7 Habits of Highly Effective Med Students

This post highlights Stephen Covey's best-selling book, The 7 Habits of Highly Effective People, and how it applies to medical school.

Habit #1: Be Proactive

“But until a person can say deeply and honestly, ‘I am what I am today because of the choices I made yesterday,’ that person cannot say, ‘I choose otherwise.’”

- Stephen Covey

Being proactive is essentially taking responsibility for your life. It’s about controlling what you can control. Whether you’re a first-year medical student or about to graduate, you have the ability to choose the attitude you attack each day with. You are in charge, and that is a beautiful thing. Once you grasp the notion that what separates those at the top of their class from those that drop out in their first year is a proactive mindset - as opposed to a reactive one - you can then understand how to achieve the former, as opposed to the latter.

A reactive person constantly searches for areas in their life to place blame upon. They feel victimized by things entirely out of their control. If it’s raining outside, they choose not to go to class and blame the rain when they fail a test because they weren’t there to receive the material. Why? It’s simple - because that’s the easy way. It takes less effort to do nothing and complain than it does to take the initiative and overcome adversity – even if that adversity is something as faint as a little rain. What they don’t realize is that even if they do choose to sit and complain, and even if their complaints are objectively valid, it still won’t get them anywhere.

A proactive person, on the other hand, realizes that all the rain has done is present them with a choice: go to class and proceed as usual, or take the easy way out. Covey stresses that what distinguishes us as humans from all other forms of life is our inherent ability to examine ourselves and make choices based upon our examination. Despite what your weather app may be telling you, you can still choose to go to class.

What it boils down to is this: In medical school, you are going to face a lot of external sources that will tempt you to be a reactive person – long hours, plenty of bills, etc. In the end, it’s all on you – you have the ability to be a proactive person and go where others are not willing to go.

Habit #2: Begin With The End In Mind

“It’s incredibly easy to get caught up in an activity trap, in the busyness of life, to work harder and harder at climbing the ladder of success only to discover that it’s leaning against the wrong wall.”

- Stephen Covey

Covey’s second habit is all about having a clear vision of what it is that you want to achieve. You hear it all the time growing up: what do you want to do with your life? Oftentimes, we get so caught up in the intricacies of life that we lose sight of the purpose behind whatever it is we’re doing. For many people, the hardest part of this is determining what exactly they want to pursue as a career in the first place – it’s impossible to begin with the end in mind if you do not know what you want the end to be. For medical students, however, the end is graduating medical school, before pursuing your dreams as a doctor. And when you have that destination engrained in the back of your mind, it makes the journey of medical school much less daunting.

Legendary basketball coach John Wooden once said, “Don’t mistake activity for achievement.” Granted, he may have been referring to sports at the time, but it’s more than applicable to all areas of life. Beginning with the end in mind correlates directly with the meaning behind Wooden’s words here. We all strive to achieve subtle victories throughout life, but if those victories are getting us closer to something that we don’t actually want, are they in fact victories in the first place? Meaning, don’t seek victories simply for the joy of winning, but rather seek the victories that will get you to your preferred destination. For example, rushing to get your paper done so can go out for a few drinks with friends might seem like a victory at the time, but that will get you nowhere in regards to reaching the destination you initially set out for.

The bottom line is at some point you have to ask yourself, “What do I want to be?” It may seem cliché, but those five words form one of the most powerful questions you’ll ever face. When you look in the mirror, what qualities and characteristics do you see? What do you want to see? More importantly, on a finite level, are you making the decisions today that are aligned with the end goals and aspirations you have set?

You know what you’re getting into when you begin med school (at least you think you do). You know the hours will be long and strenuous – and they will swallow you up if you go in with a shortsighted approach. You have to be in it for the long haul, and you cannot lose sight of your goal. In short, you have to begin with the end in mind.

Habit #3: Put First Things First

“You have to decide what your highest priorities are and have the courage – pleasantly, smilingly, nonapologetically, to say ‘no’ to other things. And the way you do that is by having a bigger ‘yes’ burning inside. The enemy of the ‘best’ is often the ‘good’.”

- Stephen Covey

The keyword here is, “priorities.” It’s absolutely crucial to maintain a balanced lifestyle with priorities in place – especially when surrounded by the demands that come with medical school.

Now that we are on to the third habit, we begin to understand that they are ordered in a premeditated manner, where each particular habit relates to those that came before. In this instance, where Covey’s second habit, Begin With The End In Mind, is all about having a vision, his third habit, Put First Things First, is about acting upon that vision. When you’re in medical school, you have all kinds of things that can keep you busy. The key is determining which things are beneficial towards your vision, and which are not.

