How to Make Tough Decisions — 7 Strategies for Better Decision Making


As a premed or medical student, you’ve likely already had to make a few tough decisions. From deciding to become a doctor to choosing your undergraduate degree to deciding which medical schools to apply to, the list goes on. And you’ll continue to have important decisions to make throughout your time in medical school.

What research experience is best for your resume? What specialty should you pursue? What residency programs do you apply to? Where do you want to live for the duration of your residency and beyond?

If you struggle with decision making, you understand how debilitating not being able to decide can be. Struggling with small, everyday decisions is one thing, but what about those major life decisions that will have a rippling effect for years to come?

Whether you’re narrowing down your final list of schools, deciding whether or not to take a gap year, choosing from your acceptances, or picking a specialty, the following decision making strategies will help you make informed decisions you can feel good about for years to come.


1 | Be Informed and Do Your Research

Doing your research is the first step to good decision making. This is especially true the more important a decision is. Major life choices, like deciding which medical schools to apply to or which acceptance to choose, require plenty of research in order to make an informed decision.

Taking time in the research phase will set you up for success and give you the tools you need to make the decision that’s right for you.

Do the research you can online, but go far beyond simple Google searches and using the MSAR. Reach out to mentors, professional acquaintances, and other students to get inside information. If you are trying to decide which schools to apply to, speak to staff at the school, ask current students specific questions, and, if you can, go to the campus yourself to get a feel for the location and community.

If you’re trying to choose a specialty, do your research about what the specialty is like, including lifestyle, education requirements, pay rate, working hours, and the type of people you’ll be working with. But don’t stop there—speak to students who are also pursuing that specialty, reach out to professionals in the field, and get as much real-life experience as you can to determine whether or not it’s right for you.

If you’re trying to decide what specialty you want to pursue, we have a whole series dedicated to dissecting different specialties and subspecialties. Our “So You Want to Be…” series takes a deep dive into how to pursue each specialty, pros and cons, and how to determine if the specialty will be a good fit for you.

Thorough research is the backbone of good decision making. Every strategy you enact from here on out will be aided by in-depth research.


2 | Consider Impact vs. Effort

What is the impact versus effort for the options you are choosing between? An impact effort matrix is a simple decision making tool that helps you align your priorities.

What options will leave the largest impact, and how much effort is needed to reach that result?

The impact effort matrix has four quadrants.

  • High impact, low effort
  • High impact, high effort
  • Low impact, low effort
  • Low impact, high effort

Impact Effort Matrix chart

Plot all of your options on your matrix in the locations that make the most sense to you. In comparison to all of your other options, how much effort will going down this path entail? In the end, what is the impact of the decision? How much do you actually want that outcome to become a reality?

For example, let’s say you are choosing which medical schools to apply to and are trying to decide whether or not to apply to Texas medical schools. If you are also applying to schools outside of Texas, adding another application service (TMDSAS) is certainly a notable increase in effort. But if you’ve always dreamed of going to Baylor’s College of Medicine, the impact of getting an acceptance from that school would be quite high and incredibly fulfilling.

Another example to consider is whether or not you want to pursue a difficult specialty, such as neurosurgery. What is the effort involved in pursuing such a competitive and difficult specialty versus the impact it will have on your enjoyment, lifestyle, and other factors? Do you care about pursuing a high-paying specialty, or would you prefer a lifestyle that allows for more work/life balance and time for family?

This tool should by no means be the only one you use to make tough decisions, but it does provide additional insight into where your limited time and resources should be spent. If you discover an option that’s high impact, low effort, it’s certainly a decision to consider.


3 | Apply Parkinson’s Law

Parkinson’s Law states that work expands to fill the time allotted for its completion. So, if you allot yourself three hours for a task, you’ll likely use the full three hours, or if you give yourself an entire weekend to complete a task, it’s going to take the entire weekend.

But by giving yourself less time, you can actually accomplish what you set out to in a shorter time frame. This law is usually applied to tasks, but making a tough decision is a task itself, and it’s one that can become incredibly time-consuming.

Give yourself plenty of time to make a tough decision, but don’t get carried away. Tough decisions can eat away at you and continue to consume your time and valuable brain space. Whether you are a premed or medical student, there’s not a whole lot of extra time to spare.

Be mindful about the amount of time you allow yourself to spend making a decision. Try applying Parkinson’s Law; give yourself a shorter amount of time to make a decision instead of applying an open-ended time frame to your decision making. If you have unlimited time to make your decision, you will very likely fill all of that time. You’re better off giving yourself a tight deadline to follow and then extending it a little if you need to.


4 | Take Time Away

Just like every great steak, tough decisions need time to rest. You need time to reflect, and you need time for your brain to get used to each idea.

After you’ve done your research or after you’ve made a bit of progress towards reaching a decision, take some time away from the question entirely. Do something completely unrelated. This could mean going to the gym, going for a walk, working on another task, or something more involved, like only focusing on your studies for a week or visiting family for a weekend.

As tough as it may be, do everything you can to push that decision out of your mind. Focus on something else to keep your mind occupied. Afterward, you can come back to the decision again to see if anything has changed. Has time away made you lean in a different direction? Did not thinking about the problem help you reach a decision? Do you have a new perspective now that you’ve spent some time doing something else?


