This post wasn't supposed to happen...

Obviously I'm a little crazy for posting pictures of myself at 40+ weeks and I'll probably regret this, considering that my face looks like a little puff ball. I actually had decided not to post anything until after the baby came (mostly due to Stephen's encouragement to avoid "all social media" after witnessing my serious frustration at seeing people due after me delivering their babies). But here I am, 40 weeks and 3 days, with no baby yet and starting to go a little stir crazy.

So let's talk about being three days past my due date with an impending move 8 hours away that was supposed to happen two weeks from now (with a four week old baby of course after my delivery at 38 weeks - ha). After said move, we were supposed to travel 10 more hours (although we were probably going to fly) to Stephen's brother's wedding at which I was going to stand in a bridesmaid dress. All this providing that the baby was born at a nice 38 or 39 week mark which would mean the baby was around 5 or 6 weeks when I start residency orientation mid-June.

But here we are, and I have to admit that I didn't mentally prepare myself at all for this...which in retrospect was pretty ignorant since I know from my fairly extensive time rotating in the OB clinic that first-time moms tend to deliver late. Honestly though, I just didn't know how we would handle it if the baby came at all late so I preferred to just plan on him being early, which happens really often with residents and med students anyways because of the stress we induce on ourselves and the ungodly amount of time we spend on our feet.

So I feel...frustrated...bitter...anxious...and most of all, sad. Sad that each day that passes means one less day that I get to spend with our little guy before I start residency and one more day of the anxiety/stress of not being able to plan our big move and this transition in our lives. My mom keeps telling me though that the baby is safe and happy inside of me and while it doesn't change how hard it will be for me to leave him while he's so very new, he becomes more bonded to me each day he spends in the womb.

And some nitty gritty (skip if you don't want 40 weeks prego details). When I first found out we were expecting, I told myself that I would ask to be induced around 38 or 39 weeks if it didn't happen naturally because of the crazy timing with residency starting - I simply just didn't know how we would do it if we delivered on my due date or afterward. However, after a lot more research into natural birth and realizing that induction before 40 weeks wouldn't be best for me or the baby (however convenient, if it worked) I decided to wait until the end to be induced. But the reality is, I didn't think I would go until the end and while I could wait until the end of my 41st week according to my doctor, since the baby isn't that big (although I'm quite sure he's at least a decent size this late in the game) and the pregnancy has been healthy, I told Stephen this weekend that I don't think I can go past Friday because of my current mental/emotional state about everything we have going on...so that is that (please please pray that it happens naturally - I would be eternally grateful). And now for a (not) brief list of the natural induction strategies I've tried (and clearly aren't scientifically based, for the most part, since they have done a whole lot of nothing):

- Red rasberry leaf tea (starting a couple weeks ago, 2-3 strong cups/day)
- Evening primrose oil (2000 mg daily for the last few weeks)
- Fresh basil
- Pineapple
- Walking (as in an hour/day lately of mostly power-walking)
- Squats/plies (30-45 min most days for the last 6 weeks, courtesy of Summer Sanders)
- Lots of "tylenol" and nip stim (see Anna's post)
- A prenatal massage with acupressure on the supposed labor points (sacrum, ankles)
- A pedicure/foot massage
- Meditation (courtesy of Fr. Benedict Groeschel's Joyful Mysteries - whether or not this has helped speed things along, it has helped me feel more at peace).

Moving on...

Dress: Anthropologie

Wedges: Old Navy

This is what I wore Sunday, to my future sister-in-law's shower yesterday. With all my lovely sisters + mom:

We went to mass Saturday night and while I was sitting there I got the sudden inspiration to hike up a small mountain 10 minutes outside of town. There's lots and lots of hills and stairs and more hills so I thought it might finally do the trick (wrong), and I dragged Stephen with me. We may have gotten a few looks as I huffed and puffed at full speed up the mountain at 40+ weeks but I made it (I did have Stephen check my heart rate once - 132). Despite no resulting contractions, it did feel like an accomplishment when I got to the top, and made me grateful for all the exercising I've done throughout the pregnancy.

After the hike:

my sisters told me that I'm smiling with my lips and not my eyes in these pics - probably right
also, hello periorbital edema! courtesy of no sleep, not preeclampsia

 

Thanks for reading through my insanely long (and somewhat therapeutic) post. Hopefully the next you'll hear from me will be a baby announcement? 

