General Residency FAQs

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HavanaGuy

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Hello everyone,

I've been reading posts here for a while and Im now begging everyone here for some advice. My fiance and I are 27 and 31 respectively and we're both MS1. We want to have at least 2, maybe 3 kids, but are concerned cause of the timing as we are afraid of complications and don't want to have any more after she's 35 (right after finishing Residency, assuming a 3 years one for her). My questions are:

1- Can / Do people have kids in residency, say after the first year?
2- If she needed some time off, can a resident skip out a few months, get back in later and finish a bit later? Is that even doable?
3- What is the general attitude of PM's/staff/collegaes about this?
4-Do they ask during interviews if you plan on having kids? Do they use it to decide? should one be honest if yes?


Any help or advice would be greatly appreciated, as we are quite concerned about this.
Thanks in advance to all
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Originally posted by HavanaGuy
Hello everyone,

I've been reading posts here for a while and Im now begging everyone here for some advice. My fiance and I are 27 and 31 respectively and we're both MS1. We want to have at least 2, maybe 3 kids, but are concerned cause of the timing as we are afraid of complications and don't want to have any more after she's 35 (right after finishing Residency, assuming a 3 years one for her). My questions are:

1- Can / Do people have kids in residency, say after the first year?
2- If she needed some time off, can a resident skip out a few months, get back in later and finish a bit later? Is that even doable?
3- What is the general attitude of PM's/staff/collegaes about this?
4-Do they ask during interviews if you plan on having kids? Do they use it to decide? should one be honest if yes?


Any help or advice would be greatly appreciated, as we are quite concerned about this.
Thanks in advance to all
Click to expand...

Do a search. This topic has been hit ad nauseum.

1) Yes. Some even have them the first year. But it would be a lot easier to have them during med school.
2) Yes. You may end up having to do another year of residency. It would be relatively easy to get a few weeks however.
3) Is that colleagues or colleges? What's a PM? Program?Colleagues don't mind unless they're dicks. Programs would probably prefer you didn't given the choice. So no one gives them the choice.
4) It is illegally to ask questions about family duirng interviews. They are not allowed to use it to decide. One should avoid the question if asked.
 
but are concerned cause of the timing as we are afraid of complications and don't want to have any more after she's 35 (right after finishing Residency, assuming a 3 years one for her)
Click to expand...

Women are far far far far more likely than not to have a completely normal healthy pregnancy and baby even at the age of 40. She has at least 15 fertile years in front of her. So just chill out and start studying for step 1.

However, the fourth year of medical school would be the most chill time to have a kid.
 
Fourth year of medical school is a great time to have kids. The only consideration would be if she is showing at interviews depending on the field. There is a wide variety in how supportive programs would be to residents having kids while there between fields and even between different programs in the same field.

Even though the question is illegal some programs will ask it and from what I have heard they geneerally ask the women if they are going to ask. Honestly, that's nothing to worry about because if a program wouldn't take you or her because you wanted to have a kid while in residecny than the place wouldn't be very supportive once you have the kid and you wouldn't want to be there anyway. I wouldn't tell an interviewer that it was an illegal question. I would answer it vaguely but try to avoid lying. One clue into this when you are interviewing is to find out the percentage of residents that are married. That will give you a general idea.

The thing about taking extended time off during residency that you need to consider is that generally other residents in your program will have to work more to make up for it. Most places will give 4-8 weeks.
You will always be busy so you just need to figure out what timing makes the most sense and do it.
 
yeah, I agree that med school is actually a better time to have kids. It is much easier for your fiancee (and/or you, if you wish) to take off time during med school if need be (at least during 2nd and 4th year, 3rd year could be pretty tough). I don't know what specialty your fiancee is going into, but I have heard that FM and Peds residency programs are particularly supportive of residents who are parents. Although it is ideal to have all your kids before age 35, the most important thing is to make sure they are well taken care of. One girl in the class above me was pregnant when she applied to med school and decided to enter med school 8 months pregnant instead of deferring 1 year. Her idea to take no time off at all (well maybe a week) didn't work so well, her son is fine now, but she had oligohydramnios and he had failure to thrive as a baby. She also had to bring the baby to class nearly every day (after her classmates voted on it) b/c her husband was working in the AM. Sure, she had a baby at age 23 instead of 30 or 35, but how much does she get to enjoy being a parent (esp. now that she is starting her OB/GYN residency)? If I end up finding a good partner, I think having a baby at the end of third year of residency is a good plan (I'll be 31), but that's not for everyone.. My mom had an uncomplicated pregnancy at age 35.
 
