To start with a cliche, life is like a juggling act. We start with a few balls and at different points along the way accrue new ones. Sometimes we drop or lose balls. Sometimes, if we are clever and self-conscious enough, we consciously put some down or keep them closer. Medical school brings both necessary balls to juggle as well as opportunistic ones, the necessary ones are obvious, the opportunistic ones enticing.

First year of medical school was all about seeing if I could do it. I put my focus there entirely. I reduced the juggle, backing off on my sporting ambitions, choosing not to chase student leadership roles. It worked and I passed.

Second year of medical school I pushed the envelope a little by getting a few more balls in the air. I ran more, I started mountain biking, I got involved with our student society. At times some of the balls hit the ground. Unfortunately those that brushed the ground tended to be the life ones – health, relationship, friends. I got it back together in time and passed again.

Third year has yet again more happening. Two years ago I could not have managed this kind of juggling. Interestingly though, this juggling is different.

I recently went along to our MedSoc’s Well Being Evening and gave some tips and tricks about getting through the early years of medical school. I was asked to speak first so I first assured people that the only tips and advice I could give would be based on the things I had got wrong so far. Some of my senior classmates then spoke, each offering additional approaches. I was struck by the similarity in some of the messages, particularly when it came to managing relationships.

Typical time constraints meant that I hadn’t really gathered all my thoughts before the evening and a lot of them evolved inside my head as different people spoke through the evening. It was through this evolution of thoughts that I pieced together what is different about my current juggle. Let me explain.

Third year for me does indeed have more happening. I’m studying, I’m now married and doing my best to be present at home, I’m the president of our student society, I’m running more and competing in more events, I’m teamed up with my friend Blair building a new project (watch this space), I’m on placements rather than in books, I’ve just been granted a spot on another leadership program, I had a little bout with sickness, I’m writing regularly to keep this blog up to date.

This is a bigger juggle and yet there remain only 168 hours in a week.

When there are fewer balls in the air you can send them higher. More flight time means that down at ground level you have more time with the catching and throwing. Each contact can be more focused, more forceful, each contact can take more time without repercussions. Translating, with few goals or projects you can take your time without detriment to the other goals, you can push each ball to higher points, you can achieve more success in each domain. As you accumulate more tasks or roles, each contact is constrained, each flight time a little shorter, each success harder to come by. Importantly, if you do commit the same time or exert the same force as once before it will be to the detriment of other tasks or roles.

Up to this point I had been slowly realising that my academic performance this year had dropped. Sure I’m still keeping up but I’m not where I have been and it’s been eating at me a little. The thought train chugging through my head starting piecing these things together until suddenly it clicked.

I realise that the study is just one ball among many others. If I want to have a hand on any of these other tasks I have to realise that my energy and time is finite and that through picking them up I inadvertently reduce some potentials and constrain time. A critical point here is that for this to be acceptable I would only drop the standards of the tasks that don’t affect others (I suppose this was happening subconsciously as it was certainly the study ball that was brushing the ground). By putting my hand up for other things I would therefore need to accept a lower standard for a short period. To again state importance, these are tasks and roles that I want to do and to me they are worth a drop in performance in other domains.

I think we inherently know that more tasks means less outright performance. Elite athletes achieve the performances they do because that is all they do. They have a single ball to juggle. The different between a medical specialist and medical generalist illustrates this again. The generalist doesn’t have the depth of knowledge that the specialist has, but they intentionally sacrifice this in order to have the necessary breadth of knowledge. I currently see myself in this category, I am throwing some balls to a lower height because I want to have more tasks and roles. Yes I may drop some balls and yes I may drop standards on the roles that don’t affect others but I am ok with that in the short term. Going further, I see that this juggle can be a fluid system. I see that with exams a long way off I need only keep the study ball in motion while the other balls soar to new heights. As the year rolls on and the exams creep nearer I will shift this balance in favour of academia, pushing myself to the standard necessary for assessment.

Advice for you? Assess which balls need motion at which times. You can’t have them all in full flight. Drop standards on those that can take it so that you have the right ones in motion at the right times.

Good luck with your juggle.