It’s the First Day of Medical School – What Should I Do?

I’ve written before about what to do before medical school starts, how to study in medical school and strategies for succeeding in the basic sciences. But how do you put this information about organizing your studying and your day into a system that works?   Everyone will have variations on how they do this, but there are some fundamental principles that apply to all.

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Don’t get behind

From day one, the material matters and, from day one, it is voluminous. If you get behind, it’s really hard to catch up.

Study, don’t just read and reread.

You have to actively engage this material and review it (multiple times) to really learn it. You are no longer studying for a test, you are studying to take care of other people. The SQ3R method is used by many students, but there are other systems as well. What is important is to develop a system that works for you.  One tool used by many students is Anki, software that allows you to create electronic flashcards to review key points.

Tips on active studying from UCSD

Tips on active studying from the University of Utah

 Use going to class as time to “study”

One of the important components to active learning is to review the lecture material before it is presented.  This is the opposite of what most of you experienced in college, but it’s key.   Survey the handouts or slides and make a list of the important points to be covered. Stay actively engaged.

p.s. You can’t learn medicine if you are on Facebook in class.

Create a summary page for each lecture

Include the big concepts, and key points. Include specifics that are stressed by the professor, but avoid listing all the details. You may choose to hand write this, but most of you will come up with an electronic format and will organize the class notes, and your summaries using One Note, Growly or an equivalent software. Although your personal notes are fine on the cloud, don’t put copyrighted material or your professor’s slides where other people can see them (it’s illegal).

Begin with the end in mind

In the long term, what you are learning (yes, all of it) will be applied to taking care of patients. In the slightly less long term, you will be tested on this information on the USMLE Step 1, a high stake exam and the first part of your medical license.   Although some dedicated time to study for Step 1 is important, having a system to really learn the material in your basic science courses is by far the best way to do well on this exam.

Don’t sacrifice sleep.

If you don’t sleep you don’t learn as well. Organize your schedule so you get at least 7, but preferably 8 hours of sleep every night.

Eat well, play hard and stay connected.

Clay Goodman,MD the Associate Dean of UME at Baylor, tells our first year class that the first year of medical school is a 60 hr/week job. They need to get up in the morning and “go to work”, using the afternoon and evening to study. He then points out that if they work 60 hours and sleep 56 hours (8 hours a night) they still have 52 hours to work out, spend time with family and friends and do whatever else they want.

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So, what should you do the first day of medical school?

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Here’s what your schedule might look like…

The night before – pack your breakfast for the morning break and lunch for the next day. Review any posted slides – survey them to understand the “big picture” and use them to start your summary of the lecture. Write down what you don’t understand from the slides (yes, at this stage it may be every line… but that will get better!).

7am – wake up (If you prefer morning workouts, you can get up earlier and workout before class)

7:30 Grab a piece of fruit or a smoothie if you don’t like to eat an early breakfast. (If you are ok with it, eat the full breakfast now, but whatever you do, don’t skip breakfast)

8-12 Attend class – Stay engaged. Take notes, make sure the questions you asked yourself in the review are answered, raise your hand and ask questions if they weren’t. Eat your breakfast or a snack at the 10 am break.

12-1 – Lunch with your classmates. Play foosball, talk, or just eat, but take a real break.

1-5 Study. One hour of studying for each hour of class is about right for most people.   This may need to go until 6 or 7 if you have afternoon labs.

7 – Workout and then make and eat dinner. Working out is an important part of self-care. Exercise is essential to decrease stress and also will help you avoid the “freshmen 10”. Your dinner should be healthy, not processed, and definitively not Ramen noodles. Make sure you have fruits and/or vegetables at every meal.

9-10 Look over tomorrow’s lectures and start your summary pages for those lectures. Once you are a week or two into this, you’ll be adding in reviews of material from previous weeks on a schedule.

10-11 Read a novel, watch TV, decompress.

