Mara Downing - from SIU to SLU

Mara Downing – SIU School of Medicine Matched to SSM-Saint Louis University Southwest Illinois Family Medicine Residency.

Mara grew up in Troy, Illinois, about an hour outside of St. Louis and considers it Southern Illinois, though people who live farther south debate her on this. She knew early on she was interested in medicine. Her mother was a labor and delivery nurse, and her older sister went to nursing school. Initially she thought she would be a pharmacist because she loved chemistry, but wanted patient interaction. “I started at a direct entry pharmacy school after high school and started working as a pharmacy tech and thought I don't think I can do this for the rest of my life. I talked to my mom and dad for some advice. I didn't really expect to be the student that changes their major. I wanted to do more for people, and my dad said, ‘It sounds like you just want to be a doctor.’ I didn't know the first thing about going to medical school or being a doctor, and my parents said you can figure it out.”

What shaped your path into ultimately matching in family medicine?
She started out shadowing her own OB-GYN because she loved hearing her mother's stories about labor and delivery. During a gap year, she took a job as a scribe for a family medicine office. “I followed them around with my little computer cart, and I loved it. The clinic was exclusively for patients that had Medicare and Medicaid so we saw older people, very complex, lots of problems, constantly going through, med reconciliations and health maintenance questions.  Then I thought maybe I would like family medicine.”

In medical school, she was part of the rural medicine program at SIU School of Medicine, which is primary care focused. “In clinics, family medicine doctors are delivering babies, family medicine doctors are doing colonoscopies, they're doing all these procedures, they're taking biopsies for derm, they're doing colposcopies, and I thought they are so cool. I really liked that they were filling that gap and care for a lot of communities and I really liked doing everything that I had spent so much time learning. And I also feel like the art of medicine was more emphasized in my experiences with my family medicine doctors, seeing how different ones practice differently to get across to different patients with different backgrounds. I felt like it was the perfect blend of medical humanities, and then every subject I had learned in medical school, it was a great experience.

Balancing Motherhood and Medical School

How did welcoming and raising a daughter during this process impact rotations and your interview journey?
Mara and her husband, Slade, knew they wanted to have a family during the medical journey. “My medical school was very, very supportive. I didn't want to have to delay graduation. That was my one thing. I wanted to stay on track to graduate.”

SIU does clerkship rotations during second year, with dedicated study time for Step 1 and Step 2 in third year. Ada Jane was born in June 2025 at the end of third year/beginning of fourth year. “It was really tough taking step 1 and Step 2 [while] pregnant. I had to use all of my breaks to pee! I did well on both and I joke all the time it was because I had her extra brain in there with me. My electives for year 3 were at the end of my third trimester. I was working in the ER very, very pregnant, and everything hurt, doing some rough hours, but we made it work. I was on labor and delivery three weeks before I delivered. It was tough, but we got through it. Like I said, my med school was very supportive, and so I was able to rearrange my vacation time to give me a nice six-week break.”

For interviews, sometimes Ada came along and stayed in the hotel, sometimes her parents watched her. “Having my husband and parents and the support of my medical school, I couldn't have done it without them, to say the least. People would say, oh, I don't know how you do it and I say when you have to do it, you make it work.”

What attracted you to the St. Louis University Southwest Illinois program?
Location was a big factor. “I have a very, very close-knit family [in Troy]. My grandparents are here, my parents, my siblings, my aunts, my cousins, some of my friends from high school are up here, so my family and the community played a really big part. My dad said to me, ‘We really want you to come home. But, this is your residency training, and it's only three years, so make sure it's a program that you're gonna thrive in.’

She did an away rotation at the residency program. “An alum of my program was a second-year resident there at the time. The whole three weeks that I was there for my away rotation, I was on inpatient, and I learned so much. I expected to use those three weeks to make a good first impression. But they just welcomed me in and were teaching me, and I was just soaking everything up like a sponge. I really liked how efficient their inpatient service was a good, rigorous training to me.”

Do you have a vision of what your life after residency will look like?
"I really enjoy rural medicine, offering that full scope of family medicine. My initial dream was to open my own practice as the old school family medicine doctor where I'm doing home visits and I'm rounding on my patients in the hospital and maybe I moonlight in the ER and maybe I deliver babies, and maybe I do vasectomies, and do all of the things. And then I had a child, and I would like to have more children in the future,  so… I kind of backed off that a little bit.  I did my internal medicine rotation in medical school with a family medicine-trained physician, (Dr Patrick Riley) and he did so much to mentor me. I realized you can do a lot of good with inpatient care where you get extra time with patients and really go through everything. In a perfect world, I would love to have a blend of outpatient clinic and inpatient medicine. I plan to keep my options open and see what opportunities come my way in the future."

What advice do you have for the class of 2027 SIU students going through the interview and matching process?
“Remember that you are interviewing the program just as much as they are interviewing you, if not more. Medical students often get into a headspace of needing to impress and work for approval, but family medicine programs want you just as much as you want them. Put your best foot forward but don't go easy on them. All programs will give you good training, so it comes down to intangibles like aligning with your values, location, what patients you'll care for, and where you feel most at home."

What advice would you have for any medical student who wants to start a family in medical school?
“Just do it. There is never going to be a perfect time, not just for people in medicine but for people in general. You could always find a reason not to. Just take that leap. You'll never quite feel ready. What's that saying? God doesn't call the qualified, He qualifies the called. That was our experience.  Also, advocate for yourself in medical school. My school was super supportive, but none of that was written down. We didn't have a parental leave policy in the student handbook about what happens if you have a child, and how much time you can take off, what flexibility is possible. So, before Ada Jane came along, we ended up writing a parental leave policy for the school. You don't have to reinvent the wheel. There are tons of resources out there to help if your school doesn't have a policy.”