Psych residency with a toddler?

[DrCookieMonster]

I'm writing to ask advice from psychiatrists about being in residency with a husband who will also be a resident while we have a young child. I am an MD/PhD student and just had my first child, who will be 2.5 years old when my husband and I begin residency. I would like to do psych and my husband is probably going to do pathology. I'm wondering whether it's doable for us to juggle child care without hiring a nanny, given our specialty choices. Will our schedules during residency allow one of us to pick up and drop off our child from preschool/child care? And even more worrying for me -- if my son is sick, what options do we have to care for him? The idea of "back up care" services frighten me, as I don't want to leave my child with a stranger. I know there are many other threads about children in residency on SDN, but I didn't find any specific to psych so I thought I would ask here. Please excuse me if this is a redundant post. Finally, one other question -- are there particular psych residency programs that are considered especially "family friendly" that I should consider? Any with child care on site? The programs my husband and I are currently looking at, given his training goals, include University of Washington, Yale, OHSU, Stanford, UCSF, Cornell, Columbia, Wash U, and MGH/Brigham. We are currently students at a peer institution of these schools. If I should be considering community programs too rather than academic ones, I'm open to that. I don't need to be "super-doc" but so far I have done well in med school and would like to continue to move my career forward while being the best mom I can.

I'd also welcome any PMs if that's easier. Thank you!

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[OldPsychDoc]

I'm writing to ask advice from psychiatrists about being in residency with a husband who will also be a resident while we have a young child. I am an MD/PhD student and just had my first child, who will be 2.5 years old when my husband and I begin residency. I would like to do psych and my husband is probably going to do pathology. I'm wondering whether it's doable for us to juggle child care without hiring a nanny, given our specialty choices. Will our schedules during residency allow one of us to pick up and drop off our child from preschool/child care? And even more worrying for me -- if my son is sick, what options do we have to care for him? The idea of "back up care" services frighten me, as I don't want to leave my child with a stranger. I know there are many other threads about children in residency on SDN, but I didn't find any specific to psych so I thought I would ask here. Please excuse me if this is a redundant post. Finally, one other question -- are there particular psych residency programs that are considered especially "family friendly" that I should consider? Any with child care on site? The programs my husband and I are currently looking at, given his training goals, include University of Washington, Yale, OHSU, Stanford, UCSF, Cornell, Columbia, Wash U, and MGH/Brigham. We are currently students at a peer institution of these schools. If I should be considering community programs too rather than academic ones, I'm open to that. I don't need to be "super-doc" but so far I have done well in med school and would like to continue to move my career forward while being the best mom I can.

I'd also welcome any PMs if that's easier. Thank you!

I started residency with 2 kids & added one during. My wife was working FT much of that time. Though she was not a resident, I often had the more flexible start/end times and had drop-off/pick-up/sick day issues. It takes juggling, but is do-able. (This was at a major midwestern university program, where many of my peers had similar issues. This particular hospital also actually subsidized a "sick at home" day care service which would send screened & approved strangers to your home if they couldn't go to regular school/day care. University day care was available, but was very popular, so wait lists could be prohibitive--we found good centers in the community, and utilized our school's pre- & post-school programs.)

 

[whopper]

A lot of the answers to your specific situation will be heavily related to the work schedule, understanding and benefits your specific program offers.

You can contact the GME office and the program directors of the residencies that interest you.

 

[DrCookieMonster]

Thank you, OPD and Whopper. I've read many of your insightful posts on other threads and always appreciate your perspectives. A follow up question: how do I ask PDs and current residents questions like, "can I leave to pick up my child from day care" without seeming totally unprofessional? I'm very dedicated to my work and would try my hardest not to inconvenience my fellow residents, and would definitely be willing to take extra call later if someone covers for me. At the same time, I would want to know whether I can take a day off to care for my child if he's really sick (the back up sick care service might be ok if he's mildly ill and can't go to his daycare as a result). I'd also want to know if my husband and I can try to coordinate our light/heavy rotations or call schedules. Overall, I'm just wondering how to explore these "family friendly" issues without seeming unprofessional. Thank you again for your help.