11 Go to sleep!

You are starting on one of the most amazing journeys any human being can have… enjoy it! Don’t forget to keep a journal and take photos (but not of patients). The first time you actually interview a patient, put on your white coat, hear a heart murmur or take a test in medical school are just that … the first time. Write about the experience.

Let me know in the comments what other advice you have for the students starting medical school this summer!

 

 

Why you should run (even if you hate it) – and how to stay safe when it’s hot outside.

Running is one of the most efficient ways for busy students, resident and physicians to stay in shape.  If you are looking for the best way to meet your “MED” (Minimal Exercise Dose) to stay fit, you really can’t do better than running. It’s cheap (but don’t skimp too much on the shoes and clothes you need), easy (we are born to do it) and incredibly time efficient. You don’t have to plan to run a marathon to gain amazing benefits from a running program.  20-30 minutes, 3-4 times a week, will keep you fit, reduce stress, and prevent the weight gain associated with residency.  If you are a beginner, check out Runner’s World 8 week to start running.

I work with a remarkable runner, Carlos Campos MD, who wrote the following for the Texas Children’s Hospital Department of Surgery wellness newsletter.  Given how hot it is in most of the country right now, I thought the following advice was important to pass on!

Training in hot weather can be challenging, and without the proper precautions it can be dangerous. But a few easy guidelines can help you beat the heat.

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Get the Data

Before stepping out on a hot day, make sure to check the heat index. The heat index combines air temperature and relative humidity to determine how hot it feels. The National Weather Service offers heat index alerts when it becomes dangerous to exercise outdoors.

Your body cools itself with perspiration which evaporates and carries heat away. When the relative humidity is high, the evaporation rate is reduced and heat is removed from the body at a slower rate.

One way to get through those hot and humid days is to avoid them. When the heat index reaches dangerous levels consider taking that well deserved day off.

If avoidance is not an option for you, try running in the early morning or early evening when the heat index is typically lower.

Another option is to do your workout indoors. A climate-controlled indoor track or treadmill can serve as an alternative to running under the scorching sun. However, not everyone has the luxury of an indoor facility so you need to plan accordingly.

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Wear the Right Clothes

You’ve probably heard the saying “there’s no bad weather just bad clothing.” Whether or not it’s true, you should always wear temperature-appropriate gear, especially when running in the heat.

Avoid dark colors since they tend to absorb heat rather then reflect it. Find clothing that is made of high performance technical materials. These materials wick or pull moisture away from your body while allowing air to flow through the material. Wicking materials are a great improvement over cotton, which tends to absorb moisture and can contribute to chaffing.

Find a Cool Course

Temperatures tend to be a few degrees cooler in the shade, so look for a running route that offers lots of it. It’s also a great excuse to get off-road and do a little cross-country training.

If you are lucky enough to live near the coast, you may want to consider a beach run. Temperatures are cooler along coastal areas, and you can always go for a quick dip to cool down.

Consider looking for an athletic facility that waters their fields with sprinklers. Running through sprinklers serves a dual purpose: It helps keep you cool and makes you feel like you’re 12 again.

Protect Your Skin From the Sun

Wearing sun block is a must. The occurrence of skin cancer is on the rise and without protection, you increase your risk. The higher the sun protection factor or SPF, the more effective the sun block is in protecting your skin against harmful rays. For example, sun block rated at SPF 30 filters out about 96 percent of ultra violet rays.

The sun’s rays are strongest between 10:00 a.m. and 4:00 p.m., so avoid training during these hours. It is recommended that sun block be applied about 30 minutes before going outdoors and every hour after.

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Wear a Cap With a Wide Brim

The first women’s marathon was introduced at the 1984 Summer Olympics in Los Angeles. As you can imagine, summers in LA are hot, and the morning of the marathon was no exception. To make matters worse, most of the course was on freeways that offered no escape from the sun.

