Taking Step 1 at 39 weeks pregnant… need advice

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    Due right about when I planned to take Step 1! Taking LOA is a non-question, I just see no way I could start clerkships 3 days post delivery. I have talked to the administration at my school and the length of LOA is also not an issue. I have searched online extensively to see if there are others who have been in this boat. The latest I have come across is women taking step 1 at 31-32 weeks. Dedicated study time for me starts somewhere in the middle of week 36 – leaving me with 2.5 weeks of dedicated study time before tackling this beast. I have talked to people and found no consensus, and I know I am unlikely to find it by soliciting advice online, but I’d still appreciate your thoughts. This is first pregnancy for me, so I don’t have a previous experience to draw from. Here’s what I’ve come up with so far:

    For taking it before delivery
    * Baby will not have rendered me completely useless for months post-delivery
    * Memory will be semi-intact without hormone/sleep deprivation induced brain fog
    * Right out of MS2, won’t have forgotten everything I learned in first 2 years of med school
    * Can enjoy time with baby in LOA without constantly worrying about the exam looming over my head

    For not taking it before delivery
    * At week 39 I am about to pop at just about any moment (assuming if I haven’t already). I am an anxious sort of person and every ache and pain sending me into panic about going into labor will probably affect my exam performance.
    * At week 39 I don’t know if I will be in tip-top shape to endure an 8 hour exam.
    * 2.5 weeks of dedicated study time really makes me uncomfortable, if pregnancy was not an issue I would have taken at least ~4 weeks

    Other considerations
    * I can extend my LOA so that I would take step 1 ~5 months post delivery
    * I will have help with the baby for these months with at least one of our parents living with us in that duration

    Please send your thoughts/ideas/advice/suggestions.


    Hey! First off, congratulations!!! Motherhood is amazing and medical school makes it even more of a wild ride. I cannot speak to Step 1 per say (as I’m taking it this June), but I wanted to chime in with my experience postpartum and studying with an infant, etc.

    I would say definitely try to take it before delivering. Can you move up your exam to the week/couple days before? I know how precious every study day is, but I went into labor at 39 + 1, so I was 6 days early. I had 8 exams to make up to finish my first year and it was an absolute BEAST with a newborn. Having a baby is the type of thing that you don’t know what the hell to expect until you’re in the thick of it. Once this little baby is in your life, things will never be the same again (in a good way!).

    Here are some of my thoughts:
    1. Many women don’t think about things like postpartum depression, which no one seems to want to talk about. I had it pretty bad, and I was in a funk until 3 1/2 months. Studying/trying to take exams was that much more difficult.
    2. Having to apply for accommodations so you can have longer breaks to pump so your breasts don’t get painfully engorged.
    3. Vaginal pain from delivery (unmediated birth, 2nd degree tear) that lasted much longer than I was anticipating. This made sitting terribly painful, I cannot imagine having to sit for an 8 hour exam! I could barely make it through my 2-3 hour long exams.
    4. Exhaustion. Exhaustion. And more exhaustion. You won’t know how little sleep you can get and still be semi-human until you’ve had a “colicky” newborn.
    5. At 37 weeks I was still running 2-4 miles every other day (I stopped around 38 weeks because my husband was out of town for work and I didn’t want to risk going into labor until he got home, haha!), standing in gross lab for 3 hours at a time, and taking 3-4 hour exams with everyone. Being pregnant didn’t hinder me from doing anything, so I don’t think taking an 8 hour exam would be a problem.

    I hope this was somewhat helpful. I cannot encourage you strongly enough to try to take it before having your baby. The first couple of months with a newborn are tough, and the last thing you’re going to want to do is think about tackling Step. Good luck! Keep us posted!



    So, I’m not sure if this is what you want to hear, but I’d really reconsider that test date… my son was born at 37 and 0 days and so I think holding out that late could really mess with you. Plus, I was just so uncomfortable toward the end… the step 1 is a long exam and you don’t want to be exhausted bc you aren’t sleeping at night b/c you are huge. This will not happen to everyone but it definitely could (I was doing great I thought until about 34 weeks…then things seemed to turn).

    I would recommend extending your LOA (assuming that you don’t feel incredibly tied to your timeline) and taking the test 5 months post partum. Will it be hard with a newborn? Yes. But, I think by then *hopefully* your baby will only be waking about 1/night (so manageable or at least it seems after the crazy early weeks) and if you arrange for full-time childcare and treat studying for the Step 1 like you are working (i.e. LEAVE THE BABY and study somewhere else- this is critical) you can definitely perform well.

    If you feel super confident that you will not come early nor will be affected by late pregnancy, you can definitely try to take the Step 1 then, but really consider the alternative. Medicine after all is a marathon not a sprint, so an extended leave might be worth it to you…


    I come from a family where it is considered odd that anyone would get an advanced degree, especially a mom. My family doesn’t give me a hard time about it, but it is hard not having role models and always feeling like you’re disappointing the matriarchs ;).

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