Monday, December 4, 2017

Comprehensive Exam Guru Review

When I entered my fourth year, it was like the floodgates of obligation burst open. ERAS, Step 2, CS, CK, interviews, and etcetera were quite overwhelming. After navigating the first half of interview season, I finally completed Step 2-- it was as if a large weight was lifted off my shoulders.

In order to prepare I used ExamGuru, Uworld, and attempted to used Step-up to medicine.
 Exam Guru was by far the most comprehensive and useful tool that I used. My first impression was that the website was visually pleasing and extremely organized. It was clear that the program designers intended to alleviate any frustrations and/or nerves associated with using ExamGuru software. Exams created enough stress.

Software: The Software was organized and easily navigable. Also, the fact that the program is website also speaks to the software’s ease of use and access. Creating test was simple. No download was necessary allowing me to pick up and study on any device.

Explanations: I found that Exam Guru was superior to other aids including physical books. I discovered this through my studies, where I found it difficult to retain the information when using the books. However, ExamGuru's explanations were easy to read and comprehend.

More control over test: In ExamGuru, in addition to choosing the regular topics of concentration (cardiology, pediatrics, etc) for each exam you can also choose specific tasks, allowing you to really fine tune your exams to address your weakness. Task you can choose to focus on through each exam including Diagnostic Technologies, Healthcare Delivery, Health Promotion, Disease Prevention, Management, Establishing a Diagnosis, and Scientific Understanding of Mechanisms. I also liked that you are not limited to 40 questions a block.

Duplicate Exams: The "Duplicate Exam" feature was essential. As a mom with a toddler,
studying between naps and meals was a way of life. Often times I would get distracting mid-block to attend to Levi, letting time run out and not thoroughly going through the explanations.  The “Duplicate Exam” feature is like a reset button for the question block.  No more wasted questions!

Guess feature: In addition to the traditional "Mark" feature, Examguru also allows you to label a question as "Guessed" and provides you with additional feedback on your guessed percentage. This allowed me to really fine tune my studying based on true knowledge instead of gaining false confidence in questions I only guessed correctly.
Difficulty: Exam Guru classifies its questions based on difficulty and complexity. This allows more insight into my knowledge of the materials. Additionally, it built my confidence when I correctly answer questions that were marked as difficult.

Check out all the other features:

Overall I was very pleased with Exam Guru and my complaints are relatively minor. I believe the mobile app could be better designed. Taking practice exams was cumbersome because it required constant scrolling up to submit the answers and back down read the explanations. I would have preferred the "submit my answer" button to be present at the bottom of the question instead of the top. Lastly, I believe subscribers would benefit from practice in abstract and statistical questions. These were present on my actual Usmle Step 2 CK, but I did not feel that I had practiced a large amount of those.

Uworld vs. Exam Guru
After completing approximately 50% of the Exam Guru program, I registered for Uworld, and would alternate back and forth between both banks. I was able to properly compare and contrast the features of both programs. My preference was for Exam Guru as it allowed for more customization and control over my studies. Also, I found that Exam Guru was easier to navigate and use. I feel the in-depth and well-organized explanations of Examguru laid a strong foundation.  At the end of my study period, my average between the two programs only differed by 3 points.

Update January 5, 2018:
I Opened my exam scores Wednesday morning and was in absolute shock! I scored significantly higher than my goal and my score was way higher (like double digits) than my highest practice exam. My score from first practice exam increased by over 20 points. I could not be any more elated!

Disclaimer: I received a free subscription to ExamGuru in return for this review. All information in this review is my true and honest opinion

Additional information:
-On my final score report my Examguru percentage correlated with the Uworld percentage column of the commonly used score predictor:

Friday, August 4, 2017

9 Reasons Breastfeeding Sucks! (Pun intended)

I am not writing this post to discourage breastfeeding what so ever. In fact, I am currently nursing my 15month old son, who was EBF (Exclusively breastfed ) for 6 months and is nursing with no end in sight. I went into breastfeeding with an unrealistic expectation of cuddles and bliss. The articles I found online only highlighted the flowy dresses and flower crown side.  Yes, breastfeeding is natural, but that doesnt mean it won't be challenging. No matter how beautiful it will be, there may be hiccups so here are my  unedited thoughts- 9 reasons breastfeeding sucks!