I think it's been pretty much said that kids are definately doable during med school and residency, they just take a little extra work.

Residency programs regularly ask all sorts of illegal questions during interviews, and there is really no good way to avoid these questions. Programs don't mind children in general, but they just want to be certain that your work won't suffer because of children.

Schedule-intensive programs such as surgery may balk at children because they expect 100% committment to work and only work. Residency programs in general do NOT like residents taking a few months off - it makes more work for everyone else. Don't plan on that option unless you want to open the possibility of getting fired or really bad recommendations.

1rst or 4th year med school are an excellent time for kids (2nd and 3rd years are the hardest). If you want to have 2 or 3, you'd better get crackin'!
 
Just an aside:

we were counseled by PDs at our school when asked an illegal question to feel free to lie, lie and then lie some more (my husband has had chemotherapy and can never have children, I hate the little buggers, of course I don't have kids now, I don't want to have children till I am established, etc.) It is illegal to ask the questions and therefore programs cannot hold you liable for an honest answer. Whether people agree it is fair, it is a well established doctrine that family plans cannot affect hiring decisions.

Having said that, I think it would be difficult to interview while obviously pregnant. For people of your age, I think the fourth year baby is ideal.

To the above poster who said that you are more likely than not to have healthy kids at 40, that is a silly way to decide. You are more likely than not to arrive home safely when drinking and driving. You are more likely than not to survive a gunshot wound to the belly. You are more likely than not to live many fulfilling years after contracting HIV. "More likely than not" odds are not good enough for your own life and should not be good enough for your children. It is worth it (to me, in any case) to rearrange your professional life in order to have a high chance of having children (many women at 40 cannot get pregnant) and maximizing the chance of their health.
 
Yeah, seriously...

Having kids is no picknick. You really can't play games like waiting until you're 40. Life is hard enough, why stack the deck against yourself and, more importantly, your kids.

That being said, one needs to think about what children need from their parents.

If you think that kids can pretty much raise themselves like corn, then it is a great idea to have kids in your residency when you'll be working 80 hours a week at least.

If you think otherwise... it may be time to reorganize your priorities.
 
good points people. Anyone who thinks they can give birth and then walk back into class (or worse, clinic) with a one-week old baby in your arms just isn't thinking straight. Having a kid after 35 is not a particularly good idea, but refusing to try your best to keep your babies healthy is WAY worse in my opinion.
 
I really appreciate all of you guys writing your ideas about it. I also wanted to clarify a few points that will hopefully invite even more opinions and recomendations.

We actually would prefer having kids as early as possible, and the 4th year idea seems nice, although I worry about where to leave the kid for so many hours a day during residency, especiually the first year. Any ideas? And yes, we do have our kids' health as a top priority, and we would definetely lie if they press hard, although I'd be better not to.

Also I've heard that it's better in terms of hours working in later years rather than first year of residency, which is why we tought of having maybe the first at the end of her second year. She actually would like to do Peds, but so far I wanna do Anesthesia.

Since I am talking about this, can we apply to the match as a couple while applying at diff specialties? Please everyone, speak your minds!!

Thanks to all
 
Having a kid after 35 is not a particularly good idea
Click to expand...

Why? It is still less than 1% chance of a chromosomal abnormality at age of 35 and still just about 1% at the age of 40.
 
Actually, the risk of Downs is less than 1% at 35 and 1% at 40 (compared with 1/1500 at age 20). The risk of any chromosomal abnormality is nearly double (1/63 at age 40).