39 weeks + graduation thoughts

Well, we made it to 39 weeks. I think everyone is a little shocked, including me. Yes, I know all too well that it's most common for first-time moms to go right around their due date or a little late, but with all the cramping early on and stress that I was under courtesy of medical school, no one thought that I would go late. And I know that I'm not late yet...but baby M is not showing any signs of coming any time soon. So what have I tried? Well, raspberry leaf tea, evening primrose oil, pineapple, a pedicure, a prenatal massage, long walks, tons of squats (I've been doing either prenatal pilates or Summer Sanders just about every day), and a few other things. All of which has only served to reaffirm that a) there's a reason that these strategies aren't scientifically proven (at least to my knowledge) and b) baby M will come when he very well wants to.

All in all, 39 weeks isn't that bad. Regardless of how I may look, I don't feel that huge (for the first time in my life, I'm so thankful for my uber long torso) and the fact that the baby dropped way down two weeks ago has taken away a lot of my pregnancy symptoms (hardly any more acid reflux! yay!). I will admit to continued crazy mood swings (so sorry Stephen...and everyone else that I've been around). The main reason that I'm so anxious though to have this baby is not preggo symptoms but the fact that we need to move in the next few weeks so that I can start residency orientation June 16. If this baby decides to wait past 40 weeks, we will be in quite the situation (also complicated by the fact that Stephen's brother is getting married the weekend before I start orientation, it is no where near my residency location, and we are both in the wedding). It's all in God's hands though, right?

This past weekend was a little tough. I decided not to go to my medical school graduation - chances were just too high that I would go into labor and deliver 7 hours away from home...and if not that, I was afraid that the car ride (14 hours total) would be miserable. I guess I didn't realize that it would feel so bittersweet. It was sad not to see my classmates and say goodbye before we go our respective ways, and it also kind of felt like the end of medical school was anti-climactic. I know that part of my feelings were from pride too. I was one of three people in my class to graduate as a member of both medical school honor societies, and I guess the human part of us always secretly wants to be recognized. The end of the story though, is that this new baby and our family are so much more important than any of that. I feel some regret right now about not going (easy to say now that I did not go into labor this weekend) but I know that it will be the very last thing on my mind after this little guy arrives.

Dress: Gap

Cardi: J. Crew (my favorite!)

Sandals: Birkenstocks

Necklace: Express (old)

Prayers for baby McMahon are much appreciated! And a very happy Mother's Day to all the moms out there! Sweet Stephen brought me these in honor of my first Mother's Day (even though baby has yet to arrive ha):

Linking it up with FL&P.

On interviewing for residency...

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It's time already for another Medical Monday (except that today's Tuesday, sorry), and I thought since Match Day has come and gone, I should do a recap of residency interviews and the things that helped me along the way. For anyone that isn't familiar with the process, residency interviews entail first filling out an online application complete with medical school grades and activities, board scores, letters of recommendation, and a personal statement and then sending that application electronically to a bunch of residency programs in the field you are interested in (or in my case, two fields - emergency medicine and OB/GYN). Shortly afterward, the interview invitations starting coming and interview season officially starts. In February, a rank list of programs is due, both from the applicant and the programs. And then sometime in March, the rank lists of both the programs and applicants go into one big computer algorithm to give medical students their match, the culmination of four years of hard work and many years of dreaming of becoming a doctor. So let's talk about residency interviews!

White coat ceremony just before med school started

How should I write my personal statement?

I really like to write, so this was one of the least painful parts of the process for me (although I've heard otherwise from many medical students). For my personal statement, I used my typical essay-writing format of starting with a story that touched me (I told a story from my time working in Haiti, this one - if you happen to watch the video the girl in the white tee/navy scrub pants is me ha). I then mentioned four strengths/qualities that would help me become a good physician and developed one in each paragraph, backing them up with anecdotes from growing up, college, doing volunteer work, working as a nurse, etc. There are a million different ways to write your personal statement, but this one worked for me. A couple tips that I've heard pretty universally are to keep it to just over a page since program directors don't have time to read a 5 page personal statement (mine was close to two pages) and try to open with something that will catch the program director's interest and set yours apart from the million others that they will read. Lastly, have a few people read it - I had several family members and friends read it including one of our assistant deans, my dad (a family physician), and my best friend's husband who has a master's in English.