Thursday, August 3, 2017

Tuesday, January 31, 2017

Pumping By Rotation

Pumping while completing my rotations has been awkward, even though no one has ever made me feel that way.  Before third year started I wasn’t’ sure how I was going to get pump breaks or who to email. One day I sucked it up and emailed the clinical coordinator about having to pump. Fortunately, the clinical coordinator was someone who breastfed their son for a year and had just recently ended her breastfeeding journey. She completely understood. I met with her before school started and she actually took me to my first attending doctor, let him know I would need to pump, how frequent and asked if I would have a room there to pump. Having someone advocate for me helped ease my transistion into my clincal years and helped me confidently begin my pumping journey. 

Amazing door to my pump room

    Dimly light, cozy, comfortable and with relaxing background music.
It is located in the Women’s center and every time I entered I am greeted warmly and met with encouragement!

When I first thought about pumping, I thought it would be a relaxing break every few hours. Even though I would be hooked up to a machine, I could get a few minutes of studying in. In reality, I could of, but most of the time I am frantically massaging -trying to get at least 12 oz. out and back to the hospital floor as soon as possible.

My biggest concern was looking like an absent student, even though I all attendings said they understood. Because of this, In fear of looking absent, I worked towards the goal of surviving on one pump session a day without significantly dropping my milk supply. I just had to be sure to get the same amount of milk as I would before (by pumping messaging etc). I was able to accomplish during my first rotation, though I don’t recommend it because I feel like I also had a history of oversupply. A week before 6 months my supply did start to go down, and I was on my psychiatry rotation. MY days were short so Levi didn't need as much milk sent. Also at this time, I added a 2nd pump session earlier in the day.

Overall pumping can be time-consuming, inconvenient and annoying, but overall, it is so rewarding knowing that no matter how busy medical school is, I can provide the best for my son.

Pumping by Rotation

Pediatrics was my first rotation. Even though I was nervous when I had first started my pumping journey, I knew that pediatricians would be the most likely to understand and welcome the pumping breaks. I found that I could easily manage my patients and attend any teaching session without my pumping breaks interfering. For this rotation, I just used one of the empty exam rooms in the outpatient clinic. This saved so much time.

Rating 10/10
Based on ease, timing and my comfort level

My second rotation was Ob/Gyn-another field that is very pro breastfeeding. The first day I went to pump at 1pm and both of my patients delivered during the 30 minutes I was gone. I was a little letdown (no pun intended), but lucky this wasn't the pattern for the rest of the rotation. For the most part, I was able to balance predicting when a patient was going to deliver and would sometimes go and pump sooner so I didn't have to worry about painful engorgement or missing the delivery.
My rotation partners have really included supporting me as a part of 'team work"
One time during this rotation while pumping one of my patients was going to have to be brought back for a C-section and my classmate texted live updates so I was able to make it to the OR just in time.
I did push pumping a little too late once and leaked, but overall I was able to make it through the rotation without any significant difficulty.
-I did have overnight shifts and that was a little tricky. I would have to pump during the shift for milk during the day, and while sleeping during the day I would still have to wake every few hours to pump for milk. It really threw off my rest and pumping at night was hard to balance because I had no idea how much Levi ate overnight.

Rating 8/10
-Points lost because of missing deliveries and possible difficulty detecting appropriate pump breaks

With shorter shifts, I thought psych would be one of the easier rotations to pump on, but during this rotation, I found pumping to be the most inconvenient. Even though we were at the hospital for a max of 7 hours. We were only with the doctor from about 9:30-130 or 2. An hour of this time we spent in our lunch lecture and about 1 hour a day was spent pumping (two breaks about 30 min each). The psych unit is locked and often times the psych team was asked to do multiple consultations within three different buildings of the hospital. I felt like I wasted a lot of time in transport, waiting for someone to open the psych ward door or chasing the team down on one of the consults. During this rotation, I felt like having to pump significantly impacted my learning experience.