The biggest problem with having kids after 35 is that some people (maybe as many as 40-50%) can't without help (which introduces all kinds of new financial and medical problems).

I don't doubt that the OP wants to do what's best; you don't post these types of questions if you don't care. One should also think about taking a year off (father or mother) so that there is no time when both parents are interns (i.e. research).
 
Hi -

I had a baby during my internship. I think that the one challenge for you two will be finding flexible childcare, esp if you are both unavoidably on call the same nite. Its also hard to know when you are going to get out of the hospital sometimes. For example, if you have to get the baby by 6 and you both have a long day, that would be tough. If you can live near family, thats perfect. If not, then you have to be able to afford it. That is the only real stumbling block that i can see.

I totally agree with the point that if you care alot about having kids, then it isn't a good idea to wait until you are all established and in your mid 30s. I know too many people who did that and have a hard time conceiving. Those graphs charting fertility versus age are scary.

I think you are smart to be thinking ahead. If you plan well, its totally doable.

Ann
 
Originally posted by tsj
Women are far far far far more likely than not to have a completely normal healthy pregnancy and baby even at the age of 40. She has at least 15 fertile years in front of her. So just chill out and start studying for step 1.
Click to expand...

What?!?!? Sure women have healthy babies at these upper ages, but odds for problems increase DRAMATICALLY. Not only are miscarriages more likely, but live births with chromosomal abnormalities are more common---approaching 1 in 10 pregnancies. Having a child with Down Syndrome is not just having a child in special classes at school. These kids are way more likely to have leukemias, over 60% have heart defects of one variety or another, are at risk for cervical dislocation, etc. Perhaps the most important consideration is that if these kids out live their parents----who's going to take care of them then?

I've seen plenty of patients born to mothers who didn't consider these potential outcomes. To simply dismiss the tremendous increase in bad outcomes due to later pregnancies is irresponsible. Perhaps if the mothers I've alluded to had had adequate pre-natal counseling, they might have chosen differently.
 
Originally posted by banner
Yeah, seriously...

If you think that kids can pretty much raise themselves like corn, then it is a great idea to have kids in your residency when you'll be working 80 hours a week at least.

If you think otherwise... it may be time to reorganize your priorities.
Click to expand...

Banner, what is up with you bashing having kids and being a resident?

There are many specialties where you work much less than 80 hours a week, and for Havana Guy, anesthesia and peds are two of these. There are programs in both these specialties with either non-call/clinic months (for peds) or shift work(anesthesia), and as long as you have some reliable family around to help with child care, it can certainly be done. Pediatrics seems particularly full of family-friendly programs. Don't worry, they won't ask you on interviews about if you plan for kids, but they will ask your wife - illegal or not, some will ask. I'd be honest about your plans, at least with residents b/c you want to get a feel for which programs are family-friendly, as these are the ones you'll be happier at. Yes, you can couples match in different specialites, most couples mathchers do.
 
Here's some anecdotal stuff for all of you:

3 women in our class had kids during med school. 1 had one at the beginning of 2nd year and survived. She has a nanny, though, and 2 other small children.

Another had one at the end of 2nd year. She postponed her 1st step until fall and is also fine. Her husband takes care of the baby.

The last one had a baby in 3rd year. She took a month off and has family helping her.

Another of my friend's in the class ahead of me at my school (she's a 4th year) is pregnant and due in June. Her husband will also take care of the baby.

I just wanted to give some credence to the fact that it is possible to have a baby in med school and deal with it. However, none of these women had husbands who were also med students. The question remains, if neither person decelerates their schedule and graduates late, who will take care of the baby? And how will you afford it? If you don't have childcare help from family, newborn care can be really pricey. At least during residency, you will both have a salary, bringing in at least 70,000 gross, and will be able to afford good help for your baby.

Just something to consider...
 
