Minority Midwife, CNM

I am a midwife.

What I should say is: I passed my boards!

When people ask me what I do, I say "I am a midwife" without any qualifiers now... no more "I'm in school to be a midwife" or "I just graduated from graduate school" no more feeling like I have no business calling myself a midwife for real.

Just, "I'm a midwife."

HOW I STUDIED FOR THE NATIONAL MIDWIFERY BOARD EXAM:

First, my reminder to "respect the distribution" was posted on the wall directly in front of my study spot:


I found that during study time I was spending way too much time on primary care and newborn- probably because these were the subjects I knew/understood the least about, and because I find them much harder to concentrate on... well, because they are my least favorite of the subjects. So while making sure I was covering them thoroughly, I also had to keep saying, "at least 65%... and maybe even 85% of the test is antepartum, intrapartum, and gynecology... get out the freakin primary care section!!" Professional Issues isn't even on this sheet... which I didn't realize until now... but I did study that a little (very little) bit... mainly I read short chapters pertaining to it.

This next photo represents one of the things I did whenever I got bored of studying... which happened very often because I was studying like 16 hours per day. Yes, 16. Yes, per day. I did this for the last week leading to the exam; the week before that I studied more like 8-10-12hrs per day. I drew things with colored pencils... I colored with crayons... I wrote and diagrammed with markers... and just had fun in general ;O) The drawing below is of some of the muscles of the pelvic floor, how to cut an episiotomy, and stitches and sutures to use for repair.


My study resources included the infamous "green book" and Varney's Fourth Edition and the now out of print Varney's Study Guide to Edition 3 which was sent to me by someone who was 100% convinced that I needed it to help me study. I am forever grateful to her for sending it. I did not use anything else like Williams Obstetrics or Gaabe, etc. Maybe once or twice I looked something up in Contraceptive Technology when studying contraceptives.

I started off by reading the green book (which is in outline form) from cover to cover, taking notes in the left margin of the left page only. I usually only did this when I got bored with reading and found it hard to concentrate without doing/writing something, or when it was something I really, really wanted to remember.... which was quite a bit, actually. Then, I recorded these margin notes into my iPhone using the handy dandy voice memo button (I love the look of this button... the microhone with the red backdrop is oh so cute!) Anyway, I labeled these recordings with titles like "common pregnancy labs" or "abnormal postpartum findings" and listened to them whenever I was doing things that kept me from studying like washing dishes or taking down my braids or walking to the library.

When I didn't understand something, concept-wise, I drew it and wrote it in my own words. This is some basic menstrual cycle stuff:


I placed these drawings and diagrams, etc. on my "study wall" which was the wall I faced when sitting/laying in bed studying. Yes, I studied in bed all day whenever I studied at home. Why? because we don't have any other furniture in our apartment. Just a bed, that's it. So it was the bed or the floor... and um, I'm too old to be sitting on the floor for hours at a time, lol. Whenever I needed to get out of the bed due to tiredness or just needing to stretch and be upright, I stood at the wall and "studied." Other drawings/diagrams included: a newborn baby with normal and abnormal physical exam findings, the Friedman curve, fetal position in the pelvis, etc.

I also used a few notecards. I made note cards for things like Bishop's score and biophysical profile configurations, and definitions of terms like protracted descent and secondary arrest of dilatation, etc. When I wanted to try something different I went to flashcardexchange.com and did USMLE OB/GYN related flashcards.

This pic is of the head I used to practice long and short arc rotation, fetal positions, anatomy of the fetal skull, etc:


And this was before it was colored all over. I first used the whole process of drawing the bones and sutures as a way to learn the anatomy, and then I used the actual finished head to practice the movements of the baby's head during birth- especially the rotations for OP presentations. This was so helpful... and eventually fun. FYI: this is my styrofoam wig head, you can buy one at a hair supply or wig store for less than $5 usually!

Although I used a combination of all of the above study tactics, how I studied the most by far was in doing practice questions. I did every.single.question in the Varney Study guide book, and most every question in the green book. (I didn't finish the green book's practice exam because I found it frustrating... actually that whole book was frustrating beyond belief because of it's inconsistencies... I kept saying how I would burn the damn thing once I was done with it!) This amounted to hundreds and hundreds of questions. In the green book, I read the chapter, then answered the questions. But in the Varney SG I would answer the questions and then look up all the answers one.by.one. It was tedious... especially because the study guide is for edition 3 of Varney's, and I have edition 4 and the chapters and pages don't match up. Thankfully, Varney's 4th edition has a phenomenal index. Whenever I didn't get an answer right... which was OFTEN... I would write that fact/info in a complete sentence. So for a chapter with about 20 questions, I would end up with maybe 10 sentences of new information. I would then recopy all of those sentences onto a clean piece of paper. It looked something like this:

CH 7 Primary Care:

1. Wellbutrin is a category B drug, and therefore preferred over Prozac, which is category C.
2. Tinel's sign and Phalen's test are used to confirm carpal tunnel syndrome.

There were about 25 chapters in the Varney SG, and each chapter had between 15 and 100 questions. This amounted to about 20 filled pages of these one-liner study facts for me!

An important question asked by more than one friend, and that I asked a few people who had already taken it: "How will you know when you're ready?"

My answer was: Once I read through the green book one time, and answer every question in the Varney study guide, and look up every answer that I don't know- that will be it.

But also... by my gut. I was reminded by a school friend that my intuition is usually dead on. And she's right, it is... even if I choose not to listen to it. So I committed to blocking out a bunch of other noise in my life and listening to what my gut was telling me about whether I was ready. It was actually a little harder than I expected because my head was FULL of negative thinking about my ability to pass this damn thing. Which comes to my last tactic:

POSITIVE AFFIRMATION.

Yep, I said it. You gotta believe you can pass it. That's what all the pink post-it notes were all about... they're positive affirmations that I stood up and looked at every time I doubted myself. I had to get that teacher's voice out of my head. I had to overcome other folks' experiences with the test and the material while still listening to the priceless advice they had to offer about being calm, and rested. I had to stop thinking about what was at stake... yes it's $750... yes it's another $500 if you fail it... yes, I had an interview... in another city... two days later. But I had to try very hard to not let the weight of all of that get to me. Honestly, I was a MESS a few weeks before the test, and it was hard to come up out of that. But eventually, after listening many, many T.I. songs, especially from Paper Trail, and lots and lots of encouraging gospel music like "It's on the Way" by Neal Robberson (new favorite during study weeks!) I eventually regained some confidence... um, swagger. :o)

So, that's how I studied. I hope this helps the next girl!