Med School Q&A: Step 1 boards and Prego interviewing

 Posting this picture again from our volunteer trip to Peru because it's my fav white coat pic

It's been a while since I've linked up with Medical Mondays! If you're new here, I'll be graduating in May with my M.D. (you can read more about my journey to med school here). I decided to do a Q&A post today on two of the most popular reader questions that I've gotten about med school and residency interviewing (I was planning on answering three but two ended up being plenty long for one post!). If you have other questions, feel free to leave a comment or send me an email at stethoscopes.style.grace@gmail.com and I will do this post again in the future.

Question 1: Can you share some advice on how you studied for Step 1 boards?

Well, first of all I'm no expert on studying for boards and I do think that everyone has different study methods that work for them! That being said, it definitely helps to hear how other people studied and if they found it effective. I was fortunate to score above the 90th percentile on my board exams (thanks to studying and prayer!) which is very helpful when it comes to interviewing for residency (although keep in mind that if you don't get the score you want residency programs really do look at the whole picture).

So my advice on Step 1: I did not start doing boards prep questions until March of second year, during my Cardiology unit. I think the best advice for second year is to focus on learning each unit really well rather than starting boards studying early, since your second year courses will prepare you for boards. We took a practice exam during the spring when I hadn't start focused boards studying yet and I scored close to the median for Step 1 without really any boards-focused prep (which I definitely attribute to doing well in my second year courses). I set my goal score at 30 points above that practice exam, which is supposed to be a realistic goal if you plan to spend 4-6 weeks studying. I started my actual Step 1 studying about 5 weeks before I took the exam and studied 8-10 (occasionally more) hours per day, with a few days off (I actually was in a wedding the weekend before I took my boards). Taking a few days off to refresh yourself is definitely important.

So the nitty gritty of how I studied: I structured my studying loosely on The Step 1 Method, which my school promoted. Basically you make a schedule for your study time of how many days you will spend in each area (ie 4 days for biochem, 1 1/2 for genetics, 2 for anatomy, 4 for cardiology, 4 for neurology, etc.) On each study day, you do blocks of 46 questions at a time (UWorld questions seem to be the universal gold standard and are what I used). Set the practice tests on "Tutor" mode which means doing one question at a time and reading the explanation for each question after you do it. After you read the explanation, read the corresponding section in First Aid and annotate any important things that are missing into First Aid (don't go too in-depth on this). At the end of each subject, do the questions that you got wrong over again. I did the prep questions by subject, but it's a good idea to do blocks of random questions the last couple days of studying. I found this method of studying very effective and used a similar method to study for Step 2. I tried to keep exercising (both to stay sane and because I got married in August after I took my boards) so most days I would either go on my elliptical trainer while I watched Pathoma lectures or walk around the neighborhood while I listened to Goljan audio lectures.

Good luck!

Question : I want to have a baby fourth year, but I've been told that it's not a good idea to show up for residency interviews pregnant. What do you think and how did you find interviewing to be while pregnant?

This is a question that I heard a lot of advice on both sides about before I interviewed for residency. I had always felt that I should 'plan' (my husband and I use natural family planning so we have a certain openness about it, although we find our method very effective) the pregnancy so that I would not look pregnant while I was interviewing. My practical self was worried that it could hurt me in the match despite the fact that I did well on boards and received AOA. However, my fears were probably unfounded since I was told (and now believe, though I was skeptical at first) that any program who would rank you lower for being pregnant is not a program that you want to be at anyways. Also, it is much better for the program if you have a baby during fourth year then during intern year. But the bottom line is that I don't think med school should dictate when to start a family.

As far as my experience, I wasn't showing enough to appear pregnant during most of my interviews (esp. with this awesome loose blouse that I wore) and I didn't tell programs that I was expecting (except for one peds emergency physician who asked and was totally supportive). My very last interviews in January I was 22 weeks and showing a little but I didn't find it to be an issue. I wore my regular suit blazer with some black maternity pants and this blouse (I wouldn't suggest wearing a tight black minidress with stilettos like the one other fellow prego on the interview trail was wearing - you don't need to emphasize it more than it shows naturally!).

I will deliver in May so I will have just enough time before I start intern year. Looking at everything now, it would have been nice to deliver earlier in fourth year so that I could have had more time with the baby (we purposefully tried to plan it so I wouldn't be showing for interviews but now I realize that there are more important things). Overall, I've gotten a lot of encouragement and support from residents and physicians who had children in residency and we are just so excited to grow our little family.