I think the most important thing to realize is that there is never an ideal time to have kids. I had mine during 3rd year of med school. worked out great. I know someone who had her fourth right before first year and her fifth during second year.


others ad thies during residenyc. Hhave your kids when you are emotionally ready. thats the most important thing.
 
keep in mind that when you apply for residency, it is a position of EMPLOYMENT, and you can pick and choose where you apply, rank, etc... Look for facilities with on-site child care/payroll deduction plans. Many hospitals/medical centers offer this as a basic perk. Also, if you end up with more than one child, a nanny can actually be LESS expensive and wonderfully flexible, even on a resident's salary. I also (obviously) suggest that if parenting during this time is important to you, you look to specialities with less intense residency hours...
 
Having a child (or rather my wife) during residency has been a FANTASTIC idea. The insurance benefits at my residency are SUPERB! The child is free. What ever the insurance does not cover, the hospital kindly writes off. No WAY I could afford a child in medschool, in fact that would have been insane. But during my second year of residency, when the money is decent, I can moonlight, and the insurance coverage being first rate is the BEST thing that could have happened. In fact, I do my own ultrasounds (if I wish), so that makes it nice also.
I really suggest waiting until you find out the benefit package at your residency.
Best of luck.
 
Hi,

At my school 4 or 5 female med students are pregnant this year (3rd year) and are planning to deliver right before 4th year, and then they can spend a lot of their 4th year doing less time consuming electives and spending time with their babies. I think most of their husbands work outside the medical profession.

I'm not at the point in my life to want kids, but if I did I think 4th year would be a great option. I know the baby doesn't go away during residency, but a year of having a lot of free time (you can schedule it that way at my school) would be great for breast-feeding/childcare issues.

Good luck!

:) kem
 
Hey DocWagner, your post seems encouraging and that's kinda hoe I feel, somehow we believe that having a kid in second year of residency should be doable, but we have certain fears becasue we don't know a few things. Only thing is that I didn't think your wife is a doc, but maybe she works many hours too.
I appreciate everyone's opinions and I am wondering if anybody knows how many hours residentes work a week on average, especially for Anesthesia and Peds which is what me and my fiancee want to do respectively. (I know the top is 80 hrs)
 
Hey DocWagner, your post seems encouraging and that's kinda hoe I feel, somehow we believe that having a kid in second year of residency should be doable, but we have certain fears becasue we don't know a few things. Only thing is that I didn't think your wife is a doc, but maybe she works many hours too.
I appreciate everyone's opinions and I am wondering if anybody knows how many hours residentes work a week on average, especially for Anesthesia and Peds which is what me and my fiancee want to do respectively. (I know the top is 80 hrs)
 
Yeah, she is not a Doc...and after the child is born, she won't be working. So yes, the situation is different, but there are 2 residents in my residency whose wives are also residents...and each have 2 children. So it is doable.
You can make it work, many do. Look at your program (if you are a current resident or looking at programs) and decide upon the best residency for child rearing (sometimes community hospitals or private hospitals have better plans than university hospitals).
Choose wisely and good luck.
 
If it helps, I'm 37, 20 weeks pregnant with my first child, and will start on Ob-Gyn residency two months before my due date. There is a lot of misinformation about what the risks of an AMA (advanced maternal age) pregnancy actually are and how miserable or not your life will be in residency with a child. There are risks associated with AMA, just as there are with pregnancies of women who are overweight, have diabetes in their families, or who are underweight. There is actually a move to recalculate risks for such things Down's based not only on maternal age, but also on family history, general health, etc, and then revise recommendations regarding genetic testing for women. Not every AMA woman has the same risk, and this is an emerging understanding that will have implications for practice in the near future.

I'm not here to be the morality police on who should reproduce and when. I've made my decisions based on where I am in my life and my supports, and I'm not really interested in either judging others or being judged by anyone. What my decisions have been based on are: do I have the maturity to look after a child, are my husband and I on the same page regarding timing and confidence in our financial resources and support systems, and have we got a workable plan for how to deal with the fact that we both are busy people who nonetheless feel confident we can be good parents (having come from two working-parent families ourselves with no ill effect)? Additionally, I chose a program that was explicitly supportive of resident's having families--I didn't have to ask; they told me. And this in one of the reputed 'worst' residencies out there, time-wise. In fact, several of the residents have children, and everyone is fine.

