For 11 years, I spent my weekdays (and a few weekends) tied to a pager. I've never had the kind of job where I was on call. I've almost exclusively worked in the outpatient setting.
I've never been on a code team, rushing to unresponsive patients. I've had the kind of job where patients scheduled appointments to be seen.
Even in my outpatient role, enough urgent issues arose that warranted being available immediately. Concerned about missing a page, it became my routine to check for pages even if I hadn't heard an alert. On elevators, walking between buildings, at my desk - I would look without even realize I was doing it.
It didn't take long for this habit to carry over to my email. I would mindlessly refresh, interrupting my other work, to be sure I wasn't missing anything.
Yes, crucial issues were supposed to warrant a page, but as our accessibility increased, it became commonplace for people to expect an immediate email response. I received more than a few pages asking "Did you see my email?"
I slipped into a routine of fragmented work. At the end of an incredibly busy day, it would feel like I had accomplished nothing.
However, in the rare stretches of time where I was not interrupted, I could easily edit manuscripts, create patient education materials, or develop a new project for the clinic.
I could get a remarkable amount done in these focused periods. But, they were few and far between. I came to realize that the reason they were rare was not related to how much I was "interrupted" but instead how much I allowed myself to be distracted.
I was the one incessantly jumping from one task to the next, creating a sense of being busy but missing out on feeling productive.
What happened to the person who used to study for 5 hours after class in PA school? The one who used to wake up day after day to repeat this routine?
Truthfully, a lot of my bad habits date back to PA school; I just had less of an opportunity to let them get out of hand.
A book I read earlier this year, Deep Work by Cal Newport, helped me to see that my struggle was not unique. In the book, Newport, an assistant professor of computer science at Georgetown University, explores how periods of in-depth, undistracted work produce an increased volume and quality of output in a shorter amount of time and why it's yet so hard to do.
I think many strategies can be adapted to getting more meaningful work done in less time when preparing for or fighting through PA school.
So, as I work through it myself, here's what I think can help you most in your journey to becoming a PA.
The Common Pitfalls
As I've come to recognize what holds me back from "going deep," I can see that the issues are not uniquely mine.
I've seen coworkers, PA school classmates, and students held back due to the same hangups. I think these pitfalls are the most relevant when it comes to future PAs:
This is particularly the case in PA school. You have SO much work outside of classes that it can feel overwhelming and like you are a victim to studying.
Waiting for the time to appear
Maybe if you get home early from your shift, you can start your CASPA application. But then the next day comes, and on Saturday you don't have food in the house, so you have to go grocery shopping.
Confusing being busy with being productive
Having three classes in a row, studying for an exam, and working a night shift means you are busy, but did your 35-minute study session prepare you well for the exam?
Not being realistic about "disconnecting"
Spending an entire Saturday afternoon "writing your personal statement" that is interrupted every 10-15 minutes for a quick text check or Instagram refresh is the mental equivalent of spending 30 minutes of concentration. Not fully concentrating on the work to be done is the biggest thief of your time.
So what's a future PA to do?
The most significant impact you can have on your ability to do "deep work" is to be deliberate and intentional with your time. Decide what types of activities would benefit from your devoted, undivided attention.
Once you establish what is worth long, deep stretches of your effort, you can then build a framework around your priorities.
1. Separate out the "shallow"
Some work involves superficial tasks, which you can squeeze into any free moment.
Superficial work can include informational finding missions, like searching for "how to write a personal statement" or finding anatomy flash cards with the best reviews.
When you sit down to do your in-depth work, having the superficial tasks knocked out and being fully ready to dive deep will help you avoid distraction.
2. Don't "find" time, schedule the time
Time will not materialize before you. In fact, when you are busy, even free time will disappear. When you thought you might have a Saturday to study, but you stayed up late studying the night before, and now you just have to sleep to recharge. Poof. Your time disappears before you know it.
I know what it's like to be busy. I worked three jobs (as a PA) when paying off my student loans. I went for 60+ day stretches without a day off. I felt extraordinarily sorry for myself even though I was solely responsible for creating my circumstances.
