you can replicate their success. Want to know the  secret? It's not their superhuman discipline or  

overpowering ambition. It's a matter of devising  the optimal systems to keep you consistently  

running at peak performance, helping you  slowly inch your way closer to your goals,  

day after day. This is how to  optimize your daily routine.

Dr. Jubbal, MedSchoolInsiders.com.

There is no single perfect daily routine  that works for two different people.  

We each have our own needs and priorities, and  our schedules should reflect that. However,  

there are a set of principles shared amongst  top performers. Once you've set your daily  

routine foundational pillars, we'll then  fill in the details based on your needs.

We must first lay the foundations, or  fixed elements, of our daily schedule.  

Consider these the pillars that hold up the rest  of the daily practice. They are of the utmost  

importance and are non-negotiable. These include  your wake up time, exercise regimen, meals,  

and wind down time. By doing the work upfront  and determining when each element will occur,  

you reduce the mental energy needed  to carry these out in the future.  

Rather than the mental exercise of asking  yourself and planning when you should exercise  

or eat lunch, you already have it figured out  and know exactly when it's going to happen.

Maybe you're rolling your eyes right now  and looking for a shortcut. If you're  

interested in nootropics, meaning drugs or other  substances used to improve congnitive function,  

understand this: there is no nootropic that  has ever even approached the cognitive boost  

you'll receive from optimizing your sleep  and regular exercise. In other words,  

nootropics have a much lower return compared  to dialing in your sleep and exercise.

Start with your calendar or planner of choice,  and fill in the fixed elements that you must  

attend and cannot change – think classes, small  group sessions, club meetings, and the like.

Next, determine your sleep and wake times.  You should allow yourself adequate sleep,  

as skimping on sleep results in multiple  downstream effects that will compound toward  

diminished effectiveness. If you're putting  in the effort to build a daily routine to be  

more productive and effective, it will all be for  nothing if you sacrifice sleep. It's best practice  

to set aside between 7 to 9 hours per night. I  actually err on the side of planning for too much  

sleep - that way, if my body is feeling well  rested I'll wake up before my scheduled time,  

and if I need additional  recovery, I have the opportunity.

How you start the day sets the tone  for the remainder of your waking hours,  

and how you wind down at the end of the day  dictates how restful your sleep will be.

Your sleep and wake times will be largely  a function of your other fixed commitments,  

like school or work. Since I'm no longer doing  plastic surgery, I have complete freedom in  

setting the start and end points to my day.  Currently, my day ends at 10:30PM and begins at  

7:00AM. For my recent client, who we'll  call Lawrence, he was subject to a more  

typical medical student schedule. He decided to  start at 6:00AM and finish his day by 11:00PM.

Most people can get behind the idea of having a  wakeup time and bedtime each day. Many can still  

agree with set times for meals. But few people  treat exercise with the same level of regularity  

and rigidity. To get those sweet cognitive  benefits of brain derived neutorophic factor,  

or BDNF, you'll need to prioritize regular  exercise into your schedule. Remember,  

those who treat exercise with a high degree of  importance have an edge over those who don't.  

The type of exercise you do is less important  than the question of whether or not you exercise  

with regularity. I opt for cycling and weight  training, but maybe you prefer running or pilates.

Lawrence is one of those people who, as a busy  medical student, knew he wasn't going to exercise  

unless he did so first thing in the morning,  otherwise there was always something else that  

he felt was more urgent. For that reason, he  starts his days early and squeezes his workout  

in before class starts at 8:00AM. Whether that  will be sustainable during his clinical years is  

yet to be determined, and that's ok. Your  schedule will adapt based your demands over time.

To ensure something like exercise actually sticks,  it's best to anchor it to a clear marker in the  

day. For some, it's the first thing they do  upon waking up. When I was in medical school,  

it was the first thing I did after class each day  – after all, the last thing I wanted to do after  

several hours of class was hit the books, so going  to the gym instead was a productive mental break.

Last, fill in your meal times. Again, this  will primarily depend on the fixed elements  

in your schedule, in addition to your personal  preferences. I practice time restricted feeding  

and don't eat until noon on most days, and  have dinner before 7PM. Lawrence follows  

the more traditional 3 meals per day and eats a  light breakfast between his workout and class.  

Whatever you decide, it's best practice to not eat  too late at night, close to your bedtime, as data  

suggests this is detrimental to your nighttime  restfulness, blood sugar, and various hormones.