I would really seriously assess your situation and see what time/money/education trade-offs you and your partner are able to manage and are comfortable with, and base your pregnancy timings on those. That being said, there is no guarantee you will get pregnant, or get pregnant right away, so delaying as if there is no biological clock, as it were, doesn't make sense either. But being thoughtful about how you will manage is key--every parent I've talked to, stay-at-home or not, 20 or 40, keeps reaffirming to me, having good logistics is key to not going crazy, esp. when they are really little :)

Good luck.
 
question guys....
is the couple defined as married? or can it be any two people paired...like bf/gf....
even if there's no connection legally, will that be still considered as 'couple' and go through couple match?
thank you
 
don't know anything about the osteopathic match, but in the allopathic match, any two random people can choose to link their destinies if they so choose. I've seen bf/gf, twin siblings, bf/bf as well as married/engaged couples.
 
Anyone can couples match in the NRMP match. You do not have to be of any specific marital status, or even of opposite genders.

In fact, you could 'triples' match by linking your Rank Order List with two other applicants that do the same with you. Not that you'd want to do that, unless you are unusally liberated in your sexual life. Never the less, another option available....
 
Ewww! This is disgusting! DOs and MDs should not be mixing! This sort of stuff may fly in Berkeley or Massachusetts but I doubt you'll ever match down here in the south! ;)
 
When can one moonlight? I understand that it may be state-specific, but is all that is required a medical degree (i.e. graduation) and completion of Step1,2,3? Or is completion of an intern year absolutely mandatory?
 
To moonlight outside your training institution you need a full medical license and your own malpractice insurance. The requirements for licensure vary by state.
 
In addition, the hours you moonlight must count toward your 80 hours/week limit by RRC. Good luck finding the time until third year...
 
Partially correct on the two responses,

Some employers will pay your malpractice insurance, it does vary from state to state on number of years postgraduate and you need a unrestricted medical license.

The hours issue is not clear cut. It is still debatable. Make sure the residency will let you moonlight in the first place.
 
NinerNiner999 said:
In addition, the hours you moonlight must count toward your 80 hours/week limit by RRC.
Click to expand...

NO!

Completely incorrect and a pet peeve of mine. See this thread for more details. Of note, some programs interpret moonlighting as counting toward 80 hours, but that's their decision, not the ACGME's.
 
Moonlighting doesn't count against the 80 hour work week.

I started last month. Worked four shifts. Made $4000. Nice.

Malpractice paid for. Didn't see anything moonlighting that I handn't seen ten-fold in my program.

It is almost like stealing.
 
Hi there,
Moonlighting is permitted once you have a permanent license and DEA number but you have to check with your program to see if it is allowed. Some programs will not permit residents to moonlight. Others will permit moonlighting during research years. Some programs even provide moonlighting opportunities for residents.

Personally, with mal-practice abounding and no great tort reform on the horizen, I just don't want to risk my state license for such a small salary. At this point in my career, the reward to risk ratio is too low. (I am a PGY-3 surgery resident).

To each his own but I can live fairly well on what I make as a resident for the time being. When I am done with residency, there will be ample opportunity for people to sue me. I don't need the hassle of tempting fate at this point in my career for a few peanuts.

njbmd :)
 
Sooooo jealous! edinOH, how ya doin, man? That's awesome that you guys can moonlight. I am so ready to make some extra cash but I have to admit that I would be nervous to work in any environment that wasn't double coverage until at least the second half of my third year. We can't moonlight until third year but I have my license and have applied for my DEA number so that I can start applying for privileges. Even better than moonlighting, at one of the local hospitals you get paid $50/hr to take call, meaning if someone calls in sick you go in (and get paid more), otherwise you take the money and run. Pretty good deal!

Take care,

Snoops
 
Many of the EM programs I'm interviewing at offer moonlighting in their own fast-track areas. The residents are still covered under their malpractice policies, get paid between $60 - $70/hr and can rest comfortably knowing help is just around the corner if they need it.

This seems to me to be a great way to get your feet wet and gradually get more comfortable with truly independent practice.

