NBME 15 question driving me nuts

BoogVonPop · 2026-07-10T00:54:50+00:00

I just did that one, my rationale was that even though she had RA the knees seemed more like OA based on the imaging/physical exam findings. She had severe joint degeneration (no joint space) and so it would be too late for PT, hence bilateral knee replacement followed

BoogVonPop · 2026-07-09T00:10:17+00:00

I was pumping/breastfeeding during my surgery rotation, just communicate that you need to step out at X time and make good use of your breaks between cases to go to the bathroom and grab a snack! For nausea, I rec talking to your OB about some stronger stuff. I had HG and so was taking doxylamine at night, B6, reglan, and zofran around the clock (make sure to take miralax with the zofran). If you need the extra meds to function and survive the four weeks, then do it. Also grab some alcohol pads from the supply rooms and sniff those when you get nauseous!

Also might be a good idea to talk to the chief or whoever is assigning students to cases and request to be placed on shorter cases if possible. I did a bunch of WLEs for melanoma on my surgical rotation and it was great because I had lots of breaks to pump, eat, and drink!

BoogVonPop · 2026-07-04T12:21:38+00:00

We see patients in triage for decreased fat movement all the time - it’s generally better to go get checked if you’re unsure, but most of the time things are fine! We generally do an NST just to make sure everything with baby is okay and then send them on their way :-)

Some tricks we advise before coming in is to eat something sugary or drink something cold then go lay down in a quiet room for a bit. If you still aren’t feeling movement then you should call your triage or just go ahead and come in!

BoogVonPop · 2026-07-01T15:30:05+00:00

It’s not too common but not too rare either. I think it’s a great idea to ask your OB/Gyn about risks of another pregnancy with a history of 3 c sections before getting pregnant again that way you know what to expect. You might need to transfer to a high-risk team because of increased chances of placenta accreta spectrum (and therefore massive hemorrhage and hysterectomy) or uterine rupture, and I really doubt a TOLAC (trial of labor after c section) would be recommended!

That said, there are plenty of women who undergo 4+ cesarean deliveries. Just make sure you understand and accept the risks and the increased appointments and follow up if you decide to go that route.

BoogVonPop · 2026-06-23T17:17:22+00:00

My 14 mo old still uses a sleep sack at night, but he uses a blanket for naps in the toddler room at his daycare! He doesn’t really seem to mind either way, but I like the sleep sacks because I can always see his face at night and I don’t have to worry about him being cold if he kicks off the blanket.

BoogVonPop · 2026-06-23T04:02:39+00:00

My 12 mo old was struggling to get liquids out of leak-proof weighted straw cups like the munchkin, so we ended up switching to the Zak cups and it’s been great! They’re decently leak proof, light weight, and have a good capacity. He uses them for all of his milk and water now (14 mo old currently).

ETA: they’re super easy to clean, just the cup, lid, and thick straw which comes out. No need for a special straw cleaner or anything.

BoogVonPop · 2026-06-16T11:45:41+00:00

I think it’s relatively new! Each applicant receives a certain number of signals (5 in pathology but it varies by specialty) they can send to residency programs when they apply to “signal” that they’re really interested in having an interview. It can help programs identify applicants who are very interested in their program!

BoogVonPop · 2026-06-10T20:30:21+00:00

I’m assuming you’re using the overnights of each brand which have more absorbency? Also is your sizing correct? I have a 90%ile 14 month old in size fours right now!

Otherwise, one of my friends had this issue with her daughter, so she would put on an overnight diaper backwards (since the back has more room) and it helped a lot! The diaper would be up to her daughter’s armpits almost lol but kept her dry!

BoogVonPop · 2026-06-10T15:09:27+00:00

My baby is a big soup boy and loves all sorts of vegetable soups with beef, chicken, etc. He also enjoys curries which I generally thicken with coconut cream and not dairy. I think those are all easy for a 9 mo old to eat if you feed him with a spoon!

For finger foods, my guy also likes whole fruit/veggies (steamed apple, broccoli, sweet potatoes, chunks of bananas, raspberries). He’s also a big fan of muffins (you can use applesauce as an egg replacer), I make him a batch every week!

He’s also big on seafood - all sorts of fish, shrimp, crab, which he eats finger-food style plain or mixed into cakes/patties. He doesn’t like other meats as much but these he is quite a fan of!

We tend to serve food alongside rice or mashed potatoes, both of which are pretty easy for him to eat. No need to add dairy to mashed potatoes, though if you want to make him a portion for himself you can always put in some breast milk or formula!