To compensate for the conditions, Joan Benoit Samuelson wore a white cap with a wide brim. The cap served the dual purpose of shielding her from the harmful rays of the sun and acting as a cooling device. Periodically she would pour water on the cap. She finished a minute ahead of her rivals to win the first women’s Olympic gold medal in the marathon.

Today’s running caps are made of high-tech materials that are both light and vented. Just add a little water to help keep cool.

If you don’t like wearing hats or want additional protection for your eyes, wear sunglasses. Make sure you find sunglasses that come with UV coating.

Stay Hydrated

Runner’s World has a great summary of how to stay hydrated in the heat.  To summarize, drink something before you go out and replace what you are losing.  For 20-30 minute runs a good drink of water before you go should be plenty.  It’s important not to go overboard by drinking too much or adding salt.

 

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Running in the heat can be a challenge, but when met with a few common sense rules you can beat the heat!

Starting Internship (I know what you are worried about)

I sat at the table this week with our new interns and the outgoing chief residents. Listening to our new interns as they asked questions, I realized everyone starting their internship has the same fears, whether or not they express them:  Will I kill or hurt someone?  Will I look stupid?  What if they find out I’m not as smart as everyone else?  Will I get divorced/separated/alienated from my friends?  Will I gain weight?  How am I going to find time to take care of myself?

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What you are feeling is normal. Every doctor who ever started an internship felt exactly the same way.  The best way to manage your (healthy) fear is to have a strategy.   I’ve written in the past about how to succeed as an intern.  But if I were going to condense that advice into three easy rules (for every day except your day off)  it would be these:

1.    Read at least one section from a textbook in your field every day

2.    Learn something (in detail) from at least one patient every day

3.    Do something to take care of yourself every day

 

Read at least one section from a textbook in your field every day.

Your goal for the year should be to read a major textbook in your field cover to cover.  You don’t have to buy the physical book.  It’s fine if it’s on line or downloaded onto your iPad.

Once you have the book, make a list or spreadsheet of all the sections in all the chapters.  For most textbooks, it’s probably going to be a list somewhere between 150 and 200 topics.  When you look at the 48-50 weeks you will be working this year, it works out to basically a topic a day (with some days for review).

The real goal is not just to read these topics, but to really learn them.  So, when you read, don’t just skim.  Read to learn.  That means taking notes – and reviewing them.

Put a chart on the wall with the list and give yourself a gold star when you finish a topic if you have to, but find a way to make sure you cover all the topics (at a steady pace) during the year.

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Learn something (in detail) from at least one patient every day.

It’s really easy, as an intern, to get caught up in the work and forget that you are fundamentally here to learn – not to provide service.  Make it a daily habit to learn in detail about one patient in your care.  It will overlap nicely with your goal to read a complete textbook.  When you admit a patient with pneumonia, read the section (and make notes) on pneumonia and then check it off your list.

One other important point (that none of us like to hear) – You will make mistakes. Be humble, be honest, and learn from your mistakes. The mistakes you make (and maybe more importantly your “near misses”) are absolutely your most valuable teacher.  When you do make a mistake, use it as the topic you will review for the day. You are going to be really upset but be easy on yourself.  Being upset is the mark of someone who cares, but don’t let it escalate beyond a healthy response. Talk to your mentors and senior residents.  They’ve been there.

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Do at least one thing to take care of yourself every day.

This may sound trivial, but it’s not. If you can, try to eat well, get some exercise and be social every day.  At a minimum, though, pick one specific thing you are going to do for yourself and then do it.

Eat well

Get Some Exercise

Be social

Shoes to Wear in the Hospital

I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet…. which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.

What kind of shoes should you wear in the hospital?

There’s a lot of walking in the hospital, but there’s even more standing.  Running shoes don’t provide the right kind of support for standing, which means your feet will suffer if that’s what you wear.

It goes without saying that you should not wear open toed shoes in the hospital.  It’s not only against the rules, but it’s going to gross you out one day.

