You and your spouse in residency at the same time (w/kids). How do you manage?

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AK_MD2BE

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I am new here to this particular forum on SDN, so if this topic has already been discussed, I would love some direction.
Otherwise, I am sure there are many of you who are doing residency at the same time as your spouse (i.e. couples match).
How you do you manage? Au pair? Nanny? I am just trying to figure out and get some ideas/advice about how two parents work 60-80 hours/week and raise young children. Any and all advice would be greatly appreciated. Thanks. :)

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There was someone in my med school class who had a baby during 4th year who was going into pediatrics. Her husband was in IM...but he would be a fellow by the time she started internship, so hopefully would have a little better hours. Also, she was doing peds and tons of pediatricians and peds residents have kids, so they are likely to be a little more understanding than some other specialties (i.e. ortho).

I think it would be important to pick a residency in a place where it's relatively easy to find good daycare, and where there is a lower cost of living and less traffic (traffic eats up your time).

Ideally, you would do residency somewhere where you have family in the same city, or at least within a few hours so they can come and help with the kids occasionally. Otherwise I think it will be really hard...part of it depends if the kids are babies (i.e. need constant care) vs. old enough to be going to school + daycare. But if both of you are residents in say years 1-3 of residency, it's going to be damn hard. I mean, the attendings and the hospital don't care that you have to pick up your kid from daycare, and the daycare doesn't care that you have to show up for work by 7 a.m. or earlier...if they open at 7, they open at 7. The higher you get in the system (i.e. 3rd year medicine resident, upper upper level surgical resident) you get a little bit of control over your schedule and maybe what rotations you get, but it's still minimal. I honestly don't know how the heck 2 married residents with kids survive...but I'm interested in what replies you'll get.
 
Because of your hours, you need someone in your home. Period. She doesn't have to *live* with you, but she needs to come stay with your kid(s) in your house from whenever you leave to whenever you return. That might well involve more than one person whose fulltime salary you have to pay (+ insurance and other benefits).
 
Raising children while both parents are residents is difficult. I have cousins doing it, and they have a very hard time. Her parents live within a couple of hours and they often go to stay for weeks at a time. That's in addition to full-time help. My cousins themselves are constantly torn, constantly exhausted, constantly feel guilty. This is not to be taken on lightly.
 
I'm a parent and a resident, so perhaps I can shed some light, even though my wife is not a resident. Sorry Blondedocteur and Dragonfly, but there's nothing worse than parenting advise from people who aren't parents themselves, even if you're right. I agree with Blondedocteur: I think it would be very difficult for two residents to finish residency without live-in help. Very few daycare centers are open past 6:00 pm, so unless you can be off work by then, you will struggle to meet you childcare needs. Unless you both matched into a family practice program, and that program was willing to work with you (i.e., ensure at least one of you is on an outpatient block at all times), daycare simply won't work. The two-resident parents I know universally need a live-in nanny, which is very expensive. This will wipe out one person's salary, making your budget tight. Your student loans may go into forbearance. If you choose an expensive city (say, San Francisco or New York) you may even have to assume more debt.

I assume the OP is considering starting a family. Truth be told, there is no convenient time to start a family. However, intern year is particularly hard. If you want to have children during your residency I would consider waiting at least until your R2 year. Dragonfly is right, having kids will weigh very heavily on what field you choose and where you live. A single student may be willing to live anywhere in the county in order to pursue a competitive residency. As a parent, your priorities will be different. Location will matter, as will work hours. This will limit the sort of programs/fields you consider. If you have a competitive streak, you may feel like you're being asked to give up on your ambitions for the sake of your child. This can realistically lead to resentment ("I could have done ortho at MGH, but I'm stuck doing FP in some backwater town"), so be aware of this before you decide to have kids. I also agree that in-laws/parents can be a godsend.

One last point: parenting is extremely tiring and difficult. Imagine, for example, you decide to use daycare, and that one of you can make it in time to pick up your child (or pretend you have a nanny, who won't work 80 hours). In the evening, you will need to bathe, feed your child, prepare his food for the next day, etc. Now imagine your partner is in the hospital on-call so you have no help. Imagine still that you have an in-service exam coming up and that you're behind in your clinic notes and dictations. Now imagine your child has a fever. What you're proposing is a difficult life, and you need to go in with your eyes wide open. If you're tired, depressed and frustrated you will not enjoy parenting and your child can suffer as a result. If you can make the necessary sacrifices (goodbye social life), then you'll have a wonderful time.

