So busy I can't think straight

The most common response to the question "what is the biggest thing holding back your career at this moment in time?" is the option ....

So busy I can't think straight

This lack of time for general routine career "maintenance" is sometimes why careers get into this situation in the first place. 

The challenge is  somewhere between
I am able to allocate time to career planning
I am unable to allocate any time at all to career planning

So a first step in getting a career from the point where it is lurching either from crisis to crisis or where the person supposedly in control of it is controlled BY it - is.... to find ways to allocate that time.

How much time? This depends but initially I'd say for most people aim for four hours a week.

Now saying this to someone who has just stated that they are so busy they can't think straight is likely to get a negative comment.

But say it I must because without that time NOTHING is likely to change
NOTHING

Time management might be an issue but most doctors I see are state of the art time managers and work very hard too. Being asked to do too much is common too - and you could be a state of the art time manager and still struggle is there is literally just too much to fit in.

The skill many medics REALLY need to master is more likely to be one of saying no.
Assertiveness.
My ebook "how to say no without upsetting people" will be available later this year but for those who can't wait - the career review programme invariably assesses and highlights assertiveness problems if they are there and the PCP invariably incorporates some assertiveness training specific to that person's situation.

So - if you feel so busy you can't think constructively about your career, whether you are enjoying it, whether you want to see some changes, whether it is affecting your quality of life or even your health - the very first thing is to allocated regular time to career planning ( and for some  - initally this four hours should go entirely to self care - NOT career planning). If you can not allocate that time - the next thing to consider is having some feedback on your assertiveness.