Basic concepts to choose good shoes for the hospital

Look for good support.  The classic “nursing” or “operating room” shoe exists for a reason – they are designed to provide the support your feet need during long days of standing and walking.

I have recently become a huge fan of Allbirds. They are amazingly comfortable, incredibly light and even after a long call night my feet really don’t hurt.  The website says they can be washed in the washing machine which is obviously a big plus, too!  Other comfortable shoes you might try include  Clarks, Rockport and ecco.

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If you will be standing for long periods on rounds or in procedures, think about getting shoes that slip on and off.  When you are standing for a long time, being able to slide out of your shoes becomes important.  If you’ve been standing for hours, it really helps to stretch your calves and change the pressure points.  It’s also easier to step out of your shoes all together and stand barefoot for a little while.  When you are sitting, you can slip them off and let your feet breathe. Dansko  professional clogs are expensive but they are the “classic” OR clog..  Sanita clogs are supposedly now made in the original Dansko factory, tend to be a little less expensive and are also loved by many.  Birkenstock or Clarks clogs are alternatives to consider, too. Crocs are tempting but have poor support, minimal ventilation and have been banned in some hospitals.

Try to get shoes that breathe.  Examples include Merrell’s Encore Breeze (a great OR shoe) or Allbirds.  These shoes are not only comfortable, but they can be put in the washing machine (minus the insoles) if they get really dirty at work.

Once you’ve met those criteria, lighter is better.

Long days standing at work also make for stinky feet.  Just like long-distance runners, you have to learn some tricks to deal with this.

  1. Have more than one pair of good shoes and alternate them.
  2. Don’t buy cheap socks. Wicking socks like Balega socks are worth the price.
  3. Take an extra pair of socks with you for long days and change them in the middle of the day.

Foot massage, pedicures, and other foot care

After work, in terms of “bang for the buck” there is nothing that will make you feel better than a little attention to your tired feet.

Use a good foot scrub in the bath or shower like Bath and Body Toe the Line of The Body Shop’s peppermint scrub .

Take 10 minutes and try some methods to soothe tired feet.  If you are lucky enough to have a significant other who will rub your feet … congratulations!  (and, by the way, it really is “true love”…)

Even if you are a guy – don’t blow off pedicures.  If you’ve had one… you know.  If you haven’t… try it before you decide.

Motivation to Exercise

For several weeks my schedule has gotten the best of me and all efforts at working out have fallen by the wayside.  So, I decided to think about fitness, motivation and the “MED” (minimum exercise dose) to maintain fitness.  Here’s what I came up with:

1. Consistency, not quantity is essential.

  • 10-20 minutes “every” day (i.e. 5 or 6 days a week) is really better than 60 minutes once a week.  Google “ten minute workouts” and you’ll find a huge number of workouts to do (or buy).
  • Concentrate on just increasing the time you move. Consider using a pedometer (cheap) or one of the more expensive monitors, like the Apple Watch.

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2. Planning helps.

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3. Having a goal works better than not having a goal.

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4. At some point you just have to decide it’s important.

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Fast Easy Exercise: The Daily Fitness Solution

I went in search of an exercise equivalent for “fast easy recipes” and came up with a good find.   The Daily Fitness Solution provides 20 minute workouts that don’t require a gym or equipment.  It’s written by Reinhard Engels, who works in bioinformatics visualization at MIT.  So, as you might expect, his program is logical, simple and without hype.

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The workout program is more than reasonable, with rest days built in (which could be swapped with a workout day if you are on call)  No matter how busy you are, you can probably find 20 minutes!

I also liked his approach to weight loss – the  The No “S” diet:

The No S Diet, also known as the “Grandma Diet,” the “Why Didn’t I Think of that Diet,” and the “No $ Diet” is a program of systematic moderation I invented for myself that I imagine might work for similarly minded people.

No funny science or calorie accounting involved, just a few simple and mnemonic tricks for giving your willpower the upper hand.

