One Block In

by MaryBeth

I have officially survived my first block of medical school, which was called “Cells to Populations” at Dell Med (read: biochem + genetics + cancer). They packed a lot of interesting material into this first block, including tons of frightening diseases and life-altering conditions. As a result, I have already experienced an early bout of anxiety stemming from “Medical students’ disease”. Let me tell you, when your 3-year-old daughter looks into your eyes and tells you, “Momma, I don’t want you to die,” any symptoms of physical discomfort can easily lead to heart palpitations and fears that one may be afflicted with a serious illness.

Having never suffered from anxiety before in my life, I feel somewhat lucky that I’m only now discovering what it feels like to fear everything for a few moments in time. There have been great weeks, just ok weeks, and at least one really bad week so far in my medical school journey. What this first block has proven to me, though, is that it CAN be done. It was a challenging block, with tons of metabolic pathways to understand, and I held my own alongside students who majored in biochemistry at top tier universities. I will never be at the top of my class when it comes to exams, but I am still so proud of myself for doing what I did with three kids under five at home.

No doubt, I wish that I could have joined my classmates for the celebratory post-exam margaritas.  I wish that when I’m at home I had more time to unwind, read or watch something fun, or go out to dinner with friends. There’s not much time for that these days. The fun I have at home is the kind of silly and exhausting fun that all parents know and understand. It’s tough and it’s wonderful at the same time. Just like medical school. And love. And life.

Working towards becoming a doctor is a scary and momentous time. There are many things that frighten me at this moment. But I’m sure, in the next five minutes, a little person with cute little feet and a sneaky smile will bring me a book to read, and I’ll forget about the fear for a while.

Detour

Last month, I was about ready to submit my application to med school when hubby states he was thinking that we should move to London by the end of the summer.

I was a little surprised but I know he has always wanted to move to a different country and I am just as adventurous. I decided that I would wait again before I submit my application to medical school.

I began my search for a Master’s program in London for Bioengineering, which has recently become a new passion of mine. Which I will probably complete before applying to medical school either there or back here in the U.S. The programs there are 5 and 6 year programs, which is another factor to take into consideration.

Traveling and living in another country has always been something I love and wanted to do. London seems like a good place to go as half of my family already lives over there so it will make the move easier.

So come next month my husband, two kids, and I will all be on a flight to London. A little nerve wracking but definitely looking forward to the adventure ahead. In the mean time I will continue to strengthen my application for medical school and keep you all posted on my progress.

Good luck to all those who did submit there applications this year. I hope all of you get in!

And for those of you who are starting medical school like our very own Mary Beth. Best of luck in your studies!

The End and The Beginning

by MaryBeth

Last week marked one of the biggest milestones in my life: I began medical school. But as I referenced in previous posts, this was not the only big change my family went through in the last month. My youngest of three just turned ONE and her sassy big sister turned three (see adorable birthday balloon above). With my baby daughter starting daycare for the first time after a year at home, I felt an unusual amount of anxiety leading up to this major transition. So much so that, over the last two months, I believe I’ve even experienced a few episodes that could be categorized as panic attacks. Turns out, just because you don’t realize how nervous and anxious you are on a conscious level, doesn’t mean you can avoid a physical reckoning! It’s definitely too early for me to self-diagnose with any degree of certainty, but let’s just say that identifying the issue and working to address it has already improved my daily life.

Speaking of…. my daily life now involves studying hard and working with some awesome peers at Dell Medical School in Austin, Texas. Our workload at the moment is incredibly diverse, which helps keep things interesting. Prep for a typical class day might involve reading a study on social determinants of health, watching a video comparing the costs and risks of different radiological tests, or exploring a relevant clinical case with a team of other students. We are definitely not lacking for material!

I’ll share more about Dell Med’s novel curriculum in a future post. For now, I’d like to impart a few things I learned about self-care during orientation and in my first two weeks of med school. These are things you may already know, but maybe reading about it again will help you make a small change that you wouldn’t have made otherwise!