After setting the foundations, it's  time to adjust the details of your  

schedule. Your foundations from  step 1 will largely be fixed, but  

it's ok to move things around as needed  to dial in your perfect daily routine.

The main element we want to optimize  for is your focused work and study time.  

This is the most mentally taxing time of the  day, and should be when you get the bulk of  

your work done. Top performers have dedicated  blocks of deep work, as coined by Cal Newport,  

whereby they study or work with high  intensity and zero distraction. In contrast,  

most frustrated students practice extended periods  of low to medium intensity studying. This is an  

insidious feedback loop - it's less efficient and  disheartening because they always feel behind,  

causing them to spend more time on suboptimal  studying, and ultimately leads to subpar results.

In designing your daily schedule, look at  your fixed elements and consider at what  

points would you be most readily able to tap into  a focused state? If you're not a morning person,  

then expecting yourself to  get your best work done at 7AM  

is not setting yourself up for success. Similarly,  

waiting until 9PM when you're exhausted at the  end of the day is also less likely to be fruitful.

Again, everyone is different, and this should  primarily be a function of your mental states  

over the course of the day. I begin my deep  work block at 8:00AM, but for Lawrence,  

we decided on his first focused study block  at 1:00PM. In my case, I am fresh and thinking  

clearly in the mornings, able to do my best  focused work at this time. In the afternoons,  

I find myself less motivated or willing to  put up with difficult work. On the other hand,  

Lawrence isn't drained from his morning  lectures, and after a lunch break,  

is ready to hit the books hard  first thing in the afternoon.

Your focused study block should be at least a  couple hours in duration - my recommendation  

is between 2 and 4. Anything less, and you're  leaving high quality study time on the table,  

and anything longer, you're devolving into  lower intensity and less fruitful efforts.

Don't get ahead of yourself in this process  - remember this daily schedule needs to be  

sustainable over the long term, not  just for a few days. If you feel that  

you're pushing yourself 10/10ths  every day, you'll burn out fast.

That means breaks are essential. When taking  breaks, I like to focus on productive breaks,  

meaning breaks that ultimately serve a purpose,  even if it isn't directly related to traditional  

productivity or studying. For example, after  a high intensity block of focused studying,  

take a break and run errands, like picking  up groceries, doing laundry, or even taking  

a shower. You're taking care of items that must  be done, and optimizing their timing by inserting  

them at a point where you wouldn't be able to  study anyway. As they are not mentally taxing,  

you're able to get an essential task out  of the way while still giving yourself  

space for mental recovery. Alternatively, go  outside for a walk to more quickly rejuvenate.

Incorporating forms of stress relief and  release from work is key. Exercise serves  

this function in a large capacity, but most of us  need something additional to maintain our sanity.  

Some people have a favorite show they want to  watch, others enjoy reading, or maybe you enjoy  

playing board games with your housemates. It's  best practice to save this for later in the day,  

as it's generally more difficult to get into  work mode at 9PM after hanging out with friends.

There are a few other details that most top  performers share - namely mindfulness or some  

form of reflection. I've covered this in  the anatomy of a perfect morning routine,  

but you can perform these habits any time  of the day. Lawrence opts for either a run  

or walking meditation at  5PM after his study block.

The fun part was planning your  daily routine. The hard part is  

putting into action and actually  sticking to it for the long term.

Rather than relying on brute force  and self-discipline, ask yourself how  

you can make it easier on future you to follow  the plan. For me, that includes using my calendar  

and saving a screenshot of my schedule on my  computer desktop and phone for quick reference.  

You may decide to lay out your gym clothes  and bag by the door to reduce the friction  

of starting your morning with a workout. And  to really make it stick, set your morning  

alarm across the room so you're forced to get  out of bed rather than go on a snooze-a-thon.  

For others, that includes having an  accountability buddy, or in the case  

with Lawrence, finding a mentor or coach to  help craft the routine and hold him to it.

Allocate time in your calendar to also  review the results of your new routine.  

Otherwise, you're likely to get  derailed and just give up on it.  

Rather, preemptively set a time in 1 or 2 weeks  to review what went well about the routine, what  

was perhaps too ambitious and not realistic to  sustain long term, and make adjustments as needed.

If you enjoy this type of content, balancing  productivity and lifestyle optimization on one  

hand with study strategies and succeeding  as a future physician on the other,  

sign up for my weekly newsletter.  Visit medschoolinsiders.com/newsletter,  

link in the description.

If you haven't already, be sure to  check out anatomy of a morning routine  

and anatomy of a night time routine.  Much love, and I'll see you guys there.