family-friendly specialties?

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kcrd

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I'm interested in finding out what the most family-friendly specialties are during residency training and after. In my mind, a family friendly field is one that would permit you to have a baby during residency, and one where it would be easy to find part-time work post-residency. This differs from the discussion of "cushiest" fields, because, for example, while derm might be cushy, if you are one of 2 residents in a program, I doubt you would be able to take time off to have a baby.

Oh - and all you guys out there who want to make sarcastic comments, try keeping them to yourselves.

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There are a small number of shared-residency positions, where you work part-time during residency. Essentially two residents share 1 residency spot.

I don't know exactly how this works and how you can become board-eligible in the field working half the number of hours, but you may want to look into this.
 
i am not sure what to offer you. you CAN have a baby during any residency. how easy it will be to do that is another question, as you suspect. but i would pick what i want to do with my life first, as residency will only be a few years. worry about rearranging training to accomodate pregnancy is nice, but shouldn't deter you from something you want to do.
the bigger question will be which jobs will allow you to go part time, and i suspect the answer will be very different when you finish training versus presently.
em would be a reasonable choice. shift work allows you to easily be part time.
hospitalist also may be consideration.
peds, im also, but i suspect they will be less and less tolerant of part time people in the future as reimbursements drop.
possibly private radiology-it really depends on how much you want to make/can afford to make in order to pay your loans off. certainly people would be willing to let you do extra work for them at low pay.
anesthesia mebbe.
i am sure there are a bunch of others, but why don't you decide what you like first and then rank those?
 
Thank you for your responses! I'm still a 2nd year, and am currently just researching different fields. There are a few specialties I'm interested in, but I don't really have my heart set on anything right now - perhaps after 3rd year. I just don't want to lean one way, only to find out that that field would be terrible for a working mom.

I'm also a few years older than the average student, so I periodically like to stress out about how I'm going to coordinate family and career. ;)
 
Like smackdaddy said, EM is one of the best fields one can pursue for family reasons. It essentially is "shift-work" like at a fast-food restaurant or anything else. No pagers, no unexpected calls (unless there's a natural disaster or terrorist strike, where they may need you). Plus, it pays very well. More and more females are going into EM actually...

Of course I am biased as I will be *hopefully* matching in EM in less than four weeks.

Other good specialties would be anything non-surgical...

Pathology/Radiology is very laid back and would get you more free time.

HOWEVER! You HAVE to pick your specialty because its something YOU WANT to do. Radiology may pay 500k+ a year and I work 9-5 but I absolutely abhor it (although I like plain films). If you hate your job, you won't take it too seriously, and you may make more mistakes. So your #1 deciding factor on what specialty you should pick is based on WHAT YOU LIKE.
Q
 
My friend is in a dermatology residency and had a baby a couple years ago. She took a year off before beginning her residency to have the baby. What I've heard is that dermatology, radiology and anesthesiology have the most regular hours, and that pediatrics and OB-GYN were the most flexible as far as shared residency and work times because there were so many more women in these fields...
 
Originally posted by QuinnNSU
Like smackdaddy said, EM is one of the best fields one can pursue for family reasons. It essentially is "shift-work" like at a fast-food restaurant or anything else. No pagers, no unexpected calls (unless there's a natural disaster or terrorist strike, where they may need you). Plus, it pays very well. More and more females are going into EM actually...

Of course I am biased as I will be *hopefully* matching in EM in less than four weeks.

Other good specialties would be anything non-surgical...

Pathology/Radiology is very laid back and would get you more free time.

HOWEVER! You HAVE to pick your specialty because its something YOU WANT to do. Radiology may pay 500k+ a year and I work 9-5 but I absolutely abhor it (although I like plain films). If you hate your job, you won't take it too seriously, and you may make more mistakes. So your #1 deciding factor on what specialty you should pick is based on WHAT YOU LIKE.
Q

Just be careful with EM, because despite the shift work, you have to enter EM with the likely possibility that you will always work some nights and your sleep cycle will be whacky. Not as "family friendly," as say, dermatology.

mike
 
Where does neurology fit in with family friendly specialties? Is it a speciality that can have you home early. Or is it one that will keep you working late and make you get calls in the middle of the night in an ER?
 
