No matter who you are - whether you’re a medical student, still in undergrad, a parent, teacher, pastor, literally everyone – we all struggle with staying motivated. It’s human nature. We try to avoid hard and boring tasks that build toward our long-term goals in favor of instant gratification and distraction. Why would you want to study or go to the gym, when you could catch up on the newest episode of Westworld or get an extra hour of sleep today? What makes everything worse (at least for me), is that the most successful people seem to never struggle with staying motivated. I’m sure you’ve seen them: the super fit classmate or co-worker who seems to be able to juggle a slew of hobbies while still being able to cook dinner every night and seemingly outperform all of their peers. I catch myself starting to resent them and their perfectly pressed shirt, with their home-made chicken and quinoa bowl for lunch. They make it seem so easy! How do they do it? What is their secret? How can I stay motivated? If there is one thing in this world that will force you to find these answers, it’s medical school. There are tons of analogies for medical school, although the most popular one is that getting through the material is akin to “drinking from a fire hose.” Personally, I don’t like this imagery as it depicts the process as something that is impossible. I prefer the “eating 1000 pancakes” comparison immortalized by this video from St. Louis School of Medicine. The short version is that you love pancakes (medicine), but eating 1000 of them is daunting. Especially when you spend all your normal time learning about pancakes, making pancakes, while talking to others about them. But, if you consistently eat 5 pancakes a day, every day, you will be finished before the end of the school year. But if you skip a few days here or there, you suddenly have to eat 7 or even 10 pancakes a day for the rest of the month to catch up. In hindsight, this is probably the most accurate depiction of medical school. If you are consistent every day, the material is manageable. But therein lies the rub. It takes monumental drive to study and work hard every single day for years on end. It’s not an intuitive skill, and most first year medical students (myself included when I started) struggle and fail a few tests before they figure it out. The good news is that most of them do figure it out, and ultimately almost 97% of medical students succeed. Even better news is that the skills these students master are not specific to medicine, or even studying/school as a whole. You can use these guidelines to stay motivated for anything. Based on our experiences, and with the input of our colleagues and mentors, we’ve compiled the top 10 ways to maintain your motivation. 1. Have specific, yet realistic expectations with a realistic timeline. Despite seeming very obvious, this is probably the most important and most difficult part of reaching any goal. Many times we set out with expectations that are either unobtainable or very unlikely. If you haven’t been to the gym in over a year, you shouldn’t expect to have that 6-pack before summer time. I struggled with this significantly as a medical student, and often tried to master a two hundred slide lecture in an hour or two. Not only was it impossible for me to digest that volume of material, failing to do so often left me frustrated. There is also the problem of setting too vague of a goal. It’s tempting to start with loose and lofty idealizations such as “getting fit” or “doing better on the next exam.” However, it becomes difficult to maintain motivation without having appropriate benchmarks to gauge your progress. With no way to track progress it is easy to get discouraged, making it less and less likely that you will see it through. This can cause a cycle of setting poor goals and failure. One study even found that having non-specific goals has been linked with depression. (For full disclosure, the study does not differentiate which came first: the depression, or the poor goal setting). The obvious take-away is to make specific objectives that will lead you to your larger goals. You will be more likely to succeed, and may even be less depressed! 2. Never lose sight of the big picture. It’s easy to get caught up in day-to-day conflicts, and forget about the light at the end of the tunnel. In the environment of constant exams and evaluations, most of our class focused on who were the highest and lowest scorers on every test. Almost every conversation during the first few years of school revolved around tests: which questions were or weren’t fair, how many people failed, and (it saddens me to admit that this happened) who we thought failed. It drove many of us into depression, and was by far the worst part our training. How do most of us survive this ordeal? The truth is, we have to take a few minutes every so often to look at the end-game. Methods of doing this vary drastically. Some of my classmates would look up prestigious residencies and fantasize about their future cardiology fellowships. Others would even look up expensive houses on the beach and dream about their glamorous lives once all this is over. As for me, I prefer more modest luxuries: a dog (or two… or three), job flexibility, and not feeling like an impostor every day. My partner admits to dreaming of returning to the west coast, and to awaiting the day she feels empowered by her training instead of being humbled all the time. The point is to find a way to keep a positive outlook on the future. Don’t just take my word for it either. A 2001 study found that having positive fantasies about the future was correlated with strong goal commitment. Keep a bright outlook for the future, and conquer your goals. 3. Never take a (full) day off! Yes, I know it sounds terrible, but bear with me. After a few days of hard work, it’s tempting to rest on your laurels. My guilty pleasure is a day of dietary debauchery after a week of clean eating. Whether we go to an AYCE Sushi restaurant or I binge on Taco Bell, I tend to go nuts once a week. This is really a bad way to diet, as it usually just results in me feeling awful and (anecdotally) increasing cravings throughout the week. If you do believe in a “cheat” meal, the scientifically best results in leptin spike comes from a modest increase in carbohydrate consumption. Key word: modest. You should still watch what you eat. This also applies to any other goal. After a long and difficult week of tests and studying it was hard not to spend an entire day playing video games and push my textbooks as far away as possible. But I feel this is the wrong strategy. To clarify, I’m not saying you can never relax. On the contrary, I am a large proponent of Netflix marathons. However, I try to get even a small amount of work done every day. For example, I find that spending even 20 minutes going over my notes on an “off day” not only helps me recall information better, it also helps reinforce the habit of studying. The relaxation hangover is easier to cure when I have made even a tiny effort toward my goals. You can apply this to pretty much anything. Take a 15 minute power walk instead of your normal 3 mile jog, or work on a blog post for half an hour instead of working until it is finished (if you can’t tell, I struggle with both). Even a small amount of time can keep you on track and lower the incidence of the Monday blues. Well, that’s it for this post. I hope to jot down a few more tips in a week or so, but reliving the first few years of training have given me flashbacks of the small windowless room I spent thousands of hours in studying for Step 1. What keeps you motivated? Let me know in the comments!