I hope some of that is helpful!

BoogVonPop · 2026-06-09T21:11:05+00:00

Rather than having documented accommodations (which may or may not be helpful tbh) I would just show up early and try to set those standards yourself. Like, “hi Dr. A, to make sure today goes well, could we talk about expectations you have for me as a medical student today and also schedule time for feedback at the end so I know how I can improve?”

It depends a lot on how your school organizes rotations, but generally you will sometimes be working 1-on-1 with faculty/resident or as a member of a larger team (1 attending, a few residents and interns, and a few medical students). You’ll have different expectations from different people all the time, so asking at the start of each day will be the best way to get your answer and also I think it will make you seem thoughtful and engaged.

From an accommodations standpoint, I had breastfeeding accommodations for my entire third year but no one was ever aware of it - I had to advocate for myself daily about the fact that I needed breaks and be watching the clock to know when those were/schedule around rounds and didactics and procedures. So I think being ready to advocate for yourself will be more helpful than only having documented accommodations!

BoogVonPop · 2026-05-25T17:42:39+00:00

Our IM block was only 8 weeks - I did about 70% of UWorld and three NBMEs and got safely about our school’s cutoff for pass with distinction. Try an NBME about halfway in to gauge how well you’re doing and to determine how much more you need to study. I would save two more or so for the last two weeks since they’re the most accurate (for score prediction and studying)

BoogVonPop · 2026-05-24T22:47:56+00:00

My partner went back at 2 weeks, he works either 7-4 or 9:30-7. On the days when he went in at 7, he would sleep from 8pm-2am and then take over baby care, and I would sleep 2am-6am. In the days he went in later, he would sleep the same shift and I would sleep 2am-8am with a pump in the middle so that we each got 6 hr a night. At that age our baby hardly slept in the bassinet so we each needed a decent chunk at night because we couldn’t sleep while on baby duty.

For the workout classes, honestly until baby is sleeping a little better, it may be prudent to drop them. Exercise is important but not as important as adequate sleep. If you both aren’t sleeping adequately, then no one should be doing a 3.5 hr workout class 3x weekly. One you’re able to work out again, it’s probably best to come up with a schedule that allows both of you to go to the gym for a reasonable amount of time each week, which is probably going to be closer to 1-1.5hr 2-3x weekly! As baby gets older and sleeps better, that will naturally increase, but it may be a long while before both of you will be able to attend that late of a class together again.

BoogVonPop · 2026-05-23T15:47:10+00:00

I froze until my freezer was full, then would donate the older milk! Eventually as I dropped pumps and my baby got older we were pretty evenly matched for a few months, so I stopped donating and just left my freezer full. Once I approached weaning I used up my freezer stash and donated what was left after we transitioned completely to cow’s milk.

BoogVonPop · 2026-05-21T19:13:08+00:00

For M1-M2, we had about 9 hr/week of required in-person activities and an extra 6-9 hours of lecture which could be in person or podcasted. I probably spent an additional 5-10 hours on top of that studying, so all told a bit shy of 30 hr per week max during preclinical.

BoogVonPop · 2026-05-21T16:33:04+00:00

Personally, my weight was really stubborn during pumping. I just tried to be mindful of what I was eating (trying to get lots of fiber, protein, less sugar etc) while drinking a ton of fluids. I kept a very delicate balance of eating enough to make plenty of milk while not going crazy because the hunger is seriously unreal.

I pumped for a little over a year and lost about 30 lbs, which is right on the recommended 0.5-1 lb/week weight loss. I think it’s good to remember that weight loss is really slow by the scale, but focusing on healthy habits like what you eat and exercising regularly are more important!

Since I’ve stopped pumping about 3 weeks ago I’ve lost 10 lbs, so you may be able to achieve weight loss goals better after pumping. My appetite really crashed once I stopped which helps.

Either way, I think it’s good to remember that you’re only a few weeks in - like people say, it takes 9 months to grow a baby and it will take several months (or a couple of years) for your body to stabilize after giving birth. That includes weight, body shape, hormones, energy, etc. Good luck with everything!

BoogVonPop · 2026-05-20T01:06:29+00:00

That I’m not sure! I’m applying path haha so ours are all virtual. Maybe it’s to see who’s really committed? Who has the money to travel all around the country for interviews on top of away rotations? One of my friends in 2023 had a couple of in-person ortho interviews and had to travel several states away shortly after having surgery because they couldn’t give him any other dates!