If the new work hour guidelines are enforced, and the ACGME is giving every indication that they will be, every residency will be family compatible if not always family friendly.

You should consider two things after that

1) How much actual _time_ do you want with your family?
Lots of people have live-in nannies. You can also hire people to do time-consuming jobs that have nothing to do with raising your children: cleaning, mowing, grocery shopping, laundry, etc.
Attendings fortunately make enough to subcontract lots of work.

2) How much income do you need? Given enough flexibility, you can work _anything_ part time.
 
Psychiatry can be a family-friendly option as well. It is very possible to work part-time after residency as well as in many programs once you hit the outpt year(s). Some programs, including UW and UNC, have a well-trodden path for those residents (usually moms) who want to make one outpt year into two and go half-time...just depends on how you feel about prolooooooooooooonging residency.

Good luck!
 
I can definately relate to your situation. I am currently a third year and also would like to have children during residency. I am planning on going into anesthesiology. My husband and I are going to try and have a first child next year before graduation. I think anesthesiology is great because the residency hours are perfect for having time for the family about 50+ hours a week. The lifestyle outside of residency is very flexible. You can easily go part time during residency (offered by many programs) and work part time after residency. Just another suggestion.
 
(I got your pm, smackdaddy - and I sent you a pm reply.)
 
Psychiatry, pathology, and PM&R would probably all have predictable hours and low call. Family practice and peds might be good if you were in a large group where you could work part-time and have infrequent call. ER and anesthesiology could probably be arranged to be part-time and predictable hours but would likely require some nights/weekends until you had been around long enough to hold some seniority.
 
Agree with the above suggestions-peds tends to be somewhat family friendly just because they'd be hypocritical otherwise and there are many women in the programs. Family med also tends to be progressive.

Some individual programs are more family friendly than others-even in areas like surgery and IM. I've heard of people doing part time surgery residencies (part time being 60-70 hours per week!). So don't discount a specialty just because it seems harder to manage; ask around.

Derm is apparently pretty good, but very competitive. Anesthesiology is popular, (not for everyone, though).

The ObGyns were trying to convince me it's a family friendly specialty (you can work part time for lots more money after training), but I just couldn't see it.
 
I have had two kids during med school -one during third year (tough) and one at the end of fourth (easy) with 3 mths off after the 1st birth and then some time off between 3rd and 4th for research then a year off after the 2nd baby before starting residency. Med school is in my opinion a good time to have a baby, maybe better than in residency when you are bound to restrictions regarding maternity leave etc. In addition, you are not yet a necessary part of the team in terms of carrying the workload.

As far as specialty choice, I agree with above posts - find what you love and then look for specific programs that appear to have family friendly policies and other women who have children. Your veiws on what is tolerable will change as you go along. With my first, I hated being on call and at work when she was an infant. After she got a bit older, I found that I really did not mind being on call or working long shifts as long as I was enjoying what I did.

The other thing to look for in a program is the daycare situation. That will make a huge difference to how you feel about your work. When you visit programs, research any onsite childcare or nearby childcare options as well - ie quality, prices and convenience. That factored in to how I ranked programs.

In any case, it is never going to be a 'good' time because there will always be some sacrifices - once you have the baby, your time will be scarce and you have to plan everything you do well in advance and coordinate everything with your spouse in order to have any time for studying, etc.

In my opinion it is well worth it though - the best thing I have ever done in my life.

Good luck!!
 
Buzz,
Thanks for the advice. It does look like there is huge variability in amount of time different programs let you take for maternity leave, availability in part time/shared positions, etc. The resounding theme really does seem to be just find what you like and then find a program/work situation that will be friendly. I guess I keep thinking the magic specialty is out there that will be perfect ;) [I sent you a pm, by the way.]