Good luck.
 
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Thank you very much for all of your replies and advice. Unfortunately, my wife and will both be starting residency a little bit later than most (I will be 30and she will be 29), so time isn't exactly on our side as far as waiting until later on in residency.
If anyone else has any other advice/experience/thoughts, my wife and I would greatly appreciate them. Thank you very much. ;)
 
Thank you very much for all of your replies and advice. Unfortunately, my wife and will both be starting residency a little bit later than most (I will be 30and she will be 29), so time isn't exactly on our side as far as waiting until later on in residency.
If anyone else has any other advice/experience/thoughts, my wife and I would greatly appreciate them. Thank you very much. ;)

Just a 4th yr med student here, but I do have 4 kids, so, I feel your guilt, already.

You really have 3 options from what I see and the choice I would make isn't here.
1. You or your wife can graduate and wait to enter residency by 2-3yrs. Now, I do not know what kind of residency you are looking into, but if it is not one of the uber competitive ones, you'll be ok. If you are willing to work hard enough to stay up-to-date and in touch with key people in the field/program of choice, a competitive program might not be out of reach. You might even be able to do research for a couple of years if you don't want to stay home with your kids.
a. This is what our Pediatrician did, albeit, 15 yr ago. Had 2 kids and then went back.
b. I think this is the best option. You will have a lifetime to work. You have a precious few years to mold your children or let someone else mold them for you.

2. Live very close and have a super relationship with grandparents, sibs, cousins, etc. You will strain those, but they can't say no as easily.

3. Loans and nanny. Not the greatest, cause they will get sick, need time off, get a DUI, steal something, want paid early, want Friday or Sat. off, ...etc.
 
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Our situation exactly. My wife and I had our first child at the beginning of 3rd year. I can tell you not having any family nearby is a crusher. We paid over $1400/month in daycare and had to have our families come to help when even daycare wasn't enough...such as during obgyn and surgery rotations. My wife is an intern and I start my residency this July. We have no family nearby to help. We are looking to hire someone who will take our child to daycare/pick him up and stay with him in our home until one of us gets home. The provider will also be needed for times when we are both on call and/or weekends when we both work. There's really no other way around it. The best option with no family is if you have a trusted neighbor who is a stay at home mom or dad. Having your child be able to spend time with other kids and have a learning environment is much better than being 'watched' by someone all day but not really being interacted with. OP let me know how things go for you. We can possibly discuss our solutions.
 
We are looking to hire someone who will take our child to daycare/pick him up and stay with him in our home until one of us gets home. The provider will also be needed for times when we are both on call and/or weekends when we both work.

Same situation here, also. SO and I will be starting residency this summer when our child is 7 months old. Quite frankly, I'm terrified over how it will all work out. My mother plans to stay with us for 4-6 weeks while we figure out long term childcare. We plan to do one of two things:

1) Ideally, find a SAHM (resident's wife or husband, perhaps?) who can accommodate our long hours
2) Full-time daycare, plus hiring a college student to fill in the early morning/late evening hours and overnight calls where neither of us is home

Au Pairs can only work 45 hours in the States, so this won't work as a stand alone option. Live-in nannies, while theoretically fantastic, run $12-$20/hr which translates to around $50,000 annually... more than my salary will be. I have toyed with the idea of splitting a nanny with another resident couple but I don't know how feasible that is.

I want to be excited about starting residency but this is causing me a ton of stress.
 
Gosh, this brings back fond memories of threads from 2 years ago : one series started with one person asking if having a dog during residency was a good idea - which was almost universally shot down because of what a commitment having a dog was, and the other about having kids and almost universally everyone (but me) felt it could be done - baby humans need very little etc. Ahhhhhh, good times.......

Just put a bowl of food on the floor and some water and the human babies will be good to go hahahahaahahahahahahahahahahaha But what ever you do, don't you dare treat a dog like that hahahahahahahaha
 
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Gosh, this brings back fond memories of threads from 2 years ago : one series started with one person asking if having a dog during residency was a good idea - which was almost universally shot down because of what a commitment having a dog was, and the other about having kids and almost universally everyone (but me) felt it could be done - baby humans need very little etc. Ahhhhhh, good times.......

