How to motivate yourself
Can’t be bothered to write that essay? By: Anita Houghton Published: 20 June 2011 DOI: 10.1136/sbmj.d3220

Life is full of things that need to be done, and medical student life is fuller than most. There are essays to write, lectures to attend, patients to see, skills to sign off, and exams to revise for. And there are also parties to go to, friends to be with, drinks to be enjoyed, sports to be played, music to be listened to, and fun to be had. How do you fit it all in?

Planners vs Last Minuters
When it comes to getting things done there are two main camps. There are the type that consider work, however unappealing, should be done before play. These people like to get things done in plenty of time, and they like to plan. They do not like finding themselves with a substantial amount of work and only a short time to do it. All these people need to get motivated is a job that has to be done. The problem arises for them when there are jobs that don’t have to be done, or at least not by a particular time, and which they find unappealing. With these they procrastinate, just like anybody else. The other problem that this type may experience is never getting to the fun. Let’s call this type the Planners. The other camp have a rather different philosophy—life is meant to be fun, why spoil it with work unless and until you absolutely have to? In fact, work itself should be fun, shouldn’t it? These are the easy going and flexible people in life. What these people need to get motivated is a job that has to be done right now. That’s because when the last minute approaches this type get a sudden surge of energy which renders them extraordinarily efficient. Entire modules can be learnt overnight. An essay can be written in an evening. Three month projects can be completed in a few days, or a week anyway, or perhaps a fortnight, or maybe a bit longer. And this is the trap that this type are in danger of falling into—not knowing when the last minute begins. They wait for that surge and then they know it is time to start—but what if the surge doesn’t come at the right time? What if it arrives two weeks before finals, when there

is actually at least three months’ worth of revision to do? What if their gut instinct isn’t all that good at making these crucial estimates? Let’s call this type the Last Minuters. To maximise motivation, Planners need to have more fun, because fun lightens the spirit and renews energy. The Last Minuters need to estimate carefully how long their projects will take. Both types need to plan.

What works in self motivation?
A few years ago Richard Wiseman, professor for the public understanding of psychology, did a study of 5000 people from all over the world who wanted to achieve something in their lives: pass exams, lose weight, progress their career, and so on. He monitored their methods and their achievements, and from the data he gathered he identified the techniques which were associated with success, and those which were not. These were the techniques that were consistently associated with success: (1) Making a plan consisting of small, achievable steps to be achieved within a specific time frame (2) Rewarding yourself when each step is completed (3) Telling others about your plan (4) Reminding yourself of the benefits of completing your plan (5) Keeping a written record of your plans and your progress.

Let’s see how this could work for you in preparing for exams.

First write down every area that you need to prepare or revise. Everything from clinical scenarios and system examinations for objective structured clinical exams and vivas, to learning the differential diagnosis of ankle oedema or the microscopic features of a cirrhotic liver.

For each area, write down what resources you will need (books, lecture notes, papers, and so on) and estimate how long you will need to spend on it, bearing in mind that you will want to revise subjects more than once. Add up the hours you need to spend revising, including the time it will take to assemble all your resources. Experience suggests that you should add at least 50% to your total hours to allow for underestimates.

Look at the time available between now and your exams and calculate the number of hours you need to work each day, allowing for rest periods/days. Draw up a timetable.

Tell your friends or family, or both, about your plan. You may like to stick it up on the wall where you work or put it on your Facebook page.

Each day, plan yourself a reward for each step. You might plan a cup of coffee and a brief chat with a friend for mid-morning, a nice lunch at midday, and some exercise or a television programme in the evening.

Write down the benefits of keeping to your plan, and each day remind yourself why it is you want to work effectively, and how much you want to do well (see below for turning “shoulds” into “wants”).

Keep a daily written record of your progress.

Other ways to get motivated
Start, even if only for a few minutes —A Russian psychology graduate in the 1920s, Bluma Zeigarnik, found that once someone starts a task, a kind of psychic anxiety is produced which stays until the task is complete. In other words, if you wait for motivation you might wait for a long time, but if you start the task, even if only for a few minutes, motivation arises. Do it with someone—Challenges are less daunting if they are tackled with a friend. Combine optimism with realism—Simply visualising success not only doesn’t work but can actually result in reduced effort and lower levels of achievement. Similarly, focusing on difficulties and obstacles is demotivating and unlikely to result in success. Gabriele Oettingen, from the University of Pennsylvania, did a study where participants were asked to identify the benefits of achieving their goal, and also to identify likely difficulties along the way. She found that people were more likely to achieve their goal if they combined optimism about achieving it with careful assessment of obstacles and how they will deal with them.

The least appealing tasks
Consider the following example. You don’t like tidying your desk or putting your notes in order, but you know your work will be easier and more efficient if you do.

Remind yourself why you want to do it
Tasks that you need to do but don’t want to do are always shrouded in “shoulds,” “oughts,” and “musts.” I should tidy my desk. I ought to put my notes in order. I must start my revision today. I really should go to the library and research that essay. I should lose weight, take exercise, drink less, eat more healthily, ring my parents, do my laundry, get my hair cut, and so on. These words are a remnant of our childhood, a time when we wanted to play but our parents and teachers wanted us to work. You wanted to play on your PlayStation, chat with your friends, or watch television, but all you ever heard was: “Do your homework,” “stop talking and concentrate,” “tidy your bedroom,” “go and practise your piano/violin/trumpet.”

All of us imbibe these admonishments until such time our parents and teachers become redundant because we carry their voices inside our heads. If you listen to yourself carefully you will hear these voices, and if you check your body you will find that the feeling that you have when you tear yourself away from doing what you want to do, to do what you should do, is exactly the same today as it was back then. An appreciable change in this one pattern will make more difference to your motivation than any other single course of action. The way to do it is to substitute “I should” with “I want”: I want to tidy my desk so that I have a clear space to work. I want to get my notes in order so I don’t have to waste valuable revision time looking for the right ones. I want go to the library today and get what I need to start my essay. I want to drink less and eat more healthily this week so that my head is clearer and I feel better.

Do it little and often
Putting off tasks will result in them getting bigger and bigger, until you need not just an hour or two, but a whole week to do them. Do them regularly and in small steps.

Do it at your best time of day
You wouldn’t start tidying your desk late in the evening after a few drinks and a heavy meal, would you?

Make it fun
How could you make it fun? Put some music on, think about how great you’ll feel when it’s all tidy, develop a new and brilliant filing system, have a competition with a friend to see who can do the best job in the least time. If you’re stuck for how to make it fun, ask one of your Last Minuter friends for some tips. A medical student’s prayer: May I turn my “shoulds” into “wants,” my tasks into plans, my obstacles into action, and my drudgery into fun.

Further reading
Houghton A. Chapter 12 Getting motivated. Chapter 14 Action! Know yourself: the individual’s guide to career development in health care. Radcliffe, 2005

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