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. I was also lucky that the hospital provided me with a lactation room that was ah-maz-ing. 

Amazing door to my pump room

    Dimly light, cozy, comfortable and with relaxing background music.
It is located within 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, I was able to make it so I could survive 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. I was able to accomplish during my first rotation, though I don’t recommend it because I feel like I was just lucky. A week before 6 months my supply did start to go down, and I was on my psychiatry rotation. Which meant my days ended early so levi wouldnt 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 puming 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 7 hours. We were only with the doctor from about 9:30-130 or 2. An hour of this time we spent on 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!' Not that I was pumping, but the fact that I have a son & breastfeed. 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 didnt want to "risk' having to defend it in te OR, so I downplayed my answer. Itgreat reat to have some pro breastfeeding encouragement, even if it was akwardly in the middle of a quiet OR!

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 were 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 or snack on the go, but overall it was manageable

Rating 10/10

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

Love Well,