How I’ve prepared to upgrade my productivity for my third year of medical school

I started my third-year clinical placement two weeks ago. During my transition between the second and third years, with lockdown in the midst of it, I had the opportunity to slow down and reflect on the good, the bad and the ugly. Not on anything too deep, just on how to upgrade my time management as a university student on a demanding course. While I’ve made significant improvements over the course of three degrees at three university institutions, I just had a nagging feeling that I wasn’t at the level I was capable of. There were time leaks I had no idea how to plug — the constant dripping of water took its toll.

Photo by National Cancer Institute on Unsplash

Lockdown: a time for introspection

With a lot of learning moved online for the new academic year, and my now position of ‘student doctor’, self-discipline is more vital than ever. Being able to manage one’s own time and learning becomes critical. Online learning is convenient but makes procrastination a more tempting option. You’ve got no one looking over your shoulder making sure you’re doing the work. As my parents say: you can deceive no one but yourself.

While my second year at medical school came to an abrupt end, the following lockdown opened another door. A door that I believe many of us needed and have immensely benefitted from entering through. We’ve had more time to spend with family, pursue hobbies we’ve put off in the name of work etc. It gave me a chance to level up mentally, intellectually and productivity-wise. I read books that I put off and wish I had read sooner. Lockdown also fast-tracked the launch of the online personal training business I had been working on for two years. If it wasn’t for lockdown, I probably wouldn’t be approaching life the way I am now; all it took was a few small tweaks that were presented to me because of the seeming vastness of extra time. In the words we far too often tell ourselves, why didn’t I think of this earlier?

Plugging the time leaks

For the past three years I’ve been a diligent student of time management/productivity. I’m always looking for ways to be more efficient and effective to maximise my time use while working or playing. What student doesn’t want to fit everything in without going crazy? Over my first two years of medical school I had an issue — in the morning and afternoon until early evening I’d be very productive. However, during the early to late evening, when I didn’t have a pressing deadline, or when my procrastination urge would kick in this happened: I would find myself scrolling through social media or watching YouTube videos about things that weren’t going to help me towards my goals.

My self-described ‘effectiveness score’ fell below my aim of at least 9/10 and sometimes down to 4/10 on weekends during evenings; this isn’t because scrolling through social media is inherently a bad thing. It is because I wasn’t in control. I hadn’t developed a proper evening routine. I wasn’t super concerned about it because I had been productive during the early part of the day, but I was still wasting time that could be put to better use. Relaxation doesn’t have to mean not being productive. You can relax and be productive. Productive to me means doing something that will help you to make progress in the future (e.g. meeting a friend you haven’t seen in a while is productive because it strengthens your relationship in the future). Relaxation and productivity aren’t mutually exclusive.

I could get away with being unproductive at times during my first and second years of medical school, because of the structured pressure that is on the student to keep on top of work. Plus, the safety nets in place including having pretty much everything you need to know for exams on the lecture slides. The study schedule is very organised in pre-clinical years. Everything is in one place; your job is simply to study and not fall behind while experimenting with learning strategies. A cramming expert could get away with leaving things to the last minute — a risky proposition. For my third year of medical school at Leeds it is up to me to create my own structure and schedule with guidance from the medical school. Now that I run an online personal training business, sit as a committee member on three student societies and involved in a couple of research projects I can’t afford to waste a single second. I’m essentially practising the life I would be practising as a qualified doctor which can involve many moving parts. I believe university is the best time to stretch one’s self, while you have the freest time you’ll ever have, before committing to a particular lifestyle for the long-term after graduation.

Here are the changes I made based on three productivity books I read and pondered over during lockdown:

Inspired by Digital Minimalism — Cal Newport

· Low-value activity (e.g. watching cute cat videos) is scheduled to certain times in the day or week, with it being replaced with what I call productive relaxation. For years I wanted to journal in the evenings before falling asleep — it never happened. Now it does because I’m no longer scrolling through social media aimlessly in my downtime. Small tweak, big change. Journaling has improved my de-stress routine — I fall asleep with my mind clear and in less time.

· I use bookmarks for websites or webpages I regularly visit to perform certain pre-planned actions when doing a work or browsing task: this allows me to bypass distracting websites and the home feeds of Facebook, Instagram or Twitter.

· I’ve scheduled ‘seasonal leisure activities’: Ensures I make time to relax and pursue my interests outside of medical school. (At the moment I’m learning jump rope tricks over three days of the week and aim to learn a new dish once a week).

· I’ve invested in a smartwatch that I’ve configured to allow only important notifications (e.g. next event on calendar, reminders, emergency phone calls and messages (when ‘Do not disturb’ mode is activated) and drink water reminders). Drinking water is easy to forget when you’re laser-focussed trying to meet a deadline. Be intentional about how you use technology to maximise its productive use, otherwise it will steal all your time. It doesn’t have to be a smartwatch — I just find it eliminates the distraction of unnecessarily using a smartphone. We tend to have good intentions when using a smartphone such as checking email to stay updated on your course, but that is the moment we get sucked down the rabbit hole. I don’t have to face the temptation of being distracted by a million other things on my phone demanding all my attention — I selectively choose what notifications I want to receive which helps me bypass the noise of unnecessary information. Smartwatches are not a gimmick (I used to think they were, silly me).