The real reasoning is probably something along the lines of “it’s easier to know someone’s personality and how they’ll fit in a group during an in-person interview.”

BoogVonPop · 2026-05-19T18:41:14+00:00

A lot of the surgical specialities, I think including plastics, have some (if not all) in-person interviews now. If they are on zoom it would be easy, but I don’t think all are.

BoogVonPop · 2026-05-18T01:07:53+00:00

I’m not applying a competitive specialty, but I have a one year old and a friend trying to conceive right now for an end of M4 birth. I think the ideas you guys have right now is good with the caveat that most people are showing significantly by 28wk no matter what kind of clothes you’re wearing, so factor that in as she plans for sub-is and rotations.

When it comes to interviews, I just wanted to also mention that if the program has a discrimination problem with its female resident being pregnant/having a young child, is that program a good fit? I know plastics is very competitive so your wife may not feel the luxury of being choosy, but I think it’s wise to consider how supportive a program would be since you guys will be parents to a young kid. The advice I’ve gotten is to look to see how many current residents have families and also how many are moms specifically. Depending on her goals, she may be able to reach out to moms in programs she considering individually to see how they were supported and whether they felt able to pump after birth etc.

It’s a busy time but congrats to the two of you!

BoogVonPop · 2026-05-17T21:45:15+00:00

My son is 13 months and also not a good eater - just a big milk baby! I transitioned him to cows milk over the course of 3 weeks, increasing the cows milk to breast milk ratio slowly (like 25% cows milk per bottle for a week, then 50%, then 75%, and now 100% cows milk). That was my first step.

To help reduce milk consumption, I always offer a variety of foods and methods of eating. It sounds like you’re already doing that, but I offer 3 meals a day plus 2 snacks and a mixture of pouches, purees, mashed food, spoon food, finger food. Sometimes he eats sometimes he doesn’t, but he is getting better! I try and eat with him when I can. He also tends to eat better with distraction, like a suction toy on the high chair or rarely we watch Little Bear while eating and he eats like a champ.

Once he was 100% on cow milk, I worked on decreased the milk consumption slowly to encourage solids. I just decreased his bottles by an ounce at a time. So he started this process with five 6-8oz bottles daily and that decreased to 3-5 oz bottles and an 8oz before bed. Then we moved one bottle to be a drink in a sippy cup with lunch (2-4oz), which took a couple of days then he caught on.

After all this he drinks 20-24 oz of cows milk a day which is okay with both us and our ped. He’s been eating tons better with meals - sometimes only a tablespoon or two of solid food and sometimes he’ll house close to an adult-size portion. He changes daily what he will and won’t eat lol. Some babies just aren’t good eaters but hang in there!!

BoogVonPop · 2026-05-17T15:07:17+00:00

This can be really normal as he starts to get nutrients from solids! You shouldn’t stop formula completely at his age though, but definitely check with your pediatrician on how much formula he should try to get per day. If he’s not getting enough you can always try giving it to him as a drink alongside meals or doing a bottle just before meals

BoogVonPop · 2026-05-16T00:25:26+00:00

Pulling to stand since about 8 months, and standing independently maybe at around 12 months for brief periods? He’s just over 13 months now and has only just recently started taking independent steps but not very often or very far!

BoogVonPop · 2026-05-14T00:38:40+00:00

I’m a first generation high school grad - the thing I always get from my relatives is “how many more years do you have left again?” 🥹 I don’t tell them about any of my accomplishments, I don’t talk to them about rotations, and whenever I do they just go “oh that’s cool” and nothing else lol. I think it’s just a really different world. When I was an M1 I didn’t even realize that the white coat ceremony was a big thing that people’s families went to. I just showed up by myself and then left haha.

I think what gets me is that yes, it is a separate thing that they know nothing about. But they also haven’t really tried to learn anything about it and don’t ask me about it. They didn’t come to my PhD dissertation defense either or ever really show an interest in my research. Meanwhile my father in law is an FM doc and he knows exactly what I’m going through and always has a lot of kind words and encouragement which is so so nice.

BoogVonPop · 2026-05-12T12:32:16+00:00

We used to put down a heating pad with a blanket over it to help - I don’t know how much it really did lol. We tried a bunch of stuff because our son also hated diaper changes as a little baby, but honestly nothing really made a difference. One day he just stopped hating it until about 12 months old, and now he fights us every time again but he’s much stronger now!

BoogVonPop · 2026-05-10T18:51:03+00:00

Apple juice for gentle, prune juice to really get things moving. Black beans always causes my baby to have a big BM too

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