The early years of your medical career are defined by constant change. No sooner have you mastered one role than you’re starting a new rotation, moving to a different site, beginning a training programme or stepping into a more demanding position – often all at once. It can feel like trying to drink from a firehose.
There is a lot to take in: new sites/departments, new teams, new systems and processes, new responsibilities - and all while being responsible for patient care. Even when you are technically coping, it can feel mentally exhausting.
This is cognitive load — and it is real.
What is cognitive load?
Cognitive load refers to the mental effort required to process and act on information. As an early career doctor, this can spike due to:
- Managing multiple patients and tasks
- Frequent interruptions (pages, notifications, questions, handovers, MET calls, code blues etc)
- Navigating unfamiliar processes
- Holding ‘mental to-do lists’ across a busy day - trying to remember who needs what, and when
- Taking on more responsibility and supervising more junior staff or students
- Managing a demanding clinical role while also studying for exams, commencing formal training or juggling increased personal demands
You may feel like you are juggling constantly — and afraid you will drop something important. That is because your working memory has limits, and when it is overloaded, errors and stress creep in.
What you can do: Practical strategies to reduce the load
You cannot remove the complexity of medicine — but you can structure your workday and non-work time to reduce overwhelm.
1. Get things out of your head early and often
Relying on memory alone is risky when your day is full of interruptions.
- Use a patient list you can scribble on — track jobs, test results, follow-ups, phone calls.
- Carry a ‘job book’ or use Notes app to jot down small tasks and reminders.
- Prioritise writing things down before moving to the next job.
Intern tip: A task is safer on paper than floating in your brain.
2. Group and batch where you can
- Batch similar tasks — chase all bloods or imaging at once; make all phone calls in one go.
- Avoid switching between different types of tasks if possible — it reduces mental fatigue.
3. Anchor yourself with short reviews
The day moves quickly, and it is easy to lose track.
Build in quick mental resets:
- Morning: What are today’s priorities? What needs chasing before midday?
- Midday review: What have I ticked off? What is still pending?
- End of day: Have I handed over anything that is unresolved?
These anchor points reduce the risk of something slipping through.
4. Use structured communication tools
SBAR or ISBAR (Identify / introduction, situation, background, assessment / analysis, response / recommendation) is not just for escalation — it is also a mental template to avoid freezing under pressure.
Use it when:
- Presenting to a registrar or consultant
- Handing over patients
- Calling another service
Structured communication reduces the cognitive effort of figuring out what to say under pressure.
Clinical handover for older people in hospital | health.vic.gov.au
ISBAR Poster | Australian Commission on Safety and Quality in Health Care
5. Minimise re-work and re-thinking
- Confirm and clarify instructions immediately — do not assume, ask.
- Double-check results and names before calling someone — it saves you from having to call back.
Mental energy is wasted most on fixing things that were not clear the first time.
6. Reduce noise and control interruptions when you can
You cannot stop all interruptions — but you can shape when and how you respond.
- Take 5 minutes to complete a task before answering non-urgent calls — if safe to do so.
- Ask teammates to hold queries that are not urgent while you finish a quick discharge or note.
It is OK to protect your concentration — it is a skill, and a necessity - ensuring patient safety and your own well-being.
7. If you are making a big career transition or commencing training
- Pause to rethink your priorities and protect downtime at all costs
- Offload or delegate tasks that drain your energy, outsource where you can
- Create a clear plan and tap into your network of mentors, peers and supervisors
- Break the year into manageable phases with defined goals
- Clarify what success looks like at each phase and at year’s end
8. Debrief and download afterward
- After a tough or complex day, take 5 minutes to mentally or physically offload.
- Write down unresolved tasks, questions for tomorrow, or key reflections.
- Note what went well and reframe challenges as opportunities to learn
- This keeps work out of your personal time and prevents rumination
And finally… Be kind to yourself
You will forget things sometimes. You will feel scattered. That is normal. The mental load of taking up your role as an early career doctor is high — and it takes time to build systems and confidence.
What matters is that you are learning to manage the load — not carry it all perfectly.
You don’t have to manage all this alone. AMA Victoria is here to support you – not just in theory, but with practical help.
- Book a career call to talk through strategies to manage your workload, reset your routine, or get support if you’re feeling overwhelmed
- Engage in confidential coaching (career or high performance) to help you develop and embed habits that reduce cognitive load and build your confidence
- Access our Workplace Relations team for advice if workplace demands are unreasonable, you’re being expected to do too much without support, or you need help asserting your rights
- Know that we’re advocating for better systems – through our Enterprise Agreement work, we’re pushing for safer workloads, protected training time, and more effective handover structures