Just put a bowl of food on the floor and some water and they will be good to go hahahahaahahahahahahahahahahaha

Thanks for not contributing anything meaningful to this topic. :cool:
 
Thanks for not contributing anything meaningful to this topic. :cool:

You are welcome. People are going to do what people do - especially having kids - regardless of whatever logical or experienced viewpoint and information you share.

I will say this though - I have seen some women in residency who went through part of residency pregnant and had one or more children - they did amazingly well, but I have never seen a couple in which both are in residency do it
 
I know a couple doing this- they are in separate residencies (about 60 miles away). They are both PGY2s, had the child 6 months ago.

They are managing, but there are multiple issues. The major one appears to be transferring the kid from spouse-to-spouse at the end of the day when one is on call- there's inevitably drama involved. Other residents are bending over backwards to help, but everyone's getting tired of it because it ends up affecting everyone else- can't do sign-out until he gets back from dropping off his child 30 minutes away.
 
i had to laugh at someone's suggestion that sacrifices will have to be made, like your "social life"

how about your sanity, not to mention your marriage?
 
Thank you very much for all of your replies and advice. Unfortunately, my wife and will both be starting residency a little bit later than most (I will be 30and she will be 29), so time isn't exactly on our side as far as waiting until later on in residency.
If anyone else has any other advice/experience/thoughts, my wife and I would greatly appreciate them. Thank you very much. ;)

First...you're not as old as you think you are. We had a child at the end of my intern year when my wife (mercifully not a doc) was 36 and I was 35. So waiting a couple of years will not be the end of the world. That said, the kid is going to come when it comes. I would HIGHLY recommend waiting until after your intern year though.

As far as how to manage the care and raising of a child (or children), it will definitely depend on what field(s) you're going into and what part of the country you wind up in. As mentioned above, daycare will be tough as most of them are open in the 7a-6p range. Some a little later, some a little earlier but in general, you won't be able to count on much more than that. One possibility is paying one of the workers at the daycare to nanny for you on an as needed basis when you can't get there in time.

Obviously a nanny or au pair would be the "best" solution in terms of schedule but what do you do when the nanny is sick?

24h care may be difficult no matter which route you go. If you both happen to be on call the same nights, you're going to be hosed.

One last option is available only if you're both going to be in the same field. That is the idea of sharing a position. You have to have your PD on board with this and is more likely to be an option in IM/FM/Peds/Psych than in Ortho. A couple in my program did this after their son was born at the end of their intern year. They've each been half-time since 2nd year. They alternate months and the person who is off is the full-time caregiver. They only make 1 salary but their child care expenses are nothing. Not for everyone but certainly an option if you're in the same program.

Good luck. You'll make it work one way or another but it will not be easy. Rewarding, yes.
 
Honestly I've looked into this quite a lot (even though, as it was pointed out above, I don't yet have kids). My partner works 80-100 weeks and has even less flexibility than a resident. If you have no family support at home and you want to do this legally (so as not to later be disqualified from, say, a New York Senate appointment) you can:

1) use day care maximally (say, 7-6) and hire someone to drop the child off in the morning (assuming your field is neither psych nor PM&R and you have to be in the hospital before 7:30), pick him up in the evenings and take care of him on weekends/evenings only. Depending on the daycare, this is probably the cheapest option. You do not need to hire a nanny fulltime and as a result you are not responsible for providing health insurance or other benefits. The downsides all turn on your feelings about daycare.

2) Hire a full-time nanny and a part-time nanny. In New York and other very large metro areas with a high concentration of power couples, "night nannies" and other services are available-- nannies who will work very odd and flexible hours, or stay overnight to care for a very young infant who is not yet sleeping through the night.

3) If you are both in demanding, long-hours fields (a surgical residency of any stripe or several months of a medical internship) then two fulltime nannies will be necessary. If you and your spouse are both working 80 hour weeks then you need at least 80 hours of care, obviously. That means providing health benefits, etc for two people. This is (IMHO) both the best option for your child, as he will always be home and will have continuous care, and the runaway most expensive option. It would probably total at least one of your pre-tax salaries. A certified professional nanny with good references, legally in this country, recommended by an agency starts at $400 a week and climbs dramatically. And of course, arrangements for her vacation and your stopgap coverage will need to be made.