There are just three rules and one exception:

  • No Snacks
  • No Sweets
  • No Seconds

Except (sometimes) on days that start with “S”

That’s it.

How could something this simple possibly work? Precisely because it’s simple — or rather, following the Einsteinian dictum, “as simple as possible, but not simpler.”

What To Do This Summer

This week approximately 16,000 US medical students are going to receive their diplomas and become physicians. There are also about 16,000 college graduates who will start medical school later this summer or early in the fall.  Congratulations to you all!

Nearly all of you have a well-deserved month (or two)  to rest and get ready for the next step in your training.  So, I thought it might be helpful to pass on a few words of advice on how to spend your time this summer.

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Do NOT study!

  • If you are starting your residency and you think it might help relieve your (normal) anxiety, here is what to do:  Buy one of the major textbooks and use it to get excited about what you are going to learn.   If you want to, plan how you are going to study for the year.   Skim the book if you really have to do something to feel less anxious, but don’t spend hours studying.
  • If you are getting ready to start medical school – step away from the books!  Seriously, there is nothing you can do that will make it any easier, so just enjoy your time off!

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Take a vacation (or two or three…)

  • Visit family and friends – take a road trip and connect with people you haven’t seen in a while
  • Hang out on a beach, go for some great hikes, read some great novels
  • Sleep late, eat well, and just rest

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Develop (or strengthen) an exercise habit

  • Use this summer to develop a daily exercise routine that you can take into your new (and crazy) schedule.  Overall, your goal for the summer should be to develop a balanced exercise program (cardio, strength training and flexibility).  If you’ve never done any strength training, hire a trainer and learn about it.  Your goal should be at least 30 minutes of cardio 4-5 times/week, 2-3 strength training sessions/week and stretching every day. If you develop a balanced exercise routine this summer, it will be much, much easier to continue this once you start medical school or your internship. Commit to doing at least 30 minutes of exercise a day this summer.
  • Running is one of the best (and most convenient) cardio exercises for medical students and residents (because it’s cheap, efficient and effective)  Use this summer to become a runner. If you hate running, find another good cardio exercise habit to develop instead – but pick one!
  • If you don’t own a bicycle, think about getting one that you can use to commute to school or the hospital.

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If you don’t know how to cook, learn.

  • Unless you want to gain a lot of weight, have poor energy and feel bad, you are really going to have to cook for yourself (or at least plan for good food cooked by someone else).  You won’t be able to eat what you need, particularly as an intern, unless you bring the food with you.
  • Learn some basic skills to cook simple things.  If you have good cooks in your family, have them teach you.
  • If you don’t have family members who can teach you, find cooking classes near you and sign up.  Many high end grocery stores and gourmet stores offer classes for beginners – look on line for classes near you.

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February’s Healthy Habit: Get Moving!

One of my New Year’s resolutions was to come up with monthly “resolutions” for myself and for anyone who follows this blog.  Cooking Light magazine (which is one of my favorite sources of recipes and ideas for healthy living) had the same idea, so I am shamelessly borrowing their healthy habits!

Cooking Light’s 12 Healthy Habits

It’s a lot easier to commit to 30 days of a new habit than a full year.  So this month’s goal is to maintain or improve fitness by increasing activity.

It may seem daunting to stay in shape or even improve your fitness level when you are swamped with studying or work in the hospital.  It’s not easy, but it is absolutely doable.  The best way to start is to pick one or two of the following ideas and make them a resolution for this month.  Pick goals that are “SMART” (Specific, Measurable, Attainable, Realistic and Timely) and then just do it! Consistency is the most important part of setting this goal – so pick something that you know you can do on a regular basis.