Take care,
Jeff
 
And still nobody has answered my question. Has anyone taken Step 3 early and started moonlighting as an intern? Or is the intern year required for licensure, and subsequently, internship. Thanks.
 
Idiopathic said:
And still nobody has answered my question. Has anyone taken Step 3 early and started moonlighting as an intern? Or is the intern year required for licensure, and subsequently, internship. Thanks.
Click to expand...

Moonlighting requires a permanent license. To my knowledge, every state requires, at minimum, completion of an internship to obtain said license.
 
Idiopathic said:
And still nobody has answered my question. Has anyone taken Step 3 early and started moonlighting as an intern? Or is the intern year required for licensure, and subsequently, internship. Thanks.
Click to expand...

I was told by a big-wig at the NBOME that you have to have completed 6 months of your internship to be able to take the COMLEX Step 3. By the time you actually get your scores back, you'd nearly be done with internship. Add to that the time to then go and get your state med license/DEA/state Rx license...you've finished your internship.


(some rough generalization here, but I think you get the point. don't know if the 6 month rule applies to the MDs out there)
 
You'd be hard pressed to moonlight until mid second year and even then it will depend on whether your program allows it or not.

I took Step 3 in September of intern year. Got my scores in October. I applied for my NY license as soon as I could which was in August (could have applied in July after finishing intern year). I did FCVS because the state I ultimately want to be licensed in requires it so with all of that I didn't get my license until December 1. I have applied for my DEA number and expect to get that in about 3 weeks.

I will spend the spring applying for privileges at places where I want to moonlight (EM) and talking to different EDs in the area.

I don't know of any setting in which you could moonlight as an intern, and, frankly, I don't think you have the medical knowledge at that stage of your training (unless you're working in your home institution with supervision).
 
edinOH said:
Moonlighting doesn't count against the 80 hour work week.

I started last month. Worked four shifts. Made $4000. Nice.

Malpractice paid for. Didn't see anything moonlighting that I handn't seen ten-fold in my program.

It is almost like stealing.
Click to expand...

This is hillarious. What field are you in, EdinOh?

Judd
 
Man, it makes all the difference in the world coming to the hospital when you know you're getting paid more than 8$/hour. I just had my first moonlighting shift the other day and I loved it! Actually getting paid to work! Everyone should try it. It makes even the most mundane, absurd pages seem okay.

The best thing is sitting on your keister making X$/hour. I can say I made 60$ reading a men's magazine.

Can't wait to graduate!
 
beyond all hope said:
Man, it makes all the difference in the world coming to the hospital when you know you're getting paid more than 8$/hour. I just had my first moonlighting shift the other day and I loved it! Actually getting paid to work! Everyone should try it. It makes even the most mundane, absurd pages seem okay.

The best thing is sitting on your keister making X$/hour. I can say I made 60$ reading a men's magazine.

Can't wait to graduate!
Click to expand...
Doing it tomorrow for $65/hr. I love internal moonlighting!
 
*cough* *cough* ER residents. *cough* :rolleyes:
 
I hear about Peds, Internal, EM residents moonlighting, but rarely about Ophtho, Radiology, PMR and others who I expect have more lax schedules during residency. Any insight?
 
DrB-- try looking at freida.org, they have all the residencies and key info about each of them.

When I talk to IM residents, most say they work up to the 80 hour max. However, when I look on freida, most the porgrams report about 60 to 70 hours a week on average... why the difference?
 
fang said:
DrB-- try looking at freida.org, they have all the residencies and key info about each of them.

When I talk to IM residents, most say they work up to the 80 hour max. However, when I look on freida, most the porgrams report about 60 to 70 hours a week on average... why the difference?
Click to expand...

Because either the FREIDA database isn't updated correctly (you'll see the same information over and over each year), is simply "guessed" at by some clerical type person, is an act meant to conceal the truth (ie, they're lying to make themselves look better) or they don't count educational conferences (mandatory ones) in the hours total.

Bottom line: do not believe any of this kind of data on FREIDA, especially if you've heard otherwise from the residents.
 
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