When you interviewed, were you up front with the fact that you were looking for a program that would be flexible for someone with kids?

-kcrd
 
I think most fam friendly goes to Derm or Optho for stability of hours (in the case of optho 4 day work weeks). I would also bet that opthos and derm have the lowest divorce rates as well.
 
Originally posted by GeneralTso
I think most fam friendly goes to Derm or Optho for stability of hours (in the case of optho 4 day work weeks). I would also bet that opthos and derm have the lowest divorce rates as well.

Optho 4 day workweek?:wow: I've never heard of such, I thought they worked all doctors over 100 hrs per week! could ya please explain more,:confused: 'cause this sounds interesting!:D
 
Here's my two cents.

Try to have kids in medical school except during 3rd year. Because during year 1-2 you are not really on the wards. During year 3 you are part of the wards, most of your most important grades come during this time and the learning curve is very steep. 4th year is nice because it is usually flexible and you can have a pretty easy year if you schedule things right. I think that having a child during 4th year towards the end is an ideal thing. Just make sure you have baby sitters lined up for internship! or alternatively you can take a year off right at the end of 4th year and enjoy a whole year with your child (if time
and money allow).

Having a baby during internship year is about the worst thing to do. Internship will be intense in almost every field (I will get to the exceptions). The exception being pathology (although this maybe changing given the residency was shortened from 5 to 4 years).

I think having a child in your senior year residency in most specialties excluding surgical ones can be a good idea, especially if the year is tailored correctly.

There are shared positions which allow time off to be with your children. If you can work it out with someone else to work 6 months and then the other person work six months that would be ideal. Although the timing could be tricky. If you could get pregnant at the beginning of the six month period when you work, that's probably a good thing.

Lastly the following specialties would be conducive to having children (with outside help of course).

So those specialties with a required internship year, forget about having a child that 1st year.

Condusive specialties to having children during residency with a required PGY-1/Internship year: Derm, Radiology, Nuclear medicine, Psych (6 months), opthamology, PMR, Radiation Oncology, and maybe anesthesiology, EM.

Condusive Specialties to having children without a required pgy-1/internship year: Pathology and maybe EM.

Specialties to avoid having children during residency: Most surgical fields except opthamology but including ob/gyn and Peds, IM, FP, Neurology. The only exception is that in peds, im, fp you maybe able to schedule your last 6 months as outpatient rotations without the responsibilities of the floors and able to have a child at the end of residency. Otherwise, it's usually too much.

After residency is done, I believe the following fields will allow you to work and still be home at a reasonable hour consistently over time: Derm, Anesthesiology, Path, Rads, Nucs, Rad Onc, PMR, EM (although working nights screws up your sleeping schedule), opthamology. Also, Peds, IM or FP, Ob/gyn (if you do only office gyn), Neurology (especially if you are doing mainly movement disorders, EMGs, EEGs, sleep studies, etc) if you work for an academic hospital and/or admit to a hospital with house staff (residents). This makes a WORLD of difference. However this may limit your practice area to those places that have house staff (residents) 24/7 covering your patients until the morning. Lastly, if you go IM, FP, Peds, ObGyn (doing gyn), or Neurology make sure you join the largest group practice possible so that call can be spread out over the most group partners (docs) possible.

Also there are some specialties like rads, nucs, anesthesiology, rad onc, EM etc that will allow you not to take call. You may never be made a partner in the practice and thus will always make substantially less than the partners, but at least you're not on call and do not have that disruption in your life. Again this is all dependent on how flexible the group you join is willing to be. Also, if they find someone willing to take call and the work stays constant you will be the first one out the door, so to speak. There are always trade-offs in life. Choose wisely.

Let the flames begin. Enjoy my two cents for what they are worth. ;)
 
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