Time Management and Staying Sane in Residency

5:00 a.m. wake up. Commute. Admission. Two cups of coffee. Discharge before noon. Skipped lunch. Rapid response. Another admission. Another coffee. In residency, you always need more time, more sleep, and more coffee. So how do you stay sane and appropriately manage your time? It’s all about having the right time management skills to get you through this important part of your medical career.

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Maximizing The Time You Have

Time is finite and fixed. We can’t change that, but we can maximize the hours we have. A normal human (aka anyone NOT in medicine) generally has their day split into quarters: one quarter is spent sleeping, one quarter is spent at work, one quarter is spent going to the gym or indulging in a hobby, and one quarter is spent socializing/ cooking / relaxing etc.

We in medicine do not have these luxuries. Often, residency/fellowship chops our time up into thirds: one third is sleeping (this is usually the first area to get sacrificed), a third is spent at the hospital (commonly and unpredictably getting extended), and then we have the remaining third that is where we have to make the decision. Are we going to: A. flop down on the couch and stuff our face full of Ubereats while Netflix doesn’t even bother to ask if we “are still watching,” (yes, yes we are) B. Go to the gym, for a run, or a spin, or C. Go out for dinner and drinks with the co-rezzies, friends, family, or a date (socialize with other humans). This then leaves us with the coveted last third and where we must ask ourselves what is most important to our mental health. If you are someone that cannot function without getting their workout in, then gym wins.

So, how do you maximize your time? Perhaps attempt a truncated 20 minute workout in the morning and then a 20 minute workout in the afternoon. If we cut it up in that way, maybe we still have time for dinner with our bestie. 

Work Smarter, Not Harder

A skill I learned as an intern is how to be efficient. Data shows us that multitasking often leads to mistakes, but there is a difference between multitasking and efficiency. This can take the form of typing up that progress note while on hold with the pharmacy or batching all your blood draws so you only have to make one trip to the lab. This obviously will vary depending on the institution where you train, but figure out early how to hone your work routine such that it is most efficient. 

Other time management tips? Make large portions of chili or stir fry for dinner and take the leftovers for lunch the next day. The same goes for coffee; make a large vat of iced coffee to keep in the fridge and take as you need throughout the week. This will not only cut down on time, but also help keep your wallet healthy too. 

A Marathon, Not a Sprint

Medical training is long. While the days seem to go on forever, the years will fly by. For this reason, it is important to have perspective. I recommend keeping short-term and long-term goals. These goals should be specific, measurable, achievable, and realistic. Write them down in a place you will see them daily. For example, a goal for the day may be finishing your progress notes before morning rounds where a long term goal may be making it to the gym 3x a week each month. In that vein, keeping to-do lists and staying organized is key. As an intern, I would keep a running to-do list and color code it with what was time sensitive/most important. I would ask myself “is this emergent? Urgent? Or can it be done later?” Often things that are not emergent or urgent will get pushed til tomorrow. 

It’s OK to not be OK.

Lastly, know when to ask for help. We are notoriously bad at advocating for ourselves. We falsely are led to believe that asking for help is a sign of “weakness” or we worry that if we ask for help it may mean unfairly forcing a colleague to carry our load. The truth is In order for us to appropriately care for others, we have to care for ourselves first. There should be systems set in place by our institutions and programs for these very things.

If you are sensing you are in a dark place, spiraling, feeling overwhelmed, or just need a chat – tell someone. Ask someone for help. Make it known and do so with a sense of pride. There is not only nothing wrong for asking for help, it should be met with praise and understanding. 

Residency is a long and exhausting part of your medical career. With the right time management skills, you will succeed!