My current strategies for coping with med school and family stress:

1. Take time for meditation/reflection – I finally subscribed to an app called Headspace (you can check out a free pack of 10 meditations just by registering) and have been pretty good about meditating at school or at home to give myself a much-needed mental break.
2. Bring plenty of healthy (and tasty!) food – I planned out a weekly grocery list and meal plan, including hearty snacks, so that I always have the best kind of fuel available at school or home.
3. Find mundane activities that offer complete satisfaction – if there’s one thing I’m already learning about med school, it’s that you’ll never be able to do/learn EVERYTHING for every class. So it’s helpful to use your off time for tasks that are guaranteed to bring you that slice of satisfaction that you might not get at the end of your study session. Example: this morning I vacuumed and straightened my house so that I could come home and enjoy a clean space. Baths with your favorite music playing are another great option 🙂
4. Smile. You know how they say that if you smile more, you actually start to feel happier? Well, in my first two weeks at school, I’ve found myself smiling at my new classmates and friends A LOT. And without realizing it at first, I think all of that smiling has generally kept my spirits up even through some stress and anxiety. As we all get more familiar, it’s likely that the smiling will gradually decrease, but it certainly won’t hurt to try and keep it up.

Best of luck to everyone who is applying this cycle! I’ll try and post again soon with more updates on how school is going.

With three kiddos under 5, it’s nearly impossible to get a pic where everyone cooperates!!

 

Sleep is the best medicine

by MaryBeth

Few people have more difficulty getting enough sleep than new parents and doctors-in-training. When I attended the Texas Maternal Mental Health Conference in April, sleep was mentioned as the first line of defense for any mom dealing with postpartum depression or anxiety. Good sleep can truly be life-saving. So it’s no surprise that researchers spend a lot of time investigating the safest and most effective sleep strategies for infants and their parents.

Recently the American Academy of Pediatrics published a new study that contradicts their previous recommendation that infants share a room with their parents for the first year. The data from this study suggest that infants who sleep in a separate room from Mom and Dad between 4 and 9 months may get more sleep and sleep for longer stretches than infants who share a room. These findings are pretty descriptive of my own experiences–even as recently as last weekend, when I tried unsuccessfully to room-share with my 11-month-old because we had family staying with us.

Below I’ve shared some of the basics of my approach to sleep during the first year of baby’s life. I am a firm believer that finding the key to infant sleep is not a “one-size-fits-all” proposition. Every family has to figure it out for themselves and go with what works for them. But, in the interest of passing on any wisdom I have, here it goes.

Safe co-sleeping was a life-saver for me as a nursing mom. The routine that we developed with our first baby (once his early weight issues were resolved) was that my husband slept in our guest bed and let me and the little one hog our entire Queen-sized bed for the first few months. We kept our bedding very simple and I made sure that my little guy was snuggled right next to me (not near any pillows). Our pediatrician knew that I co-slept and she supported that decision. Honestly, I think most moms who nurse understand that, when baby is eating frequently, the ability feed throughout the night without getting out of bed results in more and better sleep for everybody.

I always struggled with low milk supply, but as soon as we started supplementing with formula and/or solid foods between 6 and 9 months, I found that moving baby into the crib in a separate bedroom worked best. For the first few days after the transition, we used a gradual cry-it-out method for dealing with nighttime waking. We would go in and reassure after about 7 minutes of crying, but we’d always verbalize, “it’s time for sleep,” and we would not bring baby back into bed. This approach successfully limited the length of our sleep training period with all three kids to about one week. Once the night waking dropped to just 1-2 times per night, we’d stop going in the room altogether and 99% of the time, baby would get back to sleep in under 10 minutes.

Getting all of our kids to sleep through the night in a separate room by about 9-months-old wasn’t easy and I know people who’ve made different strategies work for them. But by the 9-month mark I was always ready to get my evenings back and sleep independently from my baby again. The space was welcome and helpful. Plus, we all got more sleep!! I’m also convinced that the transition would have been much harder if we’d waited until separation anxiety set in, which happened recently, around 11 months. And this was very apparent last weekend, when I could tell almost immediately upon trying to sleep in the same room as my baby girl that it was NOT going to work. Neither she nor I could sleep peacefully: I was afraid of making even the smallest noise and she awoke more often and did more crying because she could sense that I was in the room.

Even for seasoned parents, trying new things with your baby is important if the status quo is not working. I hope you have found or will soon find a sleep solution that works for your family!

Academic Fresh Start Texas Program

So, I got a few questions from a couple of readers after the introduction of Mary-Beth about the Texas Fresh Start Program. First off no Mary-Beth did not use this program but as some have showed some interest in it I decided to look into it and explain it a bit.

It is a unique program for Texas residents that allows all courses that were taken over 10 years ago to be for all intents and purposes ERASED.