· Installed Freedom.to on all my devices to block distracting sites and apps at scheduled times.

· I schedule in time for ‘communication-centric’ activities (phone calls, video-calling etc.) and minimise ‘connection-centric’ communication (e.g. ‘likes’ on social media, instant-messaging etc.).

· I use email filters to categorise emails so I can quickly see what emails need my attention to prevent getting sucked in by emails with clickbait subject lines.

Inspired by Essentialism: The Disciplined Pursuit of Less — Greg McKeown

· I’ve planned (still in the process of planning as I receive new information from medical school admin) every week of the academic year in advance, with the precise actions I’d like to take each day ensuring I don’t overschedule myself with shiny ‘non-essential’ activities.

· I’ve shifted tasks to a calendar (I swear by Google calendar) because I found that it took me some time to figure out what I should be doing if a task was not on the calendar to complete in a certain time block.

· I’ve strengthened my criteria for the tasks, requests and activities I say YES to so I can ensure I give more time to things which are actually of long-term benefit to me.

· I add on at least 50% to the amount time I think a task will take me to complete (‘50% Rule’). In the quest of maximising productivity I follow ‘Parkinson’s Law’: ‘work expands so as to fill the time available for its completion’. This is good for putting pressure on yourself to move quickly. But then there is a risk of overwhelming yourself with too many tasks which can make it harder to prioritise. I now only give myself 1–3 key tasks to do each day and give myself plenty of time to do complete them which reduces stress levels; also, it allows me to be more flexible with my schedule. If I think a task will take me one hour to complete, I block out 90 minutes to two hours on my calendar. We tend underestimate how long a task takes to complete and then pack our schedules with too many activities or find out, near a deadline, that we don’t have enough time to complete a piece of work to a satisfactory level. These are sure-fire ways to let procrastination take over your day, every day.

Inspired by 7 Habits of Highly Effective People — Stephen Covey

· Created an ‘ideal week’: every hour of each day is scheduled in advance. The schedule is rigid to allow stability and ultimately consistency. But flexibility is built in to allow for emergencies, urgent tasks and activities I think will be worth trading a pre-planned activity for. The key point here is I am in control and my time is protected with adjustments allowed to be made on my own terms.

· Divided each day of the week into themes to give me enough time to fulfil my multiple roles of university student, business owner, friend, family member etc. to a level I’m happy with. A key trick here is putting time limits on your activities — this will ensure your work and relaxation is intentional, focussed and most importantly: actually happens. For example, put a time limit on phone conversations that go on for hours without your prior approval. This includes calls with friends and family unless you’ve decided beforehand it would be an unlimited time call or what you deem to be an emergency. You set the criteria for what is a worthwhile interruption and ensure you make up for any time lost in your in ‘catch up’ time blocks. If you want to catch me on the phone, I’m only available at certain times during the day.

Is this all too extreme?

Some of you will say my new productivity approach is extreme — it sounds ‘boring’, there is no freedom and no spontaneity ‘to keep things interesting’ etc. right? This is fair enough when you only look at things on the surface. Let me answer this with a common scenario students face.

You set out to complete work and you get none of it done because you always want to be available and open to doing something else. Availability unchecked is unproductive. Freedom left unchecked leads to a bondage of missed deadlines, poor work quality, constant overwhelm, high stress and guilt. Not proactively managing your time actually makes you less free because your time gets controlled by other people and impulsivity. When it is time to work you have to cut out every possible distraction (leaving yourself open for emergencies) otherwise you will not get work done; you can still be available for some unplanned activities but do it on your own terms and within reason. This is how you stay in control, get things done and make time for your interests and relationships.

‘Discipline equals freedom.’ — Jocko Willink, retired Navy Seal and commander.

To further elaborate the point: In finance, you can’t know what your variable spending budget is like if you have no idea what your fixed expenses are. Rigidity brings stability to your routine. I have fixed time blocks in my calendar to get my obligations completed so I can avoid (or at least limit) crises. Crises can lead to time bankruptcy if you have too many of them.

Once fixed time expenses are accounted for the remaining variable time (variable because you can do whatever you like with this time after meeting your obligations) can now become productive time expenses for valuable pursuits. These can be used spontaneously within reason — you still need to budget time for emergencies and tasks that take longer than expected. With the time leaks plugged you can schedule activities at times when you know you can do these activities without feeling guilty for not doing something else work-related or fun. Spontaneity should be scheduled otherwise it can easily get out of control.

Lockdown was certainly a productive period of reflection and learning for me. The theory has been digested and applied. Let’s see how my third year of medical school goes.

Until next time.