By: Aaron Qi Yang Goh, co-author, Unlocking the Leader Within: A Medical Student’s Guide to Practical Leadership
Do you freeze when you think about some of your biggest, most audacious goals?
Oftentimes, the fear of how much effort it will take for us to reach our goals is more overwhelming than the goal itself. This can paralyze us from taking meaningful steps towards getting where we want to be. The concept of marginal gains provides us with a useful framework to break down our goals into smaller, achievable tasks.
Marginal gains was popularized by Sir David Brailsford, the performance director of British cycling. At the time, the British Cycling team (“Team Sky”) was described as a “laughingstock,” and Brailsford vowed to improve the team’s performance. He described the “1% rule”: that making even just 1% improvements in many different areas would result in cumulative gains.
For example, he painted the floor of the team truck white so that it was easier to see and remove dust which was affecting bike maintenance. He introduced orthopedic mattresses and pillows to improve athletes’ comfort. He introduced hand gel to cut down infection rates of team members. These tiny improvements, or marginal gains, helped Team Sky win 16 Olympic gold medals across the 2008 Beijing and 2012 London Olympics.
Indeed, James Clear echoes this in his bestselling book, “Atomic Habits.” It is easy to feel discouraged by the slow progress you are making, as the effects of small 1% improvements may not be immediately felt. But the math is clear: Getting 1% better every day for 365 days means becoming 37 times better than when you originally started. The reverse is a cautionary tale: becoming 1% worse each day in the same one-year period causes one to decline to near-zero!

Achieving our most audacious goals starts with making marginal gains daily. For a medical student, it might look like:
- Doing 10 exam-style questions per day to prepare for finals
- Attempting intravenous cannulation on task trainers twice a week, in preparation for IV cannulation on real patients
- Clerking 1 patient a day whilst on clinical rotations to improve your clinical acumen
What would becoming 1% better every day look like in your life?

Content adapted from
Unlocking The Leader Within: A Medical Student’s Guide to Practical Leadership
Available in print and on ClinicalKey Student
Additional References:
- BBC. Viewpoint: should we all be looking for marginal gains? BBC News. September 15, 2015. https://www.bbc.com/news/magazine-34247629.
- Mehta K. The most mentally tough people apply the 1% “marginal gains” rule, says performance expert – here’s how it works. CNBC. February 23, 2021. https://www.cnbc.com/2021/02/23/how-to-be-mentally-tough-use-the-1percent-marginal-gains-rule-says-performance-expert.html.
- https://jamesclear.com/marginal-gains

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