If you are a non-traditional that had a bad undergrad this sounds like an amazing option to essentially get a second chance and not have to get a full semester of A’s only to have your GPA rise by a measly .02 points. 😦

What’s the catch?

1. It is ALL or NOTHING if you do this you don’t get to choose what classes to keep and which to restart. ALL GRADES from 10+ years will be erased and they won’t count towards prerequisites nor your GPA.
2. Only will help if your using the TMDSAS (unfortunately AMCAS will still want all your coursework and they will calculate it into your GPA)
3. Must be a Texas Resident

While the benefits of this program are obvious there are some things that must be considered.

• The amount of financial aid you qualify for is still determined by ALL credits taken even those that were “erased”
  • So please make sure that you qualify for enough financial aid or can pay for the total amount of time required for your degree
• Other Graduate programs have different policies of how the Academic Fresh Start coursework will be counted
  • It’s a safe bet that if it is a PUBLIC Texas School then it will apply as this is a Texas Law

This is a great option if you plan on applying to only Texas schools, are financially able to support the 3+ years required, and all your bad courses are 10+ years or older.

With that said in my own opinion if you already have a Bachelors degree you may be better off just getting into a Masters program which will only take you 1 or 2 years to complete and your more recent grades will obviously have more weight than 10+ years ago. Although you must do exceptionally well in your Masters to make the argument of how you have changed from your frivolous early college years.

There are a few universities in other states that offer similar fresh start programs but I don’t see how it would help you in getting into medical school unless AMCAS adopts new policies and if TMDSAS recognizes fresh start programs from other states.

 

More Information:

TMDSAS Fresh Start Policies

Texas Fresh Start Law

Apply to Med School Like a Boss

USING YOUR MOM SKILLS TO CRUSH APPLICATION SEASON

by MaryBeth

Ever sit in class and wonder, how can these kids complain about not having time to study? I’ve got babies to feed, clothe, and put to bed. I haven’t eaten, I’ve got tons of housework to do…the list goes on and on. This, my friends, is how you succeed in the application cycle.

As a parent, you’ve already learned some of the most critical life lessons you’ll need to succeed in medical school and beyond. Your task during application/interview season is to intelligently articulate what you’ve learned and convince the committees that you belong in their next class of future docs. You need to highlight your already-honed ability to manage numerous tasks at once, your patience with difficult personalities, and your understanding of the immense responsibility involved in caring for others.

Here are some of the concepts I highlighted in my personal statement, supplemental essays, and interviews at several Texas medical schools:

“I will be a source of motivation and inspiration for my future classmates.”

Throughout your time in pre-med classes (or whatever you were doing to lead up to this juncture), you probably relished those moments when you got to talk about your kids and all the responsibilities you had ON TOP of studying. Now is the time to orient that sense of accomplishment toward the future. How will your rock-star work ethic help their school succeed? The answer: your willingness to work even harder to achieve your goals while caring for your family will motivate the other students in your med school class to be at their best. Using an example from your pre-med classes is a great way to illustrate this strength to admissions committees.

“I am mentally prepared for frustration, disappointment, and sacrifice.”

Let’s face it. Before you had children, did you really know what it meant to be exhausted? Had you used up every ounce of your energy to keep someone else happy, healthy, safe, and comfortable? Probably not. As a future physician, you will be tried and tested to your limits again and again. Starting the game with years of practice under your belt is a huge advantage and you should make sure everyone realizes this. In one of my faculty interviews, I was asked to describe how I like to work. I admitted that I prefer to work well ahead of schedule, tackling small chunks of projects to minimize my stress as the deadline approaches. The interviewer caught me off-guard by saying, “but what if you can’t do that?” I took a pregnant pause, and then answered, “I would do my best to figure out what the top priority was, and then I would get to work, realizing that I can only do what I can do – and stressing about the rest won’t help.” As a parent there have been SO. MANY. TIMES. when my mind has raced (and my pulse along with it), thinking of everything I had to get done. But when you’ve got a screaming child, you learn to prioritize. You have to prioritize. And you give up any preconceived notion of doing everything perfectly.

“I am motivated and I can do this.”