Above all, be serious re: the qualifications and reliability of your nanny. I personally will not opt for an au pair because I can think of no one who would be less interested in the care of my child than an 18 year old Swedish girl who wants to experience New York, but they are usually a much cheaper option (room + board plus a negotiable stipend, but they max out at 40 hours a week, firm). Depending on your area, a flexible after-hours + weekends person in the form of an older empty nester, or a stay-at-home mom looking for a bit of extra income, would be a safe and cheaper option.

On a personal note, for our primary caregiver we're hoping to find someone from our immigrant-heavy church (we belong to an obscure branch of Christianity) who is of course legally here, has childcare experience in the form of her own grown children, and could use the money, in addition to a second agency-hired evenings/weekends nanny. Both would come to our apartment to care for the kid. Not sure if such an option would be open or palatable to you.
 
I am an R1 whose spouse is not a resident but does work a lot (50+hrs). We have an au pair which has worked out great. The beauty of the au pair is that you can change her schedule based on your schedule. It is 45 hrs./wk. but many want to and will work over if you pay them more. Also, they can do split shifts so if you figured out a mother's day out type of thing you can have your child in daycare say 3 days a week for 6 hrs. a day, have the au pair drop off and pick up the child but she is off while the child is in day care and she can work late into the night or whenever you need her. PM me if you want more info but it really is a great solution and as affordable as daycare with much more flexibility and stability for your child. Also, you don't have to worry if your child gets sick because they can stay home with au pair. Good luck! It is a struggle but doable. You just need to bite the bullet and get the support you need for this temporary time in your life.
 
I've got to say, I'm really disappointed in the "attempts" to justify farming out kids here. Ton of myopia going on here. No wonder our economy/country is looking like crap.

The more I've thought about this, the more convicted I am to say,
The real options are:
1. Do not have kids and either wait to have them (like 3yrs min.) or wait and adopt. Or, just plain do not have kids.
2. If you do, make the true sacrifice and not do a residency on your terms. Once you do have a child, your world is turned upside down and you would want to do everything for them and won't be able to, leaving you bitter and angry.
3. Do not farm your kids out to someone else. Why even be a pseudoparent? It is really a joke that you would be considered one. Yeah, you birthed a human, but come on, that kid will not be truly yours, b/c by the time those formative years are over, you'll be neck deep in paperwork, making Benjamin's and keeping up with the Jones'. And, you'll raise a kid w/o your values, your world view and ultimately one that has a closet full of skeleton's to drag around.

Really, it boils down to why do you want children? Is it to say you've got one? Is it b/c everybody else does? Do you feel weird at parties with all of your other married friends talking about their kids? Some primal urge to further your genetic link?

The fullfillment of parenthood comes from being with the kids and watching their light turn on at rolling over/laughing/crawling/walking/talking/reading/... and sharing that with them. I would have hated to know I missed all of that. Knowing "autie ____" gets to let you know, "Jim Bob can crawl and you need more diapers" when you get home at 10p.

Basically, grow a pair, make an adult decision that doesn't revolve around you and what you want.
 
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I've got to say, I'm really disappointed in the "attempts" to justify farming out kids here. Ton of myopia going on here. No wonder our economy/country is looking like crap.

The more I've thought about this, the more convicted I am to say,
The real options are:
1. Do not have kids and either wait to have them (like 3yrs min.) or wait and adopt. Or, just plain do not have kids.
2. If you do, make the true sacrifice and not do a residency on your terms. Once you do have a child, your world is turned upside down and you would want to do everything for them and won't be able to, leaving you bitter and angry.
3. Do not farm your kids out to someone else. Why even be a pseudoparent? It is really a joke that you would be considered one. Yeah, you birthed a human, but come on, that kid will not be truly yours, b/c by the time those formative years are over, you'll be neck deep in paperwork, making Benjamin's and keeping up with the Jones'. And, you'll raise a kid w/o your values, your world view and ultimately one that has a closet full of skeleton's to drag around.

Really, it boils down to why do you want children? Is it to say you've got one? Is it b/c everybody else does? Do you feel weird at parties with all of your other married friends talking about their kids? Some primal urge to further your genetic link?