5 | Trust Your Gut

No matter how much research and preparation you do and no matter how many opinions you gather, it’s your life. What does your gut tell you? What do you feel when you consider each of your options?

If you visit a campus and something doesn’t feel right, don’t dismiss it as ‘just a feeling’ or ‘just nerves.’ Take that feeling into consideration. What does your gut tell you about the cities you visit during interviews? What does your gut tell you about the people you meet on campus or about moving across the country away from your family?

A gut feeling should by no means be your only consideration, but don’t dismiss it. It doesn’t matter if you think you should or shouldn’t like something. If you don’t like it, you don’t like it, and vice versa.


6 | Sometimes Making a Decision is All That Matters

Making a decision and committing to it is often more worthwhile than continuing to flounder in the murky, anxiety-ridden limbo of indecision. When you make a decision, you’ll finally be able to fully pursue that option; sometimes, this is the only way to find your best path forward.

Say you’re choosing between two acceptances at two very similar schools that both meet your criteria and are both located in cities where you’re excited to live. In this case, it really doesn’t matter which one you choose. Going down either path will present a number of opportunities, and since you can’t go wrong, it’s not worth your valuable energy to continue to fret over which school to choose.

But of course, the reason you fret so much over decisions is that you’re worried you’ll make the wrong one. Unfortunately, this is always a risk, and it will sometimes happen. While this may sound like your worst nightmare, it’s actually okay. Making a “wrong” decision is sometimes exactly what you need to determine what you truly want.

Let’s say you are really struggling to choose which specialty to pursue. Of course, begin by doing your research and preparing yourself for the decision, but if you still can’t decide on a specialty, you’re better off choosing any option and committing to it.

Committing to a specialty means you can fully immerse yourself in that world. Launch yourself into the rotation as if it is definitely the specialty you will pursue for the rest of your life. This will give you a real feel for what life will be like as that type of doctor. Commit to the decision, and then pay close attention. Once you’re immersed in the specialty, how does it feel? Does it feel like you made the right decision, or are you now 100% positive that you should choose a different specialty?

You may find out that the path you chose was completely wrong, but sometimes the only way to gain that insight is by choosing to give it a try. Don’t get stuck wasting time considering your options for so long that you don’t have time for the experience.


7 | Don’t Second-Guess Yourself

Once you’ve made a decision, stand by it, at least for the time being. We’re not suggesting that you can’t change your mind. As we mentioned in the previous point, you may learn that the path you went down is not the right one for you.

But be wary of regret. Don’t second-guess yourself at every turn; doing so will only waste your energy and take you out of the experience. This advice can be applied to decisions big and small.

Let’s say you’re at a restaurant and you’re trying to decide between ordering a burger or pasta. You order the burger but then spend the meal believing you should have gone with the pasta. What value does this second-guessing bring to your meal?

Once you choose the burger, commit to the decision so that you can enjoy it. The pasta might’ve been great too, but you chose the burger, and now you get to see what it’s like. If you don’t like it, you’ll know to pick the pasta next time. If you do like it, live in the moment and enjoy it. Don’t ruin the meal wondering about the pasta that might have been.

We can apply this to big decisions like choosing which medical school to attend. Once you commit to an acceptance, buy into it. You’ll be attending that medical school, and that’s truly exciting. Continue to learn more about the campus, where you will live, the types of activities you can participate in, and anything that will excite you about the journey you’re about to go on.

You won’t be doing yourself any favors by continuing to think about all the other schools you might’ve chosen. Stop following those other schools on social media. Don’t try to find out what you’re missing. Lean into the path you’re on in order to get the full experience of it.

Yes, if you find down the road that you absolutely hate the city and program you’re in, you can take steps to make changes, but begin with an open mind. Regret wastes so much of your time and energy—time and energy that could be spent on your studies and enjoying the experience of being in medical school.


Key Takeaways

Every decision making process must begin with thorough research. The larger the decision, the more research is required. Go beyond online searches. Reach out to people you can trust as well as people who have already taken the path you’re considering.

Use your research to weigh your options. Contrast and compare, and consider the impact of each possible outcome. Take time away from the tough decision so that you can come back to it with a fresh mind and renewed focus.

Next, take it back to your gut feeling. What is your gut telling you? What do you truly feel about each possible outcome? Set aside other people’s feelings and expectations. What do YOU want?

Once you make a decision, commit to that decision. See it out for at least a while so that you can enjoy the experience and actually find out if the path you’re on is right for you. Regret does you no favors; it will completely taint the journey and hinder you from succeeding in your studies.

The journey to becoming a doctor is filled with tough decisions. Put time and effort into your decision making process, but try not to let it consume you. Trust in the process, and trust in yourself, but know that it’s not the end of the world if you choose to change directions down the road.


One-on-One Advising

Need help with your decision making process? Med School Insiders offers one-on-one advising that pairs you with a physician advisor who best fits your specific needs. It’s our goal to help you create a future that aligns with your vision.

We’re dedicated to creating a generation of happier, healthier, and more effective future doctors. We can help you craft an ideal medical school list, provide advice on whether or not a gap year is the best option for you, help you make a residency program selection, and more.

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