Confidence speaks volumes in any interview situation. Being self-assured yet still humble is a skill that most 22-year-olds have not yet perfected. You, on the other hand, have life experience that the majority of applicants do not, giving you a confidence that only comes with age. You’re ready to talk about your passion for medicine, your devotion to your family, and the difficult path you took to get to where you are. If you used an anecdote about parenting in one of your essays, be prepared to add more detail and humanity to your story in the interview. Challenges that you’ve overcome are popular topics among interviewers, so practice telling your story in a compelling way that emphasizes your ability to reflect and to adapt. Even in this day and age, interviewers may use the fact that you are a mother to question your ability to handle medical school. In fact, a female interviewer at UT Southwestern gave me a particularly hard time about this. Nervous as I was, I confidently countered her doubt with details about being an exhausted, working, pumping first-time mom to 6-week-old colicky baby. I felt sure I could handle anything medical school could throw at me.

Making it work: the best way to attend my Galveston interview was to have my in-laws fly down from Ohio, rent a van, and pile all 7 people (including the 5-month-old) in for the ride. Fun times!

 

If you have questions about essays or interviews, feel free to reach out in the comments! I’d love to hear about your experiences as well.

MCAT Test Day!

Well the day has come and I am retaking my MCAT today. I got a 500 on my last test with very little studying. So I am hopeful that with a bit more preparation that I can get a better score.

I believe that the MCAT requires both knowledge of topics and strategy for taking the test. I believe I was lacking in both areas on my last test. I had not completed Organic Chemistry nor Physics, which showed and was my lowest section.

When it came to strategy I don’t think I had any besides these basic test-taking tips:

• Read passages for understanding and think about the whole time what sort of questions could be asked (you really don’t want to have to go back and re-read)
• If your stuck on a question skip it and come back to it.
• Keep your eyes OFF THE CLOCK instead use your own internal clock to know if your spending too much time.

So besides that I did not have any strategy. These are somethings I thought about after the fact:

• Scratch paper can be your best friend 
  • If you are having trouble remembering some key core concepts/formulas review it immediately before entering the test-taking center and once at your testing station write it down immediately on the scratch paper given.
  • Write down some key info from the passages (make it quick only a few words)
• DO NOT DRINK A LOT OF LIQUIDS
  • Yea I did this and I ended up in the middle of my test having to really go and rushing through questions
• Only take breaks if necessary
  • If you are on a roll and really in the zone then skip the break and keep it going.
  • Feeling exhausted or warn out take that break and try and recoup.
  • Also take it if the next section you want some time to think about the subject matter and “refresh” your memory before starting.

Applying Early to Medical School

Why is it important to apply early to medical school?

There are several reasons but here are the Top 2 reasons to apply early.

1. Most medical schools accept students on a rolling basis so applying early allows for you to get your application in when there is more spots available increasing your chances of getting in.
2. It gives you more time to work on secondaries. (Well sort of). I think it is necessary to submit your secondaries no more then 2 weeks from the time you receive them. But urgency to get them in even faster is very important the later it gets in the application cycle.

Prioritizing Maternal Mental Health

by MaryBeth

Nearly 1 in 7 women experience symptoms of postpartum depression during their reproductive years – and that number represents only the reported cases. The actual incidence is believed by some to be significantly higher. Recognizing the need to discuss this vital maternal health issue, the School of Social Work at The University of Texas at Austin and The Pregnancy and Postpartum Health Alliance of Texas (PPHA) teamed up this spring to host their inaugural Maternal Mental Health Conference (MMHC). As an incoming student at Dell Medical School, I was privileged to assist with and attend a large portion of this historic event.

Maternal Mental Health Conference ~ April 27-29, 2017 ~ #TXMMHCON

Did you know that depression is the #1 complication of childbirth? I didn’t, and I’ve given birth to three babies. Before the MMHC, I had little prior knowledge of either the clinical definition of postpartum depression or the broad spectrum of disorders that fall under its umbrella. For example, could you recognize the differences between postpartum psychosis and postpartum obsessive compulsive disorder (OCD)? I captured this photo during the excellent opening keynote presentation by Lucy J. Puryear, MD.

A tragic and well-known example of postpartum psychosis is the story of Andrea Yates, who was assisted in her re-trial by Dr. Puryear. Postpartum OCD, on the other hand, is likely suffered in silence by many women who are afraid of or who don’t understand what they’re thinking and feeling. As a future medical provider to women and families, I appreciated the high level of detail that Dr. Puryear was able to share about the symptoms, diagnosis, and treatment of postpartum depression spectrum disorders.

