The life of a medical student is incredibly regimented. As a self-proclaimed list-maker, I thrive in an environment where I have the ability to plan every minute of my day. Growing up, a common mantra in our home was, “pre-planning prevents poor performance.” I have always taken this expression to the extreme, organizing each day and week in numerous assignment pads and on wall calendars. I personally feel most comfortable following a strict routine, and any uncertainty in my schedule creates some anxiety.
As a medical student pursuing a career in Plastic Surgery, I decided to take a 1-year leave of absence after my second year of medical school in Philadelphia to complete a research fellowship in the Department of Plastic Surgery at UT Southwestern in Dallas, TX. When I began in April 2019, I did not know how rewarding or exciting my time would be at UTSW. Over time, I fell into a comfortable rhythm and by November, I decided to stay for a second year to continue on with the projects I had become so invested in. In March 2020, however, the routines I had grown accustomed to over the past 11 months were completely upended by the spread of the novel coronavirus. Although our research team followed the news and was aware of the developing situation, events seemed to unfold so quickly once we were directly impacted. Within the span of 3 days, we packed our desks, canceled all upcoming research appointments, and planned how to remotely continue as many projects as we could while working from home.
The first week at home provided a much-needed opportunity to focus on manuscripts and complete any unfinished paperwork that had previously been laid aside to prioritize patient care. Work was a welcome distraction from what was unfolding around us. New information was constantly available through social media, news outlets, and university e-mail updates. I found comfort in creating lists of what we needed to accomplish. Meticulously planning my schedule eased some anxiety over the uncertain situation that was rapidly evolving.
I did not truly start considering the long-term impact this virus would have until the second and third weeks of quarantine. While roughly 500 patients had tested positive in Texas by the end of March, positive cases in New Jersey numbered nearly 3,000. Over the past 2 months, Bergen County, a county in Northern New Jersey of roughly 1 million residents, including my parents, has been impacted to the greatest extent, with over 11,000 confirmed cases and 650 deaths as of April 17. As I was still in Texas, my parents updated me daily on new mandates, such as nightly curfews, store closures, wearing masks in public, and limiting the number of shoppers in grocery stores. We spoke about medically vulnerable relatives at risk of exposure and people who had lost their entire lifesavings, as businesses were forced to permanently close due to financial hardships. My friends in medical school also called to tell me about the shelf exams, clinical rotations, and graduations that had been canceled across the country.
Although it seemed selfish, thinking about my friends’ and family’s experiences eventually led to worry over how the current situation would impact my future, both in the short- and long-term. As the idea of work–life balance is something I have always struggled with, my coping mechanism tends to involve immersing myself in work. I continued to distract myself with this, instead of reflecting on my current circumstances and striving for a healthier balance.
By the fourth week, however, I realized that in order to get through this time to the best of my ability, I would need to create a new routine. I began to consciously implement new strategies that helped my mental well-being more than ignoring the current realities. There is no single foolproof method to achieve a perfect work–life equilibrium. Maintaining sanity during this time requires a personalized approach for each individual. Below are some personal anecdotes that proved helpful to me adapting to what was my new “normal”:
ORGANIZE AND PRIORITIZE
I personally have never thrived on a traditional 9 to 5 schedule. One silver lining of working from home is that some of us have more freedom in organizing our schedules. Although we may be more flexible, time management is still crucial to maximize work productivity and efficiency. I prefer to plan out my day as much as possible. For me, writing seems easier at night. Accordingly, I address administrative tasks early in the day and reserve time very late at night to edit protocols and manuscripts. Separating my workday over 16 hours instead of the traditional 8 allows me to accomplish my tasks successfully while avoiding mental fatigue or burn-out.
Each person’s strategy, however, must be individualized. For some, a meticulous schedule is not useful and may not be followed. Instead, creating a general list of priorities each day or week may be a more efficient use of time. Additionally, many people feel fresh earlier in the day or prefer to complete their work in one large block of time. Determining how to be most productive, therefore, is an individual process that requires self-reflection and strategizing.