Covey stresses that it’s important to manage your time, but it’s imperative to manage yourself. Essentially, know what it is that you truly value, and take actions that promote those values. With far too many people, there’s a massive deviation between what they say they want and how they allocate their time. If you want to be a doctor, you have to be willing to make the necessary choices to get there.

Here’s the good news: prioritizing your life on a day-to-day basis is easier than it sounds. For better or worse, medical school is going to eat up most of your time anyways. However, you still have the power to choose how you spend that time. You might not choose how long you are in class, but you can choose how you pay attention during class. You might not choose your reading assignment, but you can choose how hard you work to understand the material.

Covey uses two main factors that you can use to determine your priorities: urgency and importance. We react to urgent matters because they tend to press on us and insist on instant action, regardless of their significance. Importance deals directly with results - the trick is determining what is important and what isn’t. Simply put, the things that are important will contribute to your vision; the rest are not important. Take a look at Covey’s “Time Management Matrix,” below:

IMPORTANT Quadrant I Quadrant II
NOT IMPORTANT Quadrant III Quadrant IV

Take a guess what quadrant you think the most effective people typically focus on.

Most people would guess Quadrant I - and they would be wrong. The correct answer is Quadrant II, which is “the heart of effective personal management,” according to Covey. Granted, there are many influences that fall under Quadrant I that are a high priority and must be dealt with, but those who spend all of their time in Quadrant I can be overwhelmed by the stress of constantly dealing with urgent matters that tend to be problems or crises. Or, as is often the case, urgency can mislead you into believing something is important when it is not - which leads many to fill their days with Quadrant III activities, mistakenly believing they are Quadrant I activities. Quadrant II, on the other hand, deals with more lasting results, such as building relationships with your teachers and classmates. The key is to focus on Quadrant II while having the discipline to determine the Quadrant I crises from those that are not. That’s what putting first things first is all about.

Oh, and one last tip: stay away from Quadrant’s III and IV.

Habit #4: Think Win-Win

“Win-win is a belief in the Third Alternative. It’s not your way or my way; it’s a better way, a higher way.”

- Stephen Covey

This is the habit that most medical students, and most people in general for that matter, struggle with the most. The dog-eat-dog mentality of today’s society has left us in a world strangled by our over-competitive nature. From a young age, we are groomed to base our self-worth through competition and comparison. We see life as a zero-sum game in which the only way for me to win is by beating you.

7 Habits of Highly Effective Med Stud...

Thinking win-win is about throwing that notion out the door. It’s about viewing your fellow students in a cooperative light, rather than as your competition. No, it’s not about simply being nice and trying to please everyone else, and it’s definitely not about participation trophies – there is a place for competition in your life. Instead, a win-win attitude is about working together to create mutual benefits for both parties involved.

Doing so requires one big balancing act. It requires not surrendering to the either/or mindset that most people subscribe to. In order to think win-win, you must be both courageous and considerate, not one or the other. It is possible to be both nice and tough; to be greedy and generous. When you attack problems by seeking a solution where both parties involved benefit, you show true integrity and maturity, which creates a lasting relationship based on mutual cooperation, rather than competition. Furthermore, if you can’t come to an agreement where both parties benefit, that isn’t the end of the world. You don’t need to force an agreement where one side wins and the other loses merely for the sake of trying to solve the problem. Covey calls this “Win-Win or No Deal.” When you are able to understand no deal is a viable option, you liberate yourself from feeling the need to immediately solve every confrontation without regard for the outcome of both sides.

Here’s a crazy notion for you to consider: In order for you to win, another person does not have to lose! You don’t need someone else to score poorly on his or her MCAT in order for you to score well, do you? Some will argue that if others do poorly, it benefits you by allowing you to get into a better-med school, which might lead to a better job offer. While this may hold some truth at its core, those people are succumbing to scarcity mentality – believing in the idea that, “if you get, I don’t.” Covey, on the other hand, promotes the idea of an abundance mentality – believing there is plenty out there for everybody. And while it may not seem like it at times, there undoubtedly is.

The tough thing for most people to grasp is that if they win, why does it matter if someone else loses? All that matters is that you won, right? Wrong. More often than not, when someone else loses as a result of your victory, you are hindering a relationship that could have been beneficial down the road – and could end up coming back to hurt you. So while the outcome might temporarily feel like a win, it could easily turn out to be a loss in the long run. Your classmates do not want to work with someone who is only looking out for their own good. If you truly want to establish effective relationships, you must think win-win.

Habit #5: Seek First To Understand, Then To Be Understood

“Most people do not listen with the intent to understand; they listen with the intent to reply.”