Rating: 6/10.

The potential of a 10-14 hour surgery had me nervous about this rotation, but it was actually pretty relaxing and I didn't feel uncomfortable at all. When I told the neurosurgeon I would have to leave to pump he was like ' 'that’s’ so cool!' He later clarified it wasn't the pumping that was cool, but the fact that I have a son, breastfeed and take the time to balance pumping while in medical school. He even made a short Comment as how awesome it is for long term benefits. He left it up to me if I wanted to get scrubbed back into a procedure after pumping. 
Also, the OR is located right under my pumping lounge, so no scrambling between buildings.
The PA would talk about the details of the operation that allowed me to adjust the times I pumped to align with slower parts of the procedure, while patients were being prepped or in between operations without to much discomfort.

Random story: In the middle of an operation the surgeon asked me how long I plan to breastfeed (Everyone could hear). I told him at least a year and he was like "Well I really think you should go longer than that!" Apparently, he has family members who are very involved in Le Leche League! I do want to go longer than a year but am normally questioned about that decision and didn't want to "risk' having to defend it in the OR, so I downplayed my answer. It was encouraging to have some pro breastfeeding encouragement, even awkwardly in the middle of a quiet OR! It was also a lesson to not downplay the fact that I plan on breastfeeding at least 2 years. 

Rating: 9.5/10
Even though pumping was manageable, I did have to leave procedures to pump.

I was pretty nervous about neurology because it has a busy schedule but the time in between rounds was pretty independent. You were expected to see all your patients, new consults and write your notes before afternoon rounds. It was pretty easy to manage, I never even told the attending I needed to pump and was never behind. On an occasional busy day, I would skip lunch and snack on the go, but overall it was manageable

Rating 10/10

Medicine and Surgery
Medicine and surgery have the potential for long days, but I found no difficulty pumping when I needed to. It just required efficiency. A typical schedule for medicine was 1. Preround and computer round in the morning 2. Morning report  3. Round with the team 4. Continue seeing patients between now and noon lecture 5. noon lecture 6. afternoon round..
I would come in around 30 minutes earlier to round on more patients so that I had about 30-40 minutes extra time between noon lecture.

Surgery was a simular balance between rounding and surgeries. There was plenty of breaks to sneak off to pump if I needed too

Because it did require planning ahead and days could be unpredictable

Overall I have found the hospital to be very supportive of my breastfeeding goals. I look forward to updating you more on this journey!

Sunday, January 8, 2017

How To Become A Doctor

Tuesday, November 1, 2016

Levi's First Halloween

I was not allowed to celebrate Halloween until middle school, so of course it became my favorite holiday once I became an adult.

I promise it’s not just an act of adult rebellion, but because it is actually more of a family holiday than expected.
It is not as shallow as New Years, less stressful than Christmas may be and it does not require as much fuss as Thanksgiving. Depending on how you choose to celebrate, it can be the ultimate family holiday, and the flexible preparation time takes out the stress.

To me, Halloween consists of weeks of planning and DIY projects. Planning out everyone’s costumes then finding all the ways to make them. Preparation for the “big day’ is the perfect balance of both a relaxing and productive environment. When you decided to go beyond the costumes and trick-or-treating, there is pumpkin carving, fall festivals, parades, and haunted houses (which I always want to go to, but freak out the most in the parking lot.)  The best part is, if anything gets overwhelming, you can tone down the to-do list and cut out some activities. No one minds. Unlike Thanksgiving, if you got overwhelmed and couldn’t make the turkey or God Forbid, the mac and cheese, well you might as end the holiday immediately. 😜😜😜😜

Needless to say, being a third-year medical student with an infant is tiring. I had a massive list of Halloween fun, and less than half of it worked out, but the greatest thing is. I still enjoyed it.