My Personal Experience with Postpartum Mood Changes

When I was pregnant with my first baby, my doctor warned me that I might experience “baby blues” after my little one was born. Beyond that, I honestly didn’t know what to expect with regard to my mental health. The rollercoaster of emotions I felt after my son was born was unlike anything I’d ever experienced. First came the overwhelming joy of meeting the child I had grown and becoming a mother. The physiological response to new motherhood is truly transformative: I never knew I could be so happy.

But after a few days, painful challenges arose. My baby boy was born with two bottom teeth (like his Momma) and he spent the vast majority of his first 48 hours cluster feeding. By the time we got home from the hospital, my nipples were already purple and cracking. Then, at around 3 days old, he bit me – hard. I wailed in pain and sobbed as I handed my fussy bundle over to my husband and my mom. I was afraid to nurse, especially on the raw side, which took more than a week to heal. I even developed an abscess that required antibiotics.

Already exhausted from all the shushing and feeding, I sat at my kitchen table with my electric Medela pump to try and keep up my supply. In all honesty, it was humiliating. Those first three weeks were the hardest of my life. Despite my fear of the pain, I clung desperately to the nursing relationship we had started. I was not breastfed by my mom, and when I first got pregnant, I wasn’t even sure I wanted to breastfeed. And yet, here I was, terrified that I was not capable of providing for my child. Disappointed beyond measure that my poor baby was hungry and that I’d had to supplement with formula (which, in my mind, was a huge failure). I spent a lot of time in those early weeks worried and crying.

Luckily for me, things improved. A skilled and attentive lactation consultant, who I paid out-of-pocket to visit us at home, helped us get back on track and we nursed part-time until he was eight months old. This experience taught me a hard lesson about parenting: when it comes to raising your children, nothing will be perfect. A lifelong Type A perfectionist, I had to overcome my disappointment and focus on what was best for my baby. This seems like common sense, but it was actually very difficult at the time. I can imagine how easy it would have been to fall into a deeper depression, especially if I lacked family support. I didn’t realize it at the time, but my difficult initiation into motherhood played a large role in my decision to become a physician.

Knowing what I know now about the postpartum depression spectrum, I feel more qualified and motivated to help mothers and families overcome postpartum mood changes. I hope that primary care providers will take up this cause, so that all new moms have the support and resources they need to survive those critical early months of motherhood.

Helpful links:

https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml

https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/

http://women.texaschildrens.org/program/obstetrics-and-gynecology/edinburgh-postpartum-depression-screening-tool

 

 

On weaning, cloth diapers, and other big changes

by MaryBeth

Hello again and happy weekend! I love how quiet the house is on Friday evening after everyone is in bed. Heading into Saturday morning can prolong the bedtime routine, but I appreciate the sense of excitement and anticipation of fun times ahead.

For now, at least.

In a little over one month, my weekends will no longer belong wholly to my family. For a very long time my brain will volley between learning medicine and being a wife and mom.

Because of the big changes ahead, we decided we could no longer keep up with cloth diapering, which we did to a large extent with our three kids. The diapers served us well: The same set of 20 bumGenius Freetime diapers were worn by all of my babies for a year or more each. I was a bit emotional as I passed them on to a new family this week, but simplifying in this way will help us save time for more important things.

My baby daughter also seems to be getting the message that change is coming: She is losing her patience for nursing. Save for one relaxed feeding in the early morning, she now prefers bottles and lots of solid food. At nearly 11 months old she’s very mobile and curious, and she generally needs me less (except to remove choking hazards from her mouth). She might very well be my last baby, which means I could be nearing the end of my time as a nursing momma. Sigh.

Our family is about to go through more change than we’ve ever faced all at once. I am starting medical school after a year at home, my littlest baby is about to wean, walk, and start daycare, my oldest is transitioning to a dual-language elementary school for his last year of Pre-K, and my husband is also taking classes this summer (while continuing to work). In a few months’ time we’ll be following a whole new routine and we’ll spend less time together as a family.

Whether I like it or not, I’m currently feeling sad and anxious about the huge transition that looms ahead. But it’s not all bad–I’m also feeling hopeful. I have no doubt that all of this change will bring interesting and exciting new dimensions to our lives. My goals between now and Day 1 of med school are these: be thankful for the past but don’t dwell on it, live and breathe in the present moment, and make plans that will help me kick butt in the future.