Yes to one thing… no to the others.



Wellcome Library, London

One of the perennial problems that faces doctors who are in direct contact with patients is time management.  It is the one resource we all have to allocate, and with the multitude of different roles we all have to play – parent / sibling / doctor / teacher / friend / spouse / club captain / society president / charity trustee / or anything else for that matter – it can be difficult.

As a junior house officer (FY1 in modern parlance in the UK) I can remember literally running between patients on my first on call shift – simply to try to get everything done that was required.  It was only when I became more experienced and could prioritise, work smarter and effectively allocate my time that my shifts became significantly less sweaty, and I felt more confident in my work.

As we progress up the career structure of medicine, doctors tend to acquire new roles and responsibilities which take up more time, and can stretch ones resources significantly.  The most consistent advice I had when I was appointed to a consultant job was – say NO to everything for at least the first six months (and in some cases the first year.)  It is a little worrying that the main bit of advice for new consultants is to say NO – but highlights the fact that as a new face in an organisation, with seemingly a lot of time on their hands (whilst clinics are set up, and services start to gear up) most new appointees are keen to show willing, and take on projects which rapidly snowball and can overwhelm.

This month’s PMJ has a great article which should almost be on the key texts list of all postgraduate training schemes.

The paper is all about time management, and how to recapture time for what YOU want to do, not what your colleagues or boss want you to do.

The advice is all very useful – and perhaps the most important bit is beyond the tools and tricks for managing time – prioritising tasks and the like, but it is actually around the importance of goal setting.  It is easy to be very busy, but not necessarily make forward progress towards a defined end point.  If we can make time (ironic I know) to reflect on our priorities, and our desires for the future – both for work and for home, we are in a far stronger place to assess options and opportunities and how they fit into this scheme.  This process of goal setting can be difficult, and working on it alone can lead to skewed ideas about what will be profitable, and what is even possible.

This is where I have found mentoring and coaching input to be invaluable in the past.  The process of active reflection with a mentor or coach can help to crystallise ones thinking into genuine priorities and goals, and formulate a framework for assessing new opportunities as to how well they help one achieve what you have decided on as a goal.  Mentoring and coaching is often seen as a slightly left-field activity within medicine, but if you discuss personal development with any board level doctor or manager in the NHS and you will find that almost all of them will have regular coaching or mentoring sessions to assist them in their roles.  Oliver Warren and Ruth Carnall wrote a useful piece in the PMJ in 2011 which covers mentoring and coaching – and its relevance for medical trainees.

And now for my advice… the one thing which tends to keep me on the straight and narrow when considering my time management (or lack of) and my work-life balance, is that:  saying yes to one activity or project intrinsically implies saying no to something else. The decision about what you say yes to, or no to  is up to you, but we shouldn’t fool ourselves that we can do everything all of the time…


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