The fullfillment of parenthood comes from being with the kids and watching their light turn on at rolling over/laughing/crawling/walking/talking/reading/... and sharing that with them. I would have hated to know I missed all of that. Knowing "autie ____" gets to let you know, "Jim Bob can crawl and you need more diapers" when you get home at 10p.

Basically, grow a pair, make an adult decision that doesn't revolve around you and what you want.

This is the lunacy of America. Americans think they "have it all" and have a high quality of life just because they have expensive cars, enormous houses and electronic gadgets. Much of the world, heck, even parts of the so-called "third world" has a better quality of life. People live closer to nature, have much better working hours, and actually have time to spend with their family. Yes, they can't afford our possessions. But what do our possessions mean to us when we are slaves to them?

What happened to mom greeting the kids coming back from school with a warm apple pie, dad coming home at between 5 and 6, a 3-4 bedroom home, 1-2 decent cars, vacation every now and then, a steady job where you could work for the same company from your 20s until 65, and a good retirement?

Instead, we've chosen the way of frenzied men and women competing with their peers, friends, neighbors, and themselves as to who will get professor of X and who will publish Y articles per year or in Z high-impact journal, who makes $Q00K per year, staying ahead of the pack, not getting redundant at the job, hiring and firing nannies, day care, women becoming infertile because they put off children for so long, eggs being frozen "for the future," divorces left and right, paying exorbitant money to eat out (low quality food often) all the time because you can't cook or are too dead tired to do so, kids hate you or don't know you, etc.

Medicine is bad enough as it is. Both parents in residency for a grown child would be hard. For an infant? It's inhumane.
 
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What happened to mom greeting the kids coming back from school with a warm apple pie, dad coming home at between 5 and 6, a 3-4 bedroom home, 1-2 decent cars, vacation every now and then, a steady job where you could work for the same company from your 20s until 65, and a good retirement?

That is a mythology that existed for a short period of time among a specific socioeconomic subset of Americans. It was made possible in the aftermath of WWII by the uniquely prosperous conditions and the domestic imperatives of that time.

The median household income now is somewhere around $50,000. That's not enough for a "3-4 bedroom home and 1-2 decent cars" in too many places in the US.

This is the lunacy of America. Americans think they "have it all" and have a high quality of life just because they have expensive cars, enormous houses and electronic gadgets. Much of the world, heck, even parts of the so-called "third world" has a better quality of life. People live closer to nature, have much better working hours, and actually have time to spend with their family. Yes, they can't afford our possessions. But what do our possessions mean to us when we are slaves to them?

I agree that Americans are a bit nutty about their material possessions. But I think it's more that among the educated/professional groups we're taught to value ourselves through work and achievement. Consequently, in many fields there's a culture of working more-harder-longer that isn't just about the money.

People here actually brag about how many hours they work as if it were some sort of badge of honor. That's not common among, e.g., most Europeans.
 
I understand what people are saying to some extent, and certainly some people in medicine and other high-powered careers seem all too willing to put their children in the care of someone else for the vast majority of their childhoods when other options could be found. However, this is simplifying the issue dramatically for many female physicians. As someone who will turn 29 shortly after beginning residency this summer, recently got engaged and knows I want children, this is an issue I have obviously given some thought to. I would love to have a child and stay home with it, at least most of the time, for the first several years- but the reality is, I'm going to spend the next 3 years in residency which for all the aforementioned reasons is a bad time to start a family. Once I graduate, I will assume the responsiblity of paying back my six-figure debt, necessitating full-time work. That six-figure debt is, incidentally, the same reason I don't see delaying residency to have kids as a very realistic option- I would need to continue working basically full-time in whatever crappy research job I could find just to make my loan payments each month; and by the time my debt is paid down/off, my eggs will have turned to dust within my ovaries.

Essentially, now that I have completed med school and taken on substantial debt in the process, my only choice is to complete residency and work full-time to pay back that debt (not to fund some kind of extravagant lifestyle), not leaving much time for stay at home parenting and apple pie baking. So, given that I had neither the partner nor the finances to spawn before med school, my choices for a family life now are constrained. I am fortunate that my future husband is in a much more flexible (if also considerably lower paying) field than medicine, which will allow him to likely assume more of the child-care responsibilities once we procreate. I agree that where possible, people should postpone parenthood until at least one parent is able to accomodate childcare without full-time hired help. But not everyone who has to complete residency and work for the foreseeable future has a choice in the matter, as the sacrifice they would be making by not working could well be student loan payments rather than a second BMW; and it is unreasonable to suggest that these people should not be able to procreate due to this reality or to assume that all of them are materialistic and shallow.