Some ideas to consider:

  • Take the stairs at work instead of the elevator
  • Commute to school or the hospital on your feet or on a bicycle
  • Park as far away from school or work as is reasonable and walk the rest of the way
  • Plan ahead for 10 minutes of exercise while you are on call and take what you need
  • Wear a pedometer and get 10,000 steps/day
  • Do push-ups every morning before you go to work
  • Find a cardio exercise that isn’t boring for you and do it 30 minutes 3x/week
  • Run.  It’s easy, it’s cheap and it’s the most effective exercise for busy people!
  • Hire a trainer for one workout a week (or ask for this as a present)
  • Play golf, tennis, racquetball – any game that gets you moving!
  • Find a spin class or other organized exercise class to attend once a week
  • Organize a basketball or ultimate Frisbee game with your friends once a week
  • Shoot for a total minute goal/week of exercise (start with 100?) and keep track
  • Whatever you decide to do, PLAN – make it an appointment on your calendar, put it on your daily scut list, get your clothes out the night before – do whatever it takes to make it happen!

Cardio Workouts That Aren’t Boring

To maintain your fitness (and to be able to eat without gaining weight) it’s best to shoot for a minimum of 3-4 cardio workouts a week.  To be effective, the workouts should be 30 minutes or longer.  But – consistency is more important than intensity.  If all you have is 10 minutes, then do one of these 10 minute workouts or go for a fast 10 minute walk in the hospital.  If you can do three separate 10 minute workouts in a day, it is just as effective (at least for maintenance of fitness) as a 30 minute session.

Some people have incredible discipline about this (and the rest of us hate them.)  For mere mortals who basically have to really work at this, you have to have a different strategy….

The first thing you have to do is choose what kind of cardio you want to do.  The trick here is feeling like you are playing, not working.  Dancing counts… so does jumping rope. You have to look for fun ways to exercise

American College of Sports Medicine exercise guidelines for healthy adults

www.life123.com Examples of aerobic exercise

www.60in3.com cardio options

www.livestrong.com list of cardio exercises

For many people, music is the difference between feeling like you are playing during a workout vs. working.  Use music to create your own “Fartlek” workout.  Fartlek workouts are also called “speed play” – the idea is to incorporate random intervals of speed work into your workout so you don’t just plod along at the same rate.  One way to do this is to put your music on a random shuffle, or find a good (and free) music source that you can stream.  Change your speed and intensity based on the song, or part of the song you are listening to.  If the song is slow, decrease your speed (but increase the resistance if you are on a machine).  If the song is fast, move with it – increase your effort (e.g sprint if you are running) to keep in time with the music.

Have fun!  Go out and play!

Internet music sites:

  • http://www.pandora.com– internet radio that lets you design your own radio stations or choose from a large selection
  • http://www.folkalley.com– singer songwriters, irish music, bluegrass, etc
  • I’m sure there are a lot of other sites… if you have any that you use, comment below or email me.

Information on Fartlek workouts

How To Exercise Despite Your Busy Schedule

“I used to run 6 miles a day but I haven’t done any exercise at all since I started my clinical rotations.”

The medical student who was talking to us on rounds today isn’t alone.  Exercising regularly during basic sciences isn’t that hard.  But it’s an entirely different issue when you start your rotations.  Figuring out how to exercise as a resident is even harder.

The first step is to realize why it’s important.

  • It’s the right thing to do.  Physicians do physical as well as intellectual work.  You are taking care of people’s families.  It doesn’t surprise you that policemen, firemen, astronauts and soldiers have physical fitness as a requirement.  It’s no different for us. .
  • You will have a life after training.  In your 20s and 30s, you may be able to get away with not being active, but those years of inactivity will be paid for later.
  • You will feel better physically.  You will have more energy.
  • You will feel better emotionally.  There is a direct effect of working out (stress reduction), but there is also the psychological benefit of taking care of yourself.

