It is naive to think that romance, whether your own or someone else's, won't be a factor in a USMLE review. When people are thrown together in the same building for most of the day and night, flirting and relationships will be inevitable. Statistics will tell us just how true this is. Roughly half of married medical doctors met their partners or came to be a couple during the USMLE review.

While it is true that romance is an eternal part of a person's life, relations between the sexes have become a potential minefield. Questions of conflicts of interest, distraction from the USMLE steps, and the unpleasant ramifications of a fling's sour ending are very much on the minds of USMLE review mentors and staff.

Given this tricky state of affairs, how do you – as a woman or a man – proceed when you find yourself attracted to a USMLE review participant or vice-versa? Is even flirting off-limits? No. Does the manner in which you flirt with someone matter? Yes. Does the fact that your love interest and you are trying to prepare for the USMLE matter? Yes. It goes without saying that not all relationships are fraught with danger; entering a romantic involvement, however, requires no small measure of thought and care.

Because you have more time to talk and discuss review items, you notice that your colleague is attractive, dresses well, and most of all, single – and so are you. If you find yourself drawn to him or her and want to explore the possibility of taking things a step further, wait to flirt until your review days are done. In most cases, it is perfectly acceptable to extend an invitation for drinks or dinner. If the invitation is declined, stop and leave it there. Otherwise, repeated bids not only show you as a pest but could end up putting you at significant risk. Remember that you are in a USMLE review center not a singles bar and persistence is neither charming nor seductive, unless it's the review materials you are trying to learn. What's more; you can never be sure when your attention might be perceived by someone as sexual harassment.

Some review participants may already be a couple when they enrol for the USMLE review. The key here is being comfortable. If you feel uncomfortable revealing your relationships to colleagues, remember that you have no obligation to do so. A simple "I'm sorry, but I try to keep my personal life private" is good enough answer to someone who pries, although some couples find it easier to deny everything. Prejudice against non-traditional couples is an unfortunate attitude; it, however, exists and it may limit how you interact and participate in USMLE review group activities. Needless to say, it is better to leave out romance while seriously preparing for the USMLE.