Where should I apply?

Most people recommend that you should apply broadly, although it definitely depends on the specialty, the strength of your application, and your own personal/family situation. I originally put in 10 emergency medicine applications and 6 OB/GYN applications, but I added a few more based on our school's recommendation to apply to at least 15 programs for EM. I got interviews at most of the places where I applied and then ultimately ended up going to 10 EM interviews and 2 OB/GYN interviews. It's good to go to interviews at programs with a varying level of competitiveness. My husband and I are midwest people, so I didn't want to fly all over the country (although retrospectively Florida would have been nice) but I did fly to the east coast for a couple of interviews.

What should I wear?

Probably my favorite topic, which I already talked about here :) I recommend a dark suit (black, navy, or charcoal) in a solid color or a subtle pinstripe. One applicant on my interview trail wore a pale grey suit, but keep in mind that this will set you apart (the program director actually commented on it during our interview tour, jokingly but still commented on it). Either a skirt or pants is fine (I love skirt suits but pants are definitely more comfortable for walking tours) and I met a few people who wore a suit dress with a blazer. It's nice but not completely necessary to have two suits (there were weeks where I had 3 or 4 interviews in a week so having two made it easier). I had one black suit from Loft (that I found on clearance for a ridiculous price) and another charcoal pinstripe skirt suit from J. Crew. Ultimately I ended up wearing my Ann Taylor black blazer with a pair of black maternity dress pants, so I definitely could have gotten away without the J. Crew suit but oh well (speaking of which, if anyone is in the market for a J. Crew charcoal pinstripe suit only worn a few times let me know - I'm normally a size 8 or 10 but this is a 12 since I wore it when I was 5-6 months pregnant). A shirt in a fun color, style or pattern is a good way to show your personality underneath a professional suit. I'm wearing this J. Crew jeweled collar shirt in my residency picture and I also like this one, this one (I found sleeveless blouses to be the most comfortable under a suit jacket) and this one. As for shoes, a pair of pointed heels is nice, but I only wore these for the first couple of interviews - after that I stuck with a pair of buckle toe short heel shoes similar to these (so much better for long walking tours).

Residency picture

Residency interview outfit (loose shirt to conceal the baby belly!)

What should I say? 

What I found is that as my interviews progressed, I prepared less and less, partly because you just become more relaxed about the whole thing and partly because a lot of questions repeat themselves from interview to interview. For every interview, it's important to look at the residency program's website the night before and familiarize yourself with a few unique characteristics of the program to bring up during your interview. You should also have a few questions ready to ask the program director and the faculty that will interview you. Yes it gets old after you've already done 10 interviews, but if you don't have any questions you'll look a little uninterested in the program. My fallback question if I had nothing else was "What in your opinion sets your program apart from other residency programs in this field?"

As far as preparing for the interview questions that you will be asked personally, I practiced with Stephen in the car during my first couple of interviews (we had about 25 hours in the car total driving from Michigan to the Mayo Clinic to Buffalo, New York and back - it was especially fun with a pregnant bladder). I googled "common questions asked during emergency medicine residency interviews" along with the same for OB interviews, found a couple of good lists, and went through them with Stephen. As far as what I was actually asked, most of it wasn't a surprise. A few repeats that I got:

- What makes you want to go into this field?
- Tell me about one of your weakness and what you've done to combat it.
- What field of medicine would you chose if this field didn't exist and why?
- What career would you choose if medicine weren't an option for you?
- Describe an ethical situation you encountered recently and how you dealt with it.
- Tell me about a mistake that you made and what you did about it.
- How would your best friend describe you in three words?

And the weirdest question that I remember: "Is it ever ok to lie?"

Stephen and I at a medical school honors dinner

How should I rank them?

This is by far the hardest question (unless you're like me and undecided between two specialties until the last minute) and is one that only you can answer. Many, many people told me to "go with your gut feeling" and this was a factor in my decision. Ultimately the program that I chose was the one where I left saying that I could see myself there for the next few years and where I also felt comfortable around the residents and faculty. Overall I got the feeling that the residents supported each other, felt that they were getting a great education, and were happy there.