First: Friday night some of my classmates from medical school were hosting a party to “Scare Away Cancer”, raising money for St. Baldricks. Even though it was a school party, Levi was invited.  Normally the hardest part of leaving the house is getting us both ready, but surprisingly prep was flawless. Levi was dressed as Tigger. I was dressed as Winnie the Pooh. I put Levi down on the bed to check the diaper bag and put it on… less than 3 minutes. I go to pick Levi up and he fell asleep!!! Levi has never ever gone to sleep on his own! I didn’t want to wake him because I had a naïve moment thinking he would sleep through the entire night..
             Of course, he didn’t!

A few hours later he woke up, but it was too late to go out, we still had the next day.. Levis School’s party.

Second Attempt: We get ready again, absolutely flawless and start heading to Levis school. I am talking to my mom on the car phone and Levi is looking around playing with his stroller toys. As I pull onto the street I tell my mom we are about to pull into the daycare parking lot and end the phone call. I glance into the car seat mirror, and Levi is still looking around, content. I park the car and look back up… Sleep! I figured the nap would be short and we stayed in the parking lot until we saw the families in costumes walking out to their cars.

Third times the charm: The past few attempts were too hilarious to be disappointed. These stories are more memorable than attending both events with no hiccups. Lucky we still had one more time for Levi to actually make a public appearance in costume!. His school was also having a parade the day of  Halloween, and I got off in time to make it! Near the start of the parade Levi seemed fussy and was ready for a nap but he turned festive and excited right as it was time for the parade to start. Walking through the school and seeing all the babies and kiddos in costume was absolutely adorable! As soon as everything toned town Levi had a full on breakdown (something he has never done before) but once we nursed and cuddled, he was out! Sleeping hard in two seconds. We were invited to trick or treat that night but I didn’t see Levi staying awake through it, and I had some studying to do, so we ended is first Halloween night, went home and cuddled while this mama ate his Halloween Candy. 

This Halloween there was no time to hand make our costumes, carve pumpkins or even trick or treat, but either way, it was full of adorable funny memories we will cherish forever.

SN: You can still donate to St Baldricks for Childhood cancer here:

Monday, October 24, 2016

MS3- The morning of day one

We survived my first day of clinical rotations(with Ben being out of town at the same time ðŸ˜®) !

I tried to be "responsible" by going to bed at 10pm but that backfired when I woke up at 1am and could not go back to sleep. I ended up just eating cereal at 3:30am and went back to sleep shortly after..only for my alarms to start at 5:30.. I snoozed until 6 when Levi was ready to eat. I ended up walking our dog and nursing Levi at the same time.
  -I just want to say that level of multitasking should go in a letter of recommendation!

 After, I got both of Levi and my bags together for the day..even put on eye liner and had prepped instant coffee.

 I was so proud when I had Levi dropped of at care at exactly 7:00-we did pretty darn amazing this morning..

When I was in the car on the way to the hospital I confidently took a sip of my coffee...and realized I forgot to microwave the water before pouring it in... All I could do was burst into laughter ðŸ˜‚😂😂 

Even had time at lunch to see Levi
Morning number one was still perfect. Just last year I would have never even have time for breakfast in the morning and during this year off I wouldn't "have the time" even when I didn't work until 2...Levi was made me the best version of myself.

Sunday, October 23, 2016

Sunday, October 9, 2016

My Birth Story

Short Story: 3 days after water broke,induced, no epidural, natural birth

Long Story: 
4:30 Am on a Tuesday Morning, Ben and I just settled for the night and cuddled up into bed. Thirty minutes later I felt a sudden gush of water. I sat up quickly and told Ben rather calmly that I think my water just broke, so he should start packing his bags. I even gave him some suggestions, like 
“Don’t forget to bring extra shorts in case you want to get into the birthing pool with me” and “Lets take Nopey Bear on a walk”. 