SCHEDULE BREAKS
Prior to this pandemic, my everyday schedule felt fairly well balanced between work and extracurricular activities. While we were still able to conduct research appointments, these visits provided a natural break from administrative tasks and computer work. While many healthcare professionals are participating in telemedicine, direct clinical care has been completely removed from my daily routine and I no longer have any work duties away from my computer. Additionally, as a big soccer fan, I participated in organized and recreational leagues at least 3 nights during the week, and my weekends were normally spent watching the professional leagues and playing myself. Prioritizing soccer just as much as my career set boundaries on how many hours I work each week and helped me maintain an identity outside of my professional interests. With the current restrictions placed on both research and sports, I have had to find alternative activities to break up my day and fill my free time.
Since I do not naturally wake up early, exercising in the middle of the day has helped separate my morning administrative tasks and evening writing. I never knew how many exercise programs were available on the Internet, and many of which are discounted or free at the moment. Planning a work-out regimen with these online videos and guides has kept me accountable for staying in shape for soccer. My flexible workday and unscheduled weekends have also provided the time to finally catch up on the TV shows, books, and art projects I have been wanting to tackle. Finally, as my parents, brother, and I are usually on very different schedules and busy with various time-sensitive commitments, it has never been this easy to find a time when we are all free to talk. Speaking more regularly to them, as well as other family and friends, has filled up my free time that was previously spent with friends in-person or playing soccer.
The timing and nature of these breaks, however, must be individualized, as everyone’s personal needs are different. Appreciating what you enjoy outside of work and recognizing how to best time these breaks for you can not only improve productivity but also mental well-being.
COMMUNICATE AND ALLOCATE
Although we are physically separated from our coworkers, it is still important to operate as a team. While in isolation, it may seem as though we are alone in completing our work. Maintaining a distribution of responsibilities may help to avoid feeling overwhelmed. Our research team has a shared document that outlines the statuses of our current projects. This to-do list is updated daily and is used to prioritize our schedules as well as guide virtual meetings with our entire research team. Regardless of how tasks are allocated, close communication is essential while we are working remotely. The use of group text messaging and video conferencing allows teams to collectively strategize how each member can meaningfully contribute to the operation. This not only provides work–life balance but also purpose and a sense of responsibility to everyone involved.
KNOW WHEN TO WALK AWAY
This is much easier said than done. As a large portion of the American population is now working remotely, the lines between work and personal activities have been blurred. It is much harder to simply take a break or acknowledge when a distraction should be welcomed. With iPhones and computers at our fingertips, we are constantly connected and seemingly unable to “turn off.” I constantly check my e-mails, almost out of habit, as there are always things to do and duties constantly required from us.
Everyone has limits, however. At a certain point, productivity begins to decline. In order to perform one’s best, it is crucial to recognize when a break is necessary. As many clinicians and healthcare providers are goal-driven, it is easy to become shortsighted and attempt to push through fatigue simply to cross an item off the agenda. By temporarily giving the mind a rest, work completed at a later time may be done more quickly and will be of better quality.
REASSESS AND RE-STRATEGIZE
Taking a small amount of time to review the workweek each Friday can boost future productivity. Acknowledging successes and uncompleted tasks may shed light on which methods worked and which strategies might be more beneficial moving forward. It is important to remain critical regarding areas of struggle personally and professionally. Using the previous week as a learning experience may be helpful to develop a new plan for the upcoming week.
During these unprecedented times, it is important to highlight the positives. There is no single “right” way to get through the workweek. This is a new experience we are all learning to adapt to. It is difficult to set expectations for what we should accomplish, as there is very little historical information, we can use to guide our judgment. Through regular reflection on our current situation and acknowledgment of accomplishments, however small, we may be able to maintain professional productivity, while also keeping perspective on our priorities outside of work.
The novel coronavirus pandemic we are currently experiencing has changed our lives as we knew them. While government authorities are beginning to report signs of hope, it is still uncertain how long restrictions will remain in place and how the virus will change the way we live in the future. The greatest lesson I have learned during this time, however, is that we are all experiencing this uncertainty together. Continued collaboration and communication will not only promote the spread of ideas to best adapt to and recover from this situation but will also help sustain personal connections while we are physically separated from others.
Disclosures
C.E.W. reports sponsor-supported funding from Venus Concept and Bellus Medical for research studies outside of this submitted work.
Funding
The author received no financial support for the research, authorship, and publication of this article.