Some of the best advice that I received about ranking programs was from the residency coordinator at Johns Hopkins. She told us that after we finished interviewing, we needed to go home and sit down with our spouse/significant other alone in an environment where we wouldn't be interrupted. She then told us to look into our spouse's eyes and ask where they wanted to go for residency. She talked about the sacrifices that our spouses had made for us and would continue to make, and emphasized how difficult residency is on relationships and how important it was for our spouse to be happy during these intense years. Stephen and I had this conversation a couple of times, and I'm grateful that we ended up at our top program which we mutually agreed was the best place for my education, but more importantly for our family.

More posts on residency:

What to wear for residency interviews
Tough Decisions
I finally know what I want to do with my life...
Match Day

36 weeks, 5 days

Jacket: Old Navy (old, similar)

Scarf: J. Crew Factory (old, similar)

Shoes: Madewell (old, similar)

Dress: Gap

And counting. Just kidding (sort of). I figured that I better get another maternity post in before this babe decides to make his appearance (although he seems pretty comfy in there right now). My maternity tops and dresses are starting to not really fit right (I keep thinking that I shrunk things in the wash and then realize that it's just my continuously expanding belly). I have the threatening start of a stretch mark on my right hip, but I guess I can't complain too much because my stomach is still unscathed. Since I'm sure you're all fascinated by my mundane pregnancy symptoms, I also am having lots of trouble sleeping like every single other pregnant person at the end of her third trimester. I'm not sure though if every other pregnant 36-weeker has the crazy hormones that have manifested themselves this week. One minute I'm crying, the next super mad, the next not wanting to talk to anyone - it's like high school PMS x 100. In my defense, the worse day was yesterday after I spent hours awake in bed after 3:30 a.m. (no sleep + pregnancy hormones = craziness apparently). Poor Stephen does not know what to do with himself.

Otherwise things are going well. I don't feel nearly as bad as I envisioned almost full-term would feel. I've been exercising every day (my mom is doing my pregnancy DVDs with me which is awesome). I'm alternating days with this DVD and this one along with walking most days. In case you are judging my over-motivation, I'm really just scared of drug-free labor (which is my plan thus far). We had our 37 week prenatal today and things looked good - baby is still measuring on or just under target and my doctor assures me that I am not carrying an enormous baby.

And Friday is our rural medicine convocation (graduation with our whole class is in May, right around my due date so we shall see if I venture there or not). That M.D. is so close I can touch it...but at the moment I'm just happy that tomorrow is my last day in the cardiac cath lab.

Five Favorites this week:

1. This perfect swimsuit which is 50% off today (I reaaaallly want to order it because it looks like a perfect postpartum suit but have no idea what size to get).

2. Anna's tips on remixing/packing lightly (I own super similar pieces to most of these so I definitely bookmarked this for the future).

3. This totally inappropriate/irreverent (consider yourself forewarned) birth story that had me in stitches: (part one, part two, part three). 

4. Grace's new arrival...Since she was due two weeks ahead of me reality is striking that I will actually be birthing a human person in the very near future.

5. J. Crew's May Style Guide - love, love almost all of these looks (especially those aqua pants, all the linen tops, and that black and white dress).

Linking up with Hallie and the Pleated Poppy

Final days...

I just realized that this is probably the last post that I will ever write about a day in medical school, since next week is my last week ever as a med student. This month is an elective for me, and I ended up on neurology and cardiology thanks to waiting until the last minute to pick something (let's face it, at this point in my medical school career and pregnancy, I'm pretty much just ready to be done so did I care? Not really). I actually did put a little thought into it, since both cardio and neuro should help me as an ER resident, but my super prego self just kind of wanted an easy rotation (not cardio or neuro, but oh well).