 

[whopper]

What you should do is during your interview or before, communicate with the PD your situation.

OK, this is the part I hate because I may cause some unneeded paranoia.

From my own experience, some programs don't want residents that show signs that they may not be able to give their 100% all to work. That's being very diplomatic. E.g. having a child, having a disability, having a mental illness that is stabilized. Why? Well it's simply about getting as much scut-work from the resident.

How many programs are like this? I really don't know. I know a few of them were. I can think of a small handful that I felt fit this pattern.

Reason why I bring this up if it already hasn't clicked in is I can see some programs being turned off that you will have a toddler. It's not fair, however, in some ways it could actually be an advantage.

If you have several great selling points as a candidate (e.g high USMLE scores), then you may be able to afford to be seen by as "unfavorable by these programs that may unfairly hold having a child against you. These same programs are usually the ones you'd want to avoid anyway.

I can say that several programs are open minded with this. E.g. my own program was going to accept someone with some extreme physical disabilities with no concern about it because we thought she was going to be a good resident (we didn't accept her, but it had nothing to do with the disabilities). I've also seen several programs going out of their way to make accommodations to some residents with issues of concern.

 

[WhoisJohnGalt]

What you should do is during your interview or before, communicate with the PD your situation.

OK, this is the part I hate because I may cause some unneeded paranoia.

From my own experience, some programs don't want residents that show signs that they may not be able to give their 100% all to work. That's being very diplomatic. E.g. having a child, having a disability, having a mental illness that is stabilized. Why? Well it's simply about getting as much scut-work from the resident.

How many programs are like this? I really don't know. I know a few of them were. I can think of a small handful that I felt fit this pattern.

Reason why I bring this up if it already hasn't clicked in is I can see some programs being turned off that you will have a toddler. It's not fair, however, in some ways it could actually be an advantage.

If you have several great selling points as a candidate (e.g high USMLE scores), then you may be able to afford to be seen by as "unfavorable by these programs that may unfairly hold having a child against you. These same programs are usually the ones you'd want to avoid anyway.

I can say that several programs are open minded with this. E.g. my own program was going to accept someone with some extreme physical disabilities with no concern about it because we thought she was going to be a good resident (we didn't accept her, but it had nothing to do with the disabilities). I've also seen several programs going out of their way to make accommodations to some residents with issues of concern.

With all due respect to Whopper, any program that views your having a child as an "issue of concern" is somewhere you clearly don't want to be. I have been extremely open about my daughter (who will be 2 when I start residency) at each program that I've interviewed at, and it's been immediately obvious how that's being interpreted at all the programs. Two of them seemed to balk, and it's no big coincidence that they will be at the bottom of my rank list. All the rest had a neutral-to-positive reaction as psych programs in particular seem to value having a life outside of your residency program. I would not worry about the "unfavorable view" nearly as much as your need to know how a program is going to react to the real-life situations that inevitably come up with children. If I don't match I may have to eat my words, but I'm not seeing that it's been a problem, and I certainly appreciate having an idea of what to expect in terms of program flexibility. Good luck!

 

[whopper]

any program that views your having a child as an "issue of concern" is somewhere you clearly don't want to be.

I don't see why you had to add "with all due respect" since you pretty much wrote what I wrote--that it could be an advantage to find the programs that will expose themselves as less than family friendly.

If I don't match I may have to eat my words, but I'm not seeing that it's been a problem, and I certainly appreciate having an idea of what to expect in terms of program flexibility. Good luck!

Which is why I added that if you're a favorable candidate, it could be an advantage. If the candidate is, however, is not on strong ground, it could make a bad situation harder.

 

[OldPsychDoc]

With all due respect to Whopper, any program that views your having a child as an "issue of concern" is somewhere you clearly don't want to be. I have been extremely open about my daughter (who will be 2 when I start residency) at each program that I've interviewed at, and it's been immediately obvious how that's being interpreted at all the programs. Two of them seemed to balk, and it's no big coincidence that they will be at the bottom of my rank list. All the rest had a neutral-to-positive reaction as psych programs in particular seem to value having a life outside of your residency program. I would not worry about the "unfavorable view" nearly as much as your need to know how a program is going to react to the real-life situations that inevitably come up with children. If I don't match I may have to eat my words, but I'm not seeing that it's been a problem, and I certainly appreciate having an idea of what to expect in terms of program flexibility. Good luck!