Knowing what the midwives would tell me to do, I skipped calling them right away, put on a pad, and rested in bed for thirty minutes, stood up…. Yup, another gush. I didn’t pee on myself, my water actually broke.

-Contractions would start any minute now…

I called the midwife, and after she told me to lie down for thirty minutes and check, I informed her that we already confirmed it, and off to the hospital we went. Contractions never came, and an induction was almost started, but the doctor of the practiceknew my goal for natural birth. He came and informed me that What the hospital was starting was an elective induction and informed me on waiting for contractions to start on their own
. I agreed to wait, but we were hoping they would start within 24 hours. We were almost certain they would start in 24 hours actually,but i was still surprised when I was sent home to wait. More than 2 full days passed, and I was living like a baby. Waking ever 30 minutes to an hour to change my adult diaper. 

I am not really sure how so much amniotic fluid could just.. keep…coming!..but it was.

It was miserable! 

I could not sleep well constantly soaked. In between attempted naps and diaper changes, I walked, bounced, stretched, begged, used any method to induce labor… Nothing! 

When it was getting close to 3 days of my water being broken, I called the practice. I wanted everything to be as natural as possible, but We couldn’t wait any longer. Once your water breaks, you are at increased risk of infection… I had had 4+ internal exams at the hospital… all which increases that risk even further. Blah blah blah

So, Thursday afternoon, it was back to the hospital. I was planning to have an unmedicated water birth, but that plan changed. Pitocin it was, but even with the impression that Pitocin makes contractions a million times worst than natural birth without it, I was determined to still have water birth, no epidural. I was terrified of Pitocin not working and getting a C-section, but overall my perspective changed. I was ok with anything medical necessary, but I would feel really let down with myself if I got an epidural. Once I checked into the hospital, I just knew I would be very dilated… nope 1 cm! and it stayed that way for hours!

Around 2am Friday morning the midwife checked me again. I was only 4cm, disappointed and exhausted! I had not slept more than 2 hours since my water broke on Tuesday. It was the most exhausted I have ever felt. The excitement of my son was the only thing keeping me from crashing. I, still to this day don’t know how I managed to stay awake as long as I did. At this point, I was extremely anxious. When I heard I was only 4cms I almost had a panic attack, I never told anyone that
(my birthing partners aka Mommy and Ben will just find that out reading this post)

Through my contractions, I would frantically repeat what the midwife would tell me in my head...

…(Ok her version was more calm and wholesome).. 

Even though I was panicking, I still was expecting labor to get worst. I had my aromatherapy, music, etc. But I never unpacked my labor support bag. I didn’t want to use my “tools” too soon and find them ineffective by time the real pain started. I mostly used the birthing ball and actually found rolling my hips in a circle during contractions very helpful.

The midwife offered me something for anxiety. Also by making me less anxious, it would take the edge of the pain. I needed to get some rest considering the past few days. This was the first time I somewhat slept in days! I was able to relax. To be honest, the pain was still the same! But I was able to breathe through it… the thoughts in my head stayed the same, but their tone was different. I was now calmly repeating “You’re taught to be afraid of pain, but this pain is natural, its only temporary, it will be over soon, just breath”. And I did, I was able to breathe and at some point I actually fell asleep between was more like a haze, its hard to explain… but in less than 2 hours, the contractions were so bad and my panic went from 0 to 100!.


Ben had to rush over and unplug me from the machine and walk me to the bathroom. I saw some blood in my underwear and had the nurse come. Oh it is just natural they reassured… Back to the bed I went, contractions now quite severe.

At this point I started calculating, ok I remember the medical school lecture that said you dilate about 1cm an hour.. I was four cm so the max I am at is 6… At this point I told Ben 

    “I don’t think I can do this anymore, I am done, I think I want the epidural”.

 I was pretty heartbroken, thats when Ben said
       “Its ok, you can do this, the worst part is over”. 