My first two weeks on neurology were actually pretty great. I didn't get done early most days (an end-of-fourth-year med student's main goal) but I did learn a lot of useful information, saw some interesting cases, and enjoyed working with the quirky-fun neurologists. Then I started cardiology yesterday, which did not go so well. I was in the cath lab, which is pretty interesting when it involves MI treatment, stent placements, etc. but most definitely not when it comes to ablations (I didn't even know until yesterday that a cardiac electrophysiology fellowship existed and let me tell you, it is not for me). The first case was 6 hours long - and that 6 hours mostly involved watching multiple computer screens while looking for an electrical focus that was causing thousands of PVCs in a patient. I should also mention that I was wearing close to 20 pounds of lead protective gear due to the radiation used during the ablation. I really wasn't too keen on being in the room at all, but I was assured by the physician that it was "no big deal" and by the nurses that "all our babies have turned out ok so far" (that kind of reassurance makes me a little nervous). Anyways, 20 pounds of lead + 20+ pounds of baby/prego weight = a lot of discomfort. Of course I also forgot to wear my support hose yesterday (worse.decision.ever). The first 6 hour case made me think about what it would feel like to watch paint dry. Furthermore, when the cardiologist finally thought he fixed the guy (and I was breathing a hundred sighs of relief) he started having PVCs again. Funny part was that the cardiologist was going on about how the "world-renowned facility" that the guy had gone to before for an ablation failed (also happens to be the institution where I'm going for residency, but I didn't tell him that) but he was personally able to fix the guy due to his "100% success rate" (cardiologists are very modest people) right when the PVCs started up again. At that point I decided that the baby and I had enough (the baby hated the lead by the way - he was kicking up against that silly lead apron like there was no tomorrow) and headed down for lunch and a short siesta in our student lounge. I texted Stephen about how miserable I was (misery loves company) and his advice was to leave, but the overachiever in me just couldn't do it....well, until 5 p.m. rolled around.

As you can see from the above picture, baby is growing like wildfire. Lately I've had my normal scrub pants rolled way down below my belly and haven't even attempted my normal scrub top (the size large that I am wearing apparently has arms cut for a linebacker but is definitely more bump-friendly). The last few days I've been a little 'snappy' as Stephen puts it and I've been getting annoyed by all the peeps staring at my bump. I texted Stephen the scrub-bump picture right after I had texted him that "I can't believe all these people staring at my stomach, haven't they seen a pregnant belly before? And it's not even that big!" Stephen never replied to that, since I realized the irony in my words when I took another look at the picture. The nurses I'm working with keep saying how they can't believe I'm 36 weeks, blah blah, I don't look pregnant from behind [what does that mean anyways] etc.; I don't really believe it but I appreciate their attempts at making me feel better about my large self.

So there you have it, my last post about a day in medical school...a little bittersweet maybe, but mostly just sweet.

Quick Takes: Baby showers + last exam of med school

I feel like the blog has been a little neglected of late, in the whirlwind of residency matching and as this baby grows faster than I can even believe. Pulling it together today though to link up with Jen.

1. Our first baby shower was two weeks ago, and it was lovely. My mom and sisters hosted and I was just blown away by how generous everyone was. This little baby is so very loved already! 

Sorry for the grainy iPhone pics, sadly I forgot to take out our nice camera...

Handsome Just Like My Daddy:

With my youngest sister:

All the sisters:

 2. And baby shower number two (last weekend at my mother-in-law's house 7 hours away) was small and sweet, and extra fun because Stephen got to be there (he was working during our first one).

 One of my best friends, who happens to be due in August:

 With my Mom:

 And mother-in-law:

Guess this baby is going to be a doctor like his mommy (love this bib!):

Or else a firefighter like his daddy:

3. I have to share this lovely scarf that my sister got me as a gift, which is seriously cute and doubles as a nursing cover:

4. We have most of the main things now that were on our list for the little guy, and our next task is to wash all his little clothes (just found out that apparently we need to use special detergent?) and organize everything. Everyone keeps talking about the nesting thing, but it hasn't really hit me yet...hoping it will soon because we have a lot to get done. 

5. And I guess this is what 33 weeks looks like. I was feeling pretty great...until yesterday. This morning I was up for the day at 4:30 a.m. because of leg cramps and today I'm nauseous, feeling huge, and super tired. I still have 7 weeks until my due date, so I feel like I don't really have a right to complain. I'm hoping this is temporary and related to our long car trip last weekend, lots of stress over Match Day, and studying for my exam this morning. I also have been off my elliptical trainer because of cramping (it and prenatal pilates were previously my saving grace) so I think that is part of the problem...for now I'm stuck with silly third trimester pregnancy workout DVDs that mostly involve sitting in a chair.

6. Today I took my last exam EVER as a medical student...it feels kind of surreal. I almost didn't make it to the exam because of the snow that piled up last night; this was what I woke up to:

I actually got stuck trying to get out of our unplowed street and ended up driving in reverse down our entire street like a crazy women...but there was no way I was postponing my last exam of med school.

7. And lastly, I posted a few things from my closet for sale yesterday. They are all nice things that I just haven't been wearing and don't need to move with me...I'm planning on adding a few more items over the next week (including a couple new maternity things that didn't work for me).

