One of the big problems we usually confront when we make the transition from plan to action is that we avoid starting. We want to avoid the unpleasant workload that is ahead of us. We often fall into the habit of “procrastination,” thus avoid doing a task that needs to be accomplished. There are usually two correlated reasons for this behavior:

  • Lack of motivation (remember when you postponed to study until the night before the exam?).
  • The inertness to start, because you have no idea how to start.

Let us skip from the car-driving paradigm to mountain climbing. Imagine that you are in principle capable to perform complicated rock climbing. You have decided that one of the important goals of your life is to climb the Matterhorn (Fig. 4.1).

Just looking at this mountain might intimidate most of us and induce a severe bout of procrastination: “this is not manageable, not today, maybe tomorrow, I have an urgent appointment with my coiffeur and so on ….” If this project is not really important for you, then walk away from it: no harm done. However, if the project is important, then you are in big trouble by walking away. The urge to accomplish and to deliver will catch up with you and will add to the many nagging voices in your subconsciousness. Eventually, the pressure might become so overwhelming that you start climbing. There are several drawbacks with this procedure. First, you went through a tough time with the nagging voice constantly accusing you of your insufficiency. Second, your pressure-generated motivation might make you blind for weather problems and you are climbing under less than optimal conditions.

The Stepwise Approach

A very efficient way to overcome this “procrastination problem” is to transfer this huge, monstrous project into manageable portions (actions). Fig. 4.2 shows you the subdivision of this monster climb into manageable steps (at least for the few mountain climber capable to do this), so that your perspective is a now and immediately manageable action (Fig. 4.3). Therefore, after defining a goal, you need to sit down and define the subsequent steps that you need to make (Fig. 4.4). This is a crucial point. You need to translate the goal into manageable steps (= actions).

The Need to Define the First Action

Take extra care to design an easy first action. Once you have started, things often become easier and are carried by the momentum that develops after successfully climbing the first step.

Forward and Backward Organization

By subdividing a complex problem into manageable steps/actions, it is essential that you:


  • Identify all necessary actions.
  • Put them in the right sequence.

One of the very effective ways to do this is to walk through a timeline. It is often useful to start with the end point. Imagine that you organize a meeting. Think at the closing session. What is needed at this point? Brainstorm the actions that come in mind: flowers for the organizers, certifications, in which location, date of next meeting, transfers to the airport, time the meeting stops, time for the transfers, etc. Note all the actions that come in mind and repeat that exercise with a forward approach. You will end up with long list of items (actions). Now sort them into a logical sequence: according to time frame, importance, etc.


Based on: Time and Life Management for Medical Students and Residents
by Michael Sabel

As grueling as medical studies and training are, with appropriate discipline and time management it is possible to stay afloat, maintain one's sanity, achieve one's goals, and still enjoy a fulfilling life. It is the purpose of this book to stimulate thought processes that nurture a healthy attitude toward organizing one's time and life so as to improve one's own quality of life as well as the patient's well-being.


Sign up and be the first to get exclusive offers, sales, events, and more!

Yes, I would like to receive email newsletters with the latest news and information on products and services from Thieme Medical Publishers, Inc and selected cooperation partners in medicine and science regularly (about once a week). I agree to the use and processing of my personal information for this purpose. I can opt out at any time by clicking the "unsubscribe" link at the end of each newsletter.

Further information about data processing and your corresponding rights.

*Required field; all other fields are voluntary. We only use this information to personally address you in your newsletter.