Sure, the uncaring parents who have children only as a status symbol and foist them off on the first available nanny will have a number of issues to deal with later in life, but so will the child whose mommy never went to college and instead stayed home to pop out 6 kids by the time she's 30 because she considers being a stay at home mom a "career" that society values more than the big bad female physician who dares to have both a real career and a family. There is more than a hint of sexism to all of this, as historically men have been able to have their cake and eat it too with a wifey to bake cookies and watch the kids while they furthered their careers, in medicine and otherwise. Now that women are having the same opportunities, society needs to readjust and find ways to accomodate parents so both men and women can have the fulfillment of family and career. Few American companies (again, medical or otherwise) have seen fit to do this by offering flexible job positions, daycare options, and appropriate maternity leave, although this seems to be very slowly changing. Many Euopean countries provide 4-6 months (or more!) of paid maternity leave to their workers, while the US provides a measly 12 weeks of unpaid leave. The problem to me lies as much or more with our refusal to value working parents (male and female) as with a minority of selfish people who have kids for the wrong reasons and hire out their care.
 
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My wife and I were certainly able to do it. We planned our wedding/got married during our intern year, had our first kid at the end of PGY-2, and our second at the end of my PGY-4. Definitely helped to be in specialties with some degree of flexibility (she = IM, me = PM&R), as well as be in a program considered “pro-family”. We were able to arrange our call schedules so one of us was with the tyke every night. I brought the spud to my wife in the hospital cafeteria when she was on call, so as to spend some quality family time. We ended up being time zones away from our family, so it helped to be in an area where the cost of living allowed us to utilize help such as infant day care and a part-time nanny. Picking up the kid from day care before it closed at 6pm was sometimes nerve-wracking (the place would charge you by the minute if you were late!), but one of us always made it. You learn how to prioritize, you learn how to problem solve, you learn efficiency, you learn to make grownup decisions.

I take issue with those that implied that those of us are/were selfish. Parents do not have to be with their kids 24/7. We watched our wee ones walk and talk for the first time. We videotaped them in their first bath. We struggled mightily with potty training. We took them, often unnecessarily, to the ED with (in retrospect) minor rashes and viral infections. We watched them play in the sandbox alongside other toddlers. We watched them eat sand.

We’ve since moved back closer to family, and both mom and dad are immersed in our respective practices. We still make time for our kids (now in elementary school). We still use a nanny, but have grandparents and aunts/uncles on backup if needed. It definitely helps to have a strong family support base. The grandparents are actually mad that we don’t use them more. We help our kids with their homework. We pick them up from their afterschool activities. I coach my son’s little league team. We have dinner prepared most nights, eat out occasionally. We still read them to bed every night. So far, the kids say they love mom and dad. But I shudder to think what will happen come adolescence.

You find a way to make it work. You find a balance. You cherish the moments you have with each other. You enjoy work while you’re there, you enjoy family when you are at home, you have an occasional night out alone with the spouse to get away from it all.

Can’t post more, gotta get the kids off to school. ;)
 
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Honestly I've looked into this quite a lot (even though, as it was pointed out above, I don't yet have kids). My partner works 80-100 weeks and has even less flexibility than a resident. If you have no family support at home and you want to do this legally (so as not to later be disqualified from, say, a New York Senate appointment) you can:

1) use day care maximally (say, 7-6) and hire someone to drop the child off in the morning (assuming your field is neither psych nor PM&R and you have to be in the hospital before 7:30), pick him up in the evenings and take care of him on weekends/evenings only. Depending on the daycare, this is probably the cheapest option. You do not need to hire a nanny fulltime and as a result you are not responsible for providing health insurance or other benefits. The downsides all turn on your feelings about daycare.

2) Hire a full-time nanny and a part-time nanny. In New York and other very large metro areas with a high concentration of power couples, "night nannies" and other services are available-- nannies who will work very odd and flexible hours, or stay overnight to care for a very young infant who is not yet sleeping through the night.