Happy weekend! Stephen and I will be going to a labor class all day tomorrow and hopefully starting to get the nursery in order :)

Match Day!!

It's crazy how four years of hard work and craziness all culminates into one moment: Match Day. My heart was pounding when I received the envelope that contained the place where I would be molded into a real doctor, and where Stephen and I will raise our little family for the next few years. Some med schools have a ceremony where students are called one-by-one to a podium to receive their fate, but since I am in a rural medicine program with only a small number of students we got to do our own thing. Most of my classmates wanted to open their envelopes one-by-one with each other, but I chose to just open mine with Stephen and then join the group afterward. I knew that one little envelope contained so many emotions for me (regardless of what program I would get), and I wanted to process it with Stephen first. My top two programs were two of the most family-friendly institutions that we had encountered on the interview trail, and my number three was Hopkins (my dream hospital when I started med school, but very far from my family and a longer/more intense program than my top two). I ended up ranking a world-renowned institution as my number one and then a Michigan hospital close to Stephen's family as my number two. I wanted my number one so badly, but at the same time I knew that getting it would be bittersweet since neither family would be closer than a 7 hour car trip away.

After I got my envelope, I rushed to the car where Stephen was waiting and couldn't wait any longer to rip open the envelope. And then I saw it, my number one program...I felt a flood of excitement and then relief at knowing where we are going. Stephen kissed me and told me how proud he was of me...and the rest is kind of a blur :)

When I look back at the journey that has brought me to this point, I really see God's hand in it all. After sharing our news with family and then on Facebook, I started realizing that I know several nurses and doctors from my Haiti volunteer work that live around the area where I'm going (some even offered to help us with moving!) Over the weekend, I found a rental house on Craig's List across the street from the hospital where I'll be spending all my time except for a few off-service rotations. A close family friend who lives in the area was able to go look at the house and see that it is beautiful (much nicer than we require!) and only a 5 minute walk from the emergency department where I'll be working (such a relief that I'll be so close to Stephen and the baby). And when I talked to my residency program about our baby due just a few weeks before orientation starts, they were incredibly supportive (I have multiple options including taking maternity leave or some vacation time in July). 

We are thankful for so many reasons right now, and excited for the journey to come!

I finally know what I want to do with my life...

via

And it was the hardest decision that I've ever made.

I started medical school with the clear idea that I wanted to be an ER doctor. Having worked almost two years as an ER nurse and spent extensive time volunteering in Haiti with ER docs, I felt confident in my decision. But the farther along that I got in medical school, the less certain I was...I liked continuity with my patients, with is not really present in emergency medicine, and I found myself with a different personality than many of my classmates planning to pursue emergency medicine. Then enter OB/GYN...

Delivering a baby is unlike anything else in medicine or life. There's something about the raw joy of that moment and the privilege of being a part of it...nothing really compares. I also liked the prenatal care, the postpartum care, and supporting women with fertility issues. There were a couple of problems though. I knew that I would be a natural family planning OB, which mean that I wouldn't do tubal ligations or prescribe contraceptives, placing me in a very small minority of OBs. This would have implications on where our family would live, based on me finding a hospital and group that would support me practicing this way. I also knew of the implications on family life in traditionally one of the worst residencies in terms of hour requirements, and even after residency as an attending since babies are never born at predictable hours.

In August I spent a month in St. Louis, at an OB/GYN residency that was strong, high-volume, and NFP-friendly (about one-third of the residents are NFP-only). It was one of the best months of my medical school career. I participated in many, many deliveries and did some of my own. I got to know the residents, a smart, kind, and supportive group. I reaffirmed my love for OB and discovered that it was possible and needed to be an NFP-only OB/GYN (possible, but not always easy). I prayed that God would show me what I was supposed to do.

I guess I should add that when I prayed, I told God (always risky in a way) that it would help me make my decision if Stephen and I became pregnant. We had tried for a couple months, knowing that there was only a brief window between residency interviews and the start of intern year, and hadn't been successful yet. I knew that it would impact my decision if I were expecting, because of doing one of the hardest residencies with a newborn. We found out that we were pregnant the month after St. Louis (yes, God listens).