Once you recognize that regular exercise is important, you then have to realize that it’s not going to be easy.   There are two ways you can look at exercise in the context of a busy schedule.  First, think about it as activity, not “working out”.  Your goal is to be active, which you can approach by adding little bits of activity into your day:

  • Park your car in a distant lot, or at least at the back of the lot, to add walking.
  • If it’s safe, walk or ride your bike to work.
  • Take the stairs in the hospital (no matter how many flights!).
  • Buy a pedometer that counts steps and try to walk at least 10,000 steps per day.
  • Take a jump rope, stretching bands or dumbbells to keep in your locker or the break room to use when you have 10 minutes.
  • Do pushups and/or situps before you go to sleep or anytime you have a break in the call room.

Although increasing activity is essential to maintaining fitness, you really do need to have some “real” workouts in your week to build and maintain your overall fitness.  The goal for your week should be 3-4 sessions (at least 30 minutes long) of cardiovascular training, 2 sessions of weight training and stretching every day.

So, how do you actually fit this into the hectic schedule of clinical rotations or residency?

Step 1:  Make a list of things you like to do (not things you think you should do) in each of the three categories (cardio, strength training and flexibility).

Here’s an example for cardio workout:

Cardio – at home

  • Fast walk around the parking lot or neighborhood
  • Run (list different routes that work out to about 30 minutes to start with)
  • Jump rope in the driveway

Cardio – at gym

  • Treadmill
  • Elliptical trainer
  • Stationary bike
  • Racquetball
  • Basketball league on Tuesday nights
  • Monday – 5:30 am spinning class, 6:30 pm aerobics class
  • Tuesday – 5:30 am circuit weight class, 7 pm boxing aerobics
  • Thursday – 5:30 am aerobics class, 7pm spinning

Cardio – 10 minute workouts at work

  • Stairs
  • Fast “rounding” (do loops of the floors)
  • Jumping jacks
  • Up and down off a chair
  • Jump rope

Step Two:  Make a plan for every day of the week.

The real key to making this work is to plan ahead.  It’s just too hard, when you are leaving the hospital and every fiber in your being wants to go sit on a couch somewhere, to overcome that gravitational pull with the thought “but I should go to the gym”.  The only way you will be able to resist the gravitational pull of the couch is to have a plan.

Start by looking at your week and writing down what is likely to happen.  For instance, if you are on a q3 day call rotation it may look something like this

Schedule Comments
Sun Off
Mon On call
Tues Post call
Wed Out with friends after rounds
Thur On call
Fri Post call
Sat

Once you have the outline of the week, fill in the chart with the most reasonable option for exercise for the day… and then a back up plan in case the first option falls through.

Schedule 1st choice Back up Comments
Sun 24 hours off! Racquet ball with friend then weights at the gym Long bike ride with friend then weights at home
Mon On call 5:30 am spinning class or run before work Do stairs at work for total of 30 minutes
Tues Post call 8:30 aerobics class at the gym Swim at the YMCA
Wed Work at 6am Run before work Out with friends after rounds
Thur On call Take stretch bands and do weight work out on call. Do stairs at work for total of 30 minutes
Fri Post call Run before going home Gym before going home for 30 minutes on elliptical trainer
Sat Rounds 6-9 Gym for weights30 minutes on bike at gym Gym for weights after roundsRun in the evening

Step 3:  Cut yourself some slack (i.e. be flexible)

This is an ambitious schedule and there is no way it’s going to happen.  But – if you plan for 7 days, you’ll probably do at least 3 or 4.  If you plan for 3, you are likely to do just 1.   It’s also important to remember this isn’t another task on the scut list.  Above all, going to work out should feel like time to play and decompress … not another “task”.   If there’s a day you leave work to go to spinning class.. but realize you really want to be outside, go play in the park!

Step 4:  Keep a gym bag in your car

Load up a bag with anything you might need to work out – for any contingency.  Get a big bag so you can have your gear for swimming, spin class, running… whatever you like to do.  Even though it’s rare, there will be some days that you get out earlier than planned .. or the call schedule is messed up and you really aren’t on call.  Every once in a while you get a totally quiet day (yes, they are rare, but they do happen) and you can “run an errand” with the permission of your chief resident.   Take advantage of those days to take care of yourself by going to work out.