I think that's a good perspective. I wouldn't necessarily make this point a focus of your in terview with the PD, but I think you'll get a good feel for this by asking residents and younger faculty questions like "How family-friendly would you consider this program to be?", and don't be shy about asking for examples. Good programs (psych programs anyway--clearly surgery is a different deal...) don't expect residents to put their entire lives on hold until after training. If you see that a resident or faculty member has pictures of kids out--ask them how they balance the pressures. Also be prepared to demonstrate that you've thought through some of ways you anticipate needing to work things out. Everyone with kids has gone through this, and very few of us have au pairs to manage it for us.

 

[Wednesday]

University of Washington is very family friendly. However, you still have to do medicine months and will have to be on call. I'm not sure what a path schedule is like, but they may need to be in early or late for surgeries, etc. Sick days are allowed, which is what you would do if your child is sick. It gets hard when you have a bunch of outpatient scheduled, but things do happen.

As far as day care vs nanny, I would suggest a nanny, at least for the first two years (or longer depending on your program). Although at some point your child will be in school and able to stay at people's houses and such. You can do a nanny share, which is very popular where I am (Seattle) and makes things much cheaper. Of course, you may be paying a bit more since you will likely need night time or early morning care sometimes. The nice thing about a nanny is that you don't have to stay home when your child is sick, because nannies come anyway. My child's preschool/daycare is open from 6:30 to 6, I think. We don't use it that much, but on medicine, I don't think those hours would necessarily cut it. Plus I don't think I'd want my kids away from home that long. I guess what I'm saying is, I wouldn't rule out a nanny if I were you. Hiring one may not be as expensive as you think.

 

[DrCookieMonster]

Thank you to all of you for your thoughtful responses. They are very helpful. In my interviews, I think I will try to ask about this issue in a respectful way, but also make sure I have thought of contingency plans for emergencies. I've been a very hard worker and conscious of being a good team player my entire life, and that won't change now that I'm a mother. I also appreciate the suggestions for a nanny share and considering back up care. Thanks again to all of you.

 

[trophyhusband]

I'm writing to ask advice from psychiatrists about being in residency with a husband who will also be a resident while we have a young child. I am an MD/PhD student and just had my first child, who will be 2.5 years old when my husband and I begin residency. I would like to do psych and my husband is probably going to do pathology. I'm wondering whether it's doable for us to juggle child care without hiring a nanny, given our specialty choices. Will our schedules during residency allow one of us to pick up and drop off our child from preschool/child care? And even more worrying for me -- if my son is sick, what options do we have to care for him? The idea of "back up care" services frighten me, as I don't want to leave my child with a stranger. I know there are many other threads about children in residency on SDN, but I didn't find any specific to psych so I thought I would ask here. Please excuse me if this is a redundant post. Finally, one other question -- are there particular psych residency programs that are considered especially "family friendly" that I should consider? Any with child care on site? The programs my husband and I are currently looking at, given his training goals, include University of Washington, Yale, OHSU, Stanford, UCSF, Cornell, Columbia, Wash U, and MGH/Brigham. We are currently students at a peer institution of these schools. If I should be considering community programs too rather than academic ones, I'm open to that. I don't need to be "super-doc" but so far I have done well in med school and would like to continue to move my career forward while being the best mom I can.

I'd also welcome any PMs if that's easier. Thank you!

Sorry can't really comment on any of the programs you listed as my wife did not interview at any of the ones listed (we cancelled her interview at University of Washington). But programs that we noted on the interview trail that were self-described as family friedly were UT-Southwestern, UT-San Antonio, University of New Mexico, and Creighton/University of Nebraska, and Scott & White. As we are looking to start a family soon this was extremely important to us.

I don't know if you or your husband are interested in any of these programs but I thought I'd throw that out there for you.