I was incredibly busy and probably single-handedly solved some staffing shortages. But, I can't pretend that was a productive time.
Being productive is different. It requires that you are completing meaningful work with significant cognitive effort. Productive work will continue to benefit you and your career five years from now.
Productive work starts with setting priorities and giving them the time they deserve. "Deep work" is not something everyone can (or needs to) do every day. But, you have to find and schedule the time for priorities that deserve your attention.
3. Find the right time
Everyone has a particular time of day where their neurons just fire better. During this period, you are more likely to produce high-quality work with less effort.
I had a running joke with my long-term collaborating physician that I was useless in the clinic after 2:30. By that time in the afternoon, I had already made so many decisions in a day that I was usually mentally spent. Even with a snack, I could only recover to around 70% of my prior capacity.
I'm not an anomaly. Decision fatigue is well documented. Every decision we make in a day, from simple to complex, requires cognitive effort. The more decisions we make, the less mental energy we have remaining.
With in-depth work, you will be more productive and produce better quality work if you start when you are fresh. If you're like me, you might be most alert and cognitively charged in the morning. Others may operate more smoothly in the afternoon or evening.
Just be sure you are not tackling a bunch of mentally taxing activities before you start.
Schedule your in-depth work around when your mind is sharpest. You'll produce better work and more of it.
4. Eliminate distraction
Once you've scheduled your productive work session, you cannot just hope for the best. You must actively set up your environment to not be distracting.
I, too, want to know what my friends' dogs are up to at any given moment. While I'm writing a blog post, maybe Abby went to the beach or Tito got a new squeak toy. But, it would take me twice as long to produce work of a lesser quality if I constantly checked my phone.
[Abby & Tito at their finest. This is what I'm up against.]
Deep Work cites plenty of studies that support this. The brain responds to even short, minor distractions. It takes a lot longer than you think to get back to the concentration level you were at before that quick email refresh.
So, before a "deep work" session, decide on your approach. Take yourself away from your phone, shut down your email, and decide on how long you'll work. Prevent your session from being fragmented by doing the superficial tasks in advance.
If you're looking for shadowing opportunities, do your directory searching up front at a separate time. Find your list of PAs to target before your in-depth session and have it ready. Then, during your "deep work" session, you can focus on creating your email template and personalizing it for each prospect.
Rather than going down an internet search rabbit hole, you can use your session to systematically work through your list and get more done in a single sitting.
The same goes for studying for PA school. When it's time to study the heart chambers, study the heart chambers. No mid study-sesh panic where you pause to verify exam dates or text your PA school friend about how you can't keep the valves straight. Just study.
It sounds simple, but this is no easy task. It will take practice and intentional effort.
5. Be systematic
The more routine you create for your work sessions, the easier it will be to get into the groove. Having a designated "start by" time, regular work space, and even a pre-getting-to-work song can help.
(My new incarnation of this system includes noise canceling headphones and an hourglass timer, both of which I am using as I write this.)
Many proponents of in-depth work advocate working in at least 60 to 90-minute stretches and for not longer than 4 hours per deep work session for optimal results. After 4 hours, our cognitive ability declines substantially.
But, if you have more time on your hands beyond 4 hours, it's a great time to get to some of those more shallow tasks done. Managing your time well and saving these to-do list items for after can help you to clear space for your next in-depth session.
Creating a system of using little rituals trains the brain that an in-depth work session is about to start. Having a routine will help you to get the most of our your in-depth session. Over time, you'll be able to get into the heart of your important work faster with less effort.
We live in a world of near constant distractions, so if you struggle to stay focused, retraining yourself to "go deep" will not happen overnight. But, with continued effort and using these guidelines, you can produce higher quality work in a shorter amount of time.
I'm not great at it yet, but I have seen major improvements in my productivity with minor adjustments in my behaviors.
You might be amazed at how quickly you can supercharge your journey to be a PA by making time for your priorities that require depth.
Newport, C. (2016) Deep Work. New York, NY: Grand Central Publishing.