I still interviewed for OB, but I also interviewed in emergency medicine. EM was my 'first love' in a way, and residency and life after were light years different (probably one of the best residencies with a family, and certainly a great lifestyle afterward for having children). However, there was a nagging feeling inside that I didn't want to give up OB. It took me months to make my decision (which I solidified pretty much right before our rank lists were do). I reflected on life, my priorities, why I went into medicine in the first place. As I got closer to decision day, I realized a few things. One was that I didn't like the operating room: as much as I wanted to like surgery and did like the idea of it, it wasn't for me and probably never would be. Surgery is a huge part of OB, and this helped make the decision easier. I also realized that I would miss a lot of the medicine that I'd learned by pursuing OB. It's a very specialized field, and the broad spectrum of knowledge that I'd always hoped to have as an emergency physician wouldn't be a part of it. Knowing both of this things helped me to be at peace in the end, because I didn't want to make the decision based only on family life or the fact that being an NFP-only OB would be difficult.

And so I made my decision of emergency medicine. There's a part of me that still has a hard time letting go of the idea of delivering babies (not that I won't ever in the ER, ha) but I know in my heart that it was the right decision for both our family and for me. It was reaffirmed last month when I was working in the ICU: ER doctors can pursue a fellowship in critical care and become an intensivist, and I realized that the ICU encompasses so many of the reasons that I went into medicine: caring for patients at their most vulnerable, and practicing in a field that requires me to use all of the pathophysiology that I've learned on a daily basis.

That brings me to today, Match Day. If deciding between emergency medicine and OB was the hardest decision that I've ever made, then ranking programs was a close second. I was so torn between the programs closer to family and a few programs at some of the top hospitals in the nation. Ultimately, I ended up ranking the two programs that I felt were the combination of most family friendly with the best education at the top...one is close to family, where we'll have a lot of support, the other is at a world-renowned facility. The Match leaves a certain element to fate (and God) since we rank our top programs and the programs do the same, but then it all goes into one big computer system to give us our assignment. It's 5:30 a.m. now, and in only a few hours we'll know...the countdown continues...

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.

Tough decisions...

 

I've had a lot on my mind lately. I've been lying awake in the middle of the night or early morning feeling the baby move around inside of me and wondering what it will be like when I start residency with a four week old. I had a dream the other night that I missed his first steps because I was at the hospital, and I was devastated.

My attending physician the other day started talking about how she had her first baby during intern year. She said that she couldn't prepare herself for how she felt...it was such a change to go from carrying her baby with her everywhere, inside of her, to leaving him behind. I felt a deep ache when she talked about it, like it was a glimpse of what was to come that I hadn't anticipated and couldn't really fully prepare myself for at all.

I've thought a lot about what to do with my life these past months. I've struggled about what specialty to pursue and where I'm being called. Struggled about the timing of things. Regretted not having more time with our baby as a newborn before it's even happened. Even considered taking a year off to spend more time with him.

Yesterday I awakened again way too early with random thoughts running through my mind, my hand on my belly feeling the reassuring dance he usually does at 5 a.m. (and 3 a.m.). I got up, and finally certified my match list for residency (the list of the programs where we interviewed in the order of where we want to go). Until then, I couldn't bring myself to make it permanent. But I knew what I had to do and I did it, and ultimately I think that what I did was the best decision for our family and our future. And I'm at peace with that.

Quick Takes: Pink dresses, face make-up, and prego pillows...

 Linking up with Jen for some quick takes (and by the way, hers are hilarious this week).

1. This week started off with Sean and Catherine's wedding Sunday night, which my sisters and I have been counting down for months. It was interesting to say the least. I love that Sean and Catherine didn't live together before they were married and made it clear that they were waiting for the wedding night. Buuut anyone who watched the wedding knows that ABC made such a big deal out of them waiting that it was almost trashy (I know - sounds completely counter-intuitive...but trust me). Anyways, the live wedding made up for the pre-wedding banter (and awkward lingerie shopping). Sean's dad, a pastor, did the ceremony and I loved it when he said "Love God the most and you'll love each other more." Catherine's dress was a gorgeous lace and we have similar taste in bridesmaid dresses:

Ok, I like hers a little better...but same pale pink, wide straps, sweetheart neckline:

2. I still haven't had a chance to watch the Grammy's (actually just the E dress commentary that I recorded) since bachelor wedding > Grammy's but Taylor Swift's dress was oh so classy and beautiful:

via

3. Hallie's post Love in the Time of Scarlet Fever had me laughing and crying and deeply appreciating my husband all at the same time.