I told him, no its not, and started telling him my reasoning, but I told myself I will give it one more hour without an epidural and decide how I felt. I am so glad Ben “lied’ and said the worst part was over. I knew it wasn’t true, but it got me to wait it out..first and last mention of the epidural. I didn’t want it but got scared and tired. That’s why it’s  important to have a birthing team who knows you and your goals. I think I would have been heart broken otherwise. 

Less than 5 minutes later:

I had the strongest contraction ever, and I feel like I was going to.. um well use the bathroom on myself :/ … Ben and my mom were not moving fast enough. I was literally jumping into Bens arms because he wasn’t picking me up fast enough. Why was my mom just opening the bathroom door.. she needs to run over here and yank me off of this machine.

-Why is everyone moving so slow! They don’t understand how URGENT this is! I need to get to the bathroom now, i need to push! this hurts!!..

I guess it is safe to say the “anti-anxiety” was having little effect now.. When I was in the bathroom, there was blood again… a lot of it!

“Ben get the nurse now! This is NOT normal!”

The med student in me came out... severe pain, gush of blood, had a sudden loss of amniotic fluid earlier. .placental abruption!! Oh my god, I'm terrified!!

But Nope- calm down Kristin, it’s a normal contraction and your mucus plug. Dramatic much! smh
The midwife came in and calmly and cheerfully said “Its time to have a baby”! There wasn’t even time to set up the water birthing pool, or call the photographer.

Using a naturally focused practice, I was able to birth anyway I choose, Something I will forever be grateful for. I was laying somewhat on my side with my arms fully around my husbands and his around mine. It felt so safe and so intimate, what better way to bring our child into this world than in each others embrace. Looking back on it there were several medical staff around the room, but during the birthing process, I barely noticed them. It felt like it was just us. Me and Ben with my amazing mommy for support. For the most part I was able to push when I pleased (except when the midwife was preventing tears or unwrapping the umbilical cord from around his head). I remember my mom telling me I could reach down and touch his head, but I refused. I knew I would get so emotional, and at that point, I needed to stay focused on pushing. 50 minutes later he was here, on my chest, and not to be touched by anyone else for the first hour. Knowing his mama, he cried right away, thank goodness because the anxious mess I was would not have lasted a second of silence.

I thought when I first saw him I would cry, I cried during all the videos I watched of other births, but I was silent. I had this absolute overwhelming feeling of calmness, of peace. All pregnancy I was anxious, after being told I would have fertility problems and a pregnancy loss, I never fully celebrated my pregnancy. I was always too nervous that something would take this away. It was too good to be true… But now he was here, real and immaculate.

Medical staff completely cleaned me up, changed the room setting, even changed me, but I barely noticed. We were in our own perfect and tranquil world.

Other funny labor moments:
I didn’t scream during labor, but was making a really weird “eeiiiffaa” sound… Even in pain, I randomly burst into laughter at how I sounded.. Ben didn’t know why I was laughing so I pretty sure he thought I was crazy.

At one point I felt really exposed down there… In response I yelled out “MY BUTT HOLE!”. The midwife understood what I meant and covered it with some gauze.

My mom was trying to get into Bens phone to take pictures and kept asking him for the password.. through a push I started yelling out his password. I was also really afraid of kicking the phone out of her hand into the birthing area haha

Sunday, October 2, 2016

Welcome Forest Friends: My DIY Woodlands Baby Shower

 So, before I got pregnant (when I pinterest planned my entire life), no one told me you don't plan your own baby shower. Well, I already had my mind set on a woodlands themed shower and brainstormed all the DIY ideas around it. I pretty much begged my way into taking over my baby shower... Not really. I was pretty much like you host it, but I will make everything *angel face* Without med school I had a lot of extra time this year off, but this ended up working out well with my friends own demanding personal commitments... As tiring as it was, I was happy to have the perfect Woodlands themed baby shower, held in a cabin of course, with 20 forest animals (stuffed animals I still have no idea what to do with now) and all my family and friends. I loved this neutral theme for a co-ed baby shower! If you have any questions about how something was made let me know. I made every thing pictured, except for the cake, lamp, oh and my grandpa.