3) If you are both in demanding, long-hours fields (a surgical residency of any stripe or several months of a medical internship) then two fulltime nannies will be necessary. If you and your spouse are both working 80 hour weeks then you need at least 80 hours of care, obviously. That means providing health benefits, etc for two people. This is (IMHO) both the best option for your child, as he will always be home and will have continuous care, and the runaway most expensive option. It would probably total at least one of your pre-tax salaries. A certified professional nanny with good references, legally in this country, recommended by an agency starts at $400 a week and climbs dramatically. And of course, arrangements for her vacation and your stopgap coverage will need to be made.

Above all, be serious re: the qualifications and reliability of your nanny. I personally will not opt for an au pair because I can think of no one who would be less interested in the care of my child than an 18 year old Swedish girl who wants to experience New York, but they are usually a much cheaper option (room + board plus a negotiable stipend, but they max out at 40 hours a week, firm). Depending on your area, a flexible after-hours + weekends person in the form of an older empty nester, or a stay-at-home mom looking for a bit of extra income, would be a safe and cheaper option.

On a personal note, for our primary caregiver we're hoping to find someone from our immigrant-heavy church (we belong to an obscure branch of Christianity) who is of course legally here, has childcare experience in the form of her own grown children, and could use the money, in addition to a second agency-hired evenings/weekends nanny. Both would come to our apartment to care for the kid. Not sure if such an option would be open or palatable to you.

You may have looked at it quite a lot, but you still don't have any children. You don't know what you are talking about and it shows. Your check list barely covers technicalities and doesn't look into the emotional roller-coaster of raising young children during medical training. As a parent starting residency this summer, here's my advice to the OP: Read threads written by parents and dismiss those by who write posts that read like a technical manual (Next post by BD: how to program your Tivo.) :laugh:
 
That is a mythology that existed for a short period of time among a specific socioeconomic subset of Americans. It was made possible in the aftermath of WWII by the uniquely prosperous conditions and the domestic imperatives of that time.

The median household income now is somewhere around $50,000. That's not enough for a "3-4 bedroom home and 1-2 decent cars" in too many places in the US.

.

I don't think its a mythology if you choose to make it a reality. In 19 years of marriage my wife never worked outside the home until I went to residency in another state while they stayed behind so my oldest son could finish high school. My youngest son would have been in first grade my intern year in medical school and her job would have allowed her to only work the hours they were in school. Over the course of our marriage, we had a few lean years and and a few rather well off years.

This summer my wife had to quit her job to take care of her mom who had a stroke, and to reduce the cost of dual households I resigned residency and moved back home - and am working 3 crappy jobs, making about $40K for 7 people (including mother in law living with us). There is no extra's, due to a recent car wreck where an uninsured motorist crashed into me destroying my car - my oldest son has given up his car for me, and for a while we were a one car family when a relay in my car went out and we could not afford to fix it for awhile. I have to say we are happier than most although we have not a penney extra each month - things are tense at times, my wife wishes I was still in residency, my oldest daughter is kind of embarrassed of me because I am working such crappy jobs - but looking around we are happier than most.

I got to watch my son swim at state invitationals and get an All-American for swim - enjoy his social life in proxy (girls ask him out on dates frequently and he dated one girl several times over a month without ever knowing her name and only discovered it after putting a bulletin on his myspace to find out what her name was...I don't know I think that is funny), I watched my daughter have the lead in school plays - get tons of offers from the best schools in the nation - an offer to go to the Oxbridge program in England, I got to go on 3 boyscout campouts with my 7 year old son since being back from residency, etc. My wife is busy at home with her mother, but drives everyone to school and is here when it is time for them to come home. We sacrifice things, but all my children are quite happy and we are very close , and they all know I would do anything for them.

Some people may have it all. We don't. But we have alot - but we have had to sacrifice THINGS. I often wish I had just kept my former occupation and not made this error of going back to medical school when I was middle aged. Medicine really is not as cool, prestigious or fun as I thought it was - and the cost is way to high - but it is what it is. But a family can choose to have a stay at home mother - its a reality if you make it reality

What happened to mom greeting the kids coming back from school with a warm apple pie, dad coming home at between 5 and 6, a 3-4 bedroom home, 1-2 decent cars, vacation every now and then, a steady job where you could work for the same company from your 20s until 65, and a good retirement?