4. The partly sleepless nights have continued as this baby gets bigger and after a week of them (and several of your suggestions to get a pregnancy pillow) I got this email in my inbox:

After confering with Stephen that $79 (!) was worth it for a pillow, it was on it's way to my doorstep. Crossing my fingers that it works (and gets here soon).

5. Grace suggested this acne system from Paula's Choice a while back, and I ordered the trial kit last week to try it out due to the havoc that pregnancy has wreaked on my skin (partly hormones, partly not being able to use my Retin-A). I'm honestly stunned by the difference it made in just a few days (and Stephen concurs). My skin is so much clearer, smoother, and even...it works almost as well or even better than my Retin-A did. 10 dolla off link here if you want to try it for yourself (the trial kit is only $13).

6. Has anyone tried this foundation? I've been using Clinique for years, but I've been looking for something with a little better/more even coverage. The Tarte Amazonian Clay one has great reviews, and apparently it's sold at Ulta so I'm planning to head there this weekend with a 20% off coupon plus a credit that I have been waiting to use.

 

7. This week marked the end of my Senior Surgery rotation and I was not not sad to scrub my last surgery as a medical student or to take my last oral exam of medical school. I can't believe that my M.D. is only three short months away.

Happy weekend!

23 weeks + what I wore Sunday

A few pregnancy updates: 23 weeks and he apparently is the size of a grapefruit or an eggplant and as long as a green onion. He moves around constantly, which I love (maybe I won't love it as much when he starts kicking me in the ribs). I've gained about 10-12 pounds and even though the baby was a small-ish 19th percentile on his 20 week scan, I'm positive he's had a growth spurt since then. I had a really easy second trimester until I ended up in the hospital with the flu at 19.5 weeks, and I feel like it's kind of been downhill from there. I still have sinus drainage and a sore throat (although whether the sore throat is from the sinus issues or the awful acid reflux I've been having is up in the air). I'm also overwhelmingly tired which I thought wasn't supposed to happen in the second trimester? But it started with the flu and hasn't gone away and now that I'm just a few weeks away from the third trimester, I guess I'm resigned to it just being part of the pregnancy.  Also sleeping has started to be difficult...I'm a diehard stomach sleeper which is not working out so well anymore. I'm contemplating getting one of those pregnancy pillows to keep me on my side...but enough complaining. 

We did have a little scare last week where I started having intermittent cramping. I gave it an hour and a half and then called my doctor, who sent me to the OB floor. They monitored the baby, who looked just fine, and monitored me for signs of labor progression. Fortunately the cramping stopped after about 3 hours...but I've kind of been ill-at-ease since then. Part of the problem is that I know too much (influenza A puts pregnant moms at a higher risk of pre-term labor). They did do another ultrasound at the hospital and got the most beautiful profile of our little babe:

In other news, I *think* I'm done with residency interviews (I still have one more scheduled but will probably cancel). I haven't written much about it partly because I was struggling internally with my decision and partly because I'm leery to put anything on the blog until my rank list is due at the end of next month (in the off chance that some program should stumble on my little corner of the internet). I definitely will share more about it when the time is right. I think that my decision (which is really just as much Stephen's decision - he's been so supportive) for my top four or five programs is pretty much made, which is exciting but frightening all at the same time. I also got my Step 2 boards score last week, which far exceeded any of my expectations and I'm just thanking God and St. Gianna because I know that I couldn't have done it on my own.

On to what I wore Sunday (linking up here). I probably changed my outfit three times yesterday, sigh. But neutrals are always a good decision, and tops that drape in the right places are a lifesaver while my body changes in ways I didn't know it could. This top was a deal of the week at veryjane.com, and even though it isn't maternity it's long enough to work right now. It does have dolman sleeves, which I didn't realize when I ordered it and have always thought look sort of like bat wings...but it was cheap enough and fits well enough that I'll accept the bat wings. Funny sidenote about mass yesterday that when I knelt I felt like I barely had enough room between the kneeler and the pew in front of me for my uterus (which apparently is almost the size of soccer ball). Even funnier since I know it's about to get much bigger....

 Infinity scarf: J. Crew (old)

Top: veryjane.com

Denim skirt: Noppies via Amazon (but I should have waited because I spotted a perfect maternity one on thredup.com)

Boots: Frye