as the episode I listened to today made me feel). It is presented like a morning talk show, and it truly is some of the funniest and most interesting medically-related talks I have experienced. I do listen primarily to podcasts now, and I allow myself a break every once and a while for music sessions blaring musing and shouting like there's no tomorrow (especially when I volunteer to take the kids to school occasionally).  

3. Failure to plan - Proper planning prevents poor performance is an old adage that I have found over the years does yield valuable insight to time management. If you schedule out your Saturday to include 6 hours of study time with 2 being focused on practice questions, 3 hours for review books, and 1 hour for videos then you are likely to stick to what you have prescribed yourself and achieve these very realistic goals instead of saying "I will study Saturday". Goal setting needs to be measurable (time to complete activity) and specific ( the activity you will perform). Discipline is the key to achieving said goal, and is easier to have if you learn how important goal setting is and stay motivated to fulfill your goals. If you haven't learned discipline by the third year of medical school then you might find difficulty in adequately preparing for the NBME shelf exams or spending quality time with your family. Goal setting helps me with improving my funds of knowledge, my relationship with my partner, and my bond with my children. It is my goal to have a one-on-one talk everyday with my older son about his day and show him undivided attention and genuine interest for what he has learned or done. I also give my younger son my undivided attention in a different way (he is two so his attention span is less) by doing things around the house with him like chores or playing with his toys. It is also my goal to spend part of the evening connecting with my wife by talking about our days, sharing stories, laughing with each other, and getting the children to sleep. If I did not adequately prepare myself with planning then I would not be able to have this valuable time with my family. 

Also, find out how to do what you're trying to do from gathering advice from sources. In the age of Google, you can easily get tips for acing that shelf exam or making the perfecting your surgeon's knot. The point being make your journey easier by learning from other's mistakes and looking for common themes. If 10 people say that they used Uworld, case files, and a random third resource then try the same approach instead of re-inventing the wheel. Whatever you plan, be prepared to see it through the end and accept the possible consequences that could come. As long as you're chronically evaluating what works for you and not repeating what doesn't work for you, then you'll constantly improve toward a better method for you. 

4. Being Inflexible or Rigid - Goal setting and planning your day is essential. However, there also must be balance. You cannot schedule every minute of your day because things happen. You will have to stay late at clinic one day (at least), you will have changes to your schedule with minimal notice due to unforeseen circumstance, or you might have a sick child that causes you to rearrange your day. Whatever comes up, you must be able to be flexible to the situation. If your schedule is too rigid, you're setting yourself up for failure. You should set realistic expectations for yourself instead of giving yourself 20 minutes to read 50 pages of a review book. Be practical and allow wiggle room. If I am sitting down on a Saturday to study for 6 hours then I am going to allow myself time to account for topic transitions, spending more time on certain ideas I come across, or interruptions to be expected from a 2 and a 5 year old living in the same home. When you are able to adequately judge your average time needs, then planning becomes more simple and so does reaching those goals. If you are too rigid with yourself then you don't account for human error which will make it less likely that you will stick to your schedules or goals. This is true regardless of what you're goal-setting to achieve, and is probably one of the key things I learned through life that has helped me with counseling patients. You will make mistakes so forgive yourself and try again tomorrow. If you don't stick to your Cramfighter schedule, there's a way to rebalance the task. If you don't get to see your family one evening because you're too late and they've gone to bed, they're likely to understand and know that you still prioritize them because they can see it in the majority of your actions (and you already plan time for family because of the previous point). 

5. Having a Hard Time Saying NO - so this is something that I have definitely improved on since I transitioned from Dominica back to the USA. Trying to please everyone will get you nowhere but burned out or resentful toward life. You do not have to check every email right now, respond to every Facebook notification as they occur, or take on every extra project. Saying no will help you be able to stick to your schedule and keep you from being more overwhelmed than medicine can already make you feel. Your friends will understand if you don't go out every weekend. Seeing friends is important for social interaction for sure but (as with most things in life) moderation is key. If someone calls you and you can't talk anytime soon then be honest and say that, but also make sure that you follow up when you say that you will. You don't want to make people think that you're too important for them now (as some people get this sense when you're attending med school) or that you do not value the relationship anymore because you're too busy. I always try to make the time for others and I am honest when I am busy. Ena, a long-time-now-and-practically-a-sibling friend in Texas, is someone who I talk to occasionally when we have random down time to catch up. She has also called me wanting to talk when I haven't had the energy or time for conversation. I am always honest with her and end the conversation with a pleasant "Bye Felicia, I gotta go!?!" and we always pick up the conversation (weeks or months later) like no time has gone by at all. This is also true for some other very close friends in my life, and I even send old school greeting cards back and forth between some (and extended family too because that is just a good feeling when they call because they got your card...). 

Now, I do not say no if the opportunity can teach me something new, help me network in medicine, help me connect with my family, or strengthens the relationships I realize have faded. You cannot say no to everything if you're trying to improve yourself overall to be a well-rounded human. This week I volunteered for a small community health screen because it would help me learn something new through new patient encounters and would help me network in medicine because you do not know who else may have volunteered or who you may meet. I do have the altruistic drive naturally to help people, but realizing the less-subtle incentives helps you maintain positivity and higher energy levels to be as awesome at the task as possible.

Unfortunately, this is not an exhaustive list but it highlights the majority of themes students encounter when learning how to manage time. I will blog soon about motivation as having the passion helps to fuel the dedication and discipline. Anyway, there are many areas of opportunity in your life to be more efficient with your time and maximize the hours you can get out of your day. Do some introspection, and find out if you really are living up to your potential. If the answer is no, then make changes. If the answer is yes, then you aren't being honest with yourself because you are always capable of more. If you have any questions or comments then please do not hesitate to reach out to me however you want, and feel free to share this post with anyone you wish. All the best! - Sham. 

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