- Stephen Covey

Perhaps none of the seven habits relate to medical school more than the fifth habit: seek first to understand, then to be understood. Covey’s quote above says it all – many people only have two stages of the conversation. They’re either speaking or they’re preparing to speak, both of which are filtered through their own personal paradigm. In theory, listening should be a fundamental part of all forms of communication, but most people become too absorbed with their side of the conversation that they completely ignore the other side. The reality is that many people hear, but few truly listen. And if they do in fact listen, it is for all the wrong reasons. That’s what the fifth habit is all about: understanding why and how to listen for the right reasons.

Listening with the intent to reply, as opposed to listening with the intent to understand, can be extremely dangerous – especially for a doctor. It means you are prescribing a solution before you have fully diagnosed the problem.

You wouldn’t prescribe a certain medication merely because a patient is complaining about chest pain, would you? Of course not. You would ask follow-up questions, perform tests, and do whatever it is you can to thoroughly understand the problem first.

Covey refers to this type of listening as “empathic listening.” It simply means listening to understand – to really understand. It means listening not so that you can pass an exam, but listening so that you truly understand the material – passing the exam will come with that.

Learning to listen empathically is not something you will learn to do overnight. It takes time, effort, and focus. Think about it – we spend years learning how to read, write, and speak at a young age; but we’re never taught how to listen. Learning how to listen the right way is mostly about breaking bad habits you have formed from listening the wrong way. However, if you make a conscious effort to truly listen, you will be a much more effective medical student, a much more effective doctor, and a much more effective communicator in general.

Habit #6: Synergize

“Synergy is everywhere in nature. If you plant two plants close together, the roots comingle and improve the quality of the soil so that both plants will grow better than if they were separated. If you put two pieces of wood together, they will hold much more than the total weight held by each separately. The whole is greater than the sum of its parts. One plus one equals three or more.”

- Stephen Covey

“One plus one equals three or more.” That might be hard for some people to really grasp. Why would one plus one be anything other than two? The answer, as you might have guessed, is synergy. In essence, synergy is all about believing the whole is greater than the sum of its parts; that two heads are better than one. In simple terms, it’s about living a lifestyle that promotes creative cooperation and open-mindedness.

In order for this habit to work, you must have already adopted the previous habits – specifically habit #4: think win-win, and habit #5: seeking first to understand, then to be understood. In a sense, synergy is a combination of all the previous habits. It allows you to genuinely interact in a positive manner. Amazing things happen when you accept the fact that you are working together towards a common goal that both sides can benefit from, and you are truly willing to listen to others and accept their influence.

The driving force behind synergy is having the wisdom to value differences. People are different – mentally, emotionally, and psychologically. They can view the same thing, and see it differently. Once you’re able to accept this as a blessing rather than a curse, you can create endless possibilities. Unfortunately, many people would rather everyone just agree with their point of view and move on, only eventually they will get stuck. Synergy is about not only understanding that differences are present but seeing those differences as strengths, rather than weaknesses. It promotes the type of creativity and cooperation that allows you to push past boundaries that would otherwise hold you back if you went at it alone.

Synergy can certainly help ease your journey through medical school, but it will become an indispensable part of your medical career. Selfless teamwork and open-minded cooperation are the backbones of any hospital. Being able to work together and embrace different perspectives is what allows you to solve a case that you might not have been able to solve individually – to save a life that you might not have been able to save individually.

One plus one equals three or more.

Habit #7: Sharpen The Saw

“Moving along the upward spiral requires us to learn, commit, and do on increasingly higher planes. We deceive ourselves if we think that any one of these is sufficient. To keep progressing, we must learn, commit, and do – learn commit, and do – and learn commit, and do again.”

- Stephen Covey

The seventh and final habit of effective medical students is all about preserving and enhancing the greatest asset you have – yourself. While the first six habits call for a specific action or attitude, the last habit calls for you to keep yourself fresh so you can continue to focus on those first six habits.

Covey breaks our nature down into four dimensions, each of which must be exercised differently. The four dimensions, along with several corresponding exercises are as follows:

  • Physical: good eating, physical exercise, proper rest
  • Social/Emotional: making meaningful social connections with others, seeking to deeply understand others, maintaining an abundance mentality
  • Mental: enhancing your mind through reading, writing, and learning
  • Spiritual: meditation, prayer, being in nature, listening to music

While sharpening the saw to increase your medical aptitude is important, finding the time to recharge your batteries is absolutely vital for a med student. Medical school is incredibly draining in itself; it’s nearly impossible if you are not taking care of your mind and body. As we all know, however, feeling good is not something that just happens; it takes a conscious effort to renew yourself and live a balanced lifestyle.

Exercising each of these dimensions will stimulate growth and maturity in your life, which in turn will increase your ability to effectively communicate and handle the challenges that come with a medical school. The more you sharpen the saw, the more synergistically capable you are of employing the other six habits into your life.

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