Instead, we've chosen the way of frenzied men and women competing with their peers, friends, neighbors, and themselves as to who will get professor of X and who will publish Y articles per year or in Z high-impact journal, who makes $Q00K per year, staying ahead of the pack, not getting redundant at the job, hiring and firing nannies, day care, women becoming infertile because they put off children for so long, eggs being frozen "for the future," divorces left and right, paying exorbitant money to eat out (low quality food often) all the time because you can't cook or are too dead tired to do so, kids hate you or don't know you, etc.

Medicine is bad enough as it is. Both parents in residency for a grown child would be hard. For an infant? It's inhumane.

Blasphemy. hahahaha I agree with you. I really long for the years we lived in a small midwest town of 3,000; I owned a business, my wife stayed at home , I came home for lunch every day and played with the kids during my extended lunch break (its great being the boss). There is no way we could get back to that until the real estate market corrects ... hopefully. But damn those were good times - Now I live in a 4 bedroom home on the water in a fast growing city, persuing medicine and in the stupid rat race I escaped.

On a personal note, for our primary caregiver we're hoping to find someone from our immigrant-heavy church (we belong to an obscure branch of Christianity) who is of course legally here, has childcare experience in the form of her own grown children, and could use the money, in addition to a second agency-hired evenings/weekends nanny. Both would come to our apartment to care for the kid. Not sure if such an option would be open or palatable to you.

As much as I hate to say it again, I like what BD has to say. One group I have seen do a great job as live in nannies, and do it rather inexpensively is Mormons (Church of Jesus Christ of Latter Day Saints). They often grow up in large families, very tight knit, use to doing everything from taking care of younger siblings to baking pies from scratch (they will even grind their own wheat to make the flour to make the pie...I kid you not). THey will balance a kid on their hip while cooking food like an assembly line and be happy as a clam doing it. Its nuts.
 
What happened to mom greeting the kids coming back from school with a warm apple pie, dad coming home at between 5 and 6, a 3-4 bedroom home, 1-2 decent cars, vacation every now and then, a steady job where you could work for the same company from your 20s until 65, and a good retirement?

+pity+
 
You may have looked at it quite a lot, but you still don't have any children. You don't know what you are talking about and it shows. Your check list barely covers technicalities and doesn't look into the emotional roller-coaster of raising young children during medical training. As a parent starting residency this summer, here's my advice to the OP: Read threads written by parents and dismiss those by who write posts that read like a technical manual (Next post by BD: how to program your Tivo.) :laugh:

The OP asked about au pair/nanny options for 60-80 hour weeks. So I wrote about that. Feel free to point out options I overlooked, or errors in the content.

Believe it or not, mechanically working out a feasible schedule for child care is, in fact, not the sum total of my philosophy of child-rearing. That would involve that emotions business you alluded to but again was not of interest to the OP.
 
Essentially, now that I have completed med school and taken on substantial debt in the process, my only choice is to complete residency and work full-time to pay back that debt (not to fund some kind of extravagant lifestyle), not leaving much time for stay at home parenting and apple pie baking. So, given that I had neither the partner nor the finances to spawn before med school, my choices for a family life now are constrained. I am fortunate that my future husband is in a much more flexible (if also considerably lower paying) field than medicine, which will allow him to likely assume more of the child-care responsibilities once we procreate.

I have a high school friend, now himself a medical doctor, whose mom was a single parent MD. His dad died, and as a widow she did it all - raised him while working at a major medical center. When were in grade school she somehow made it to most of our school plays etc and I of course had no idea what a big deal that was. Even now I wonder how the heck she did it. Certainly the Michael Phelps of parenting to pull that off. But she was involved with him, cranking busy with medicine, and did it single handedly. pretty amazing. Not something the average person (such as myself- but then again I flatter myself with the title of average) could do.

Ummm, when you sweet talk your man....do you refer to it as procreating?
 
Basically, grow a pair, make an adult decision that doesn't revolve around you and what you want.

How about you grow a pair and accept the responsibilities of a career medicine.

Having been raised by a surgeon as a parent in the days of Q2 call with no cap AND having a child myself while working 2 jobs throughout medical school while earning AOA membership, and the wife who is also in AOA I feel somewhat knowledgble on this topic.

I can tell you I don't love my father any less because he was gone probably > 70% of the time when I was 0-6 years old. He still was a great Dad and I had so many more opportunites as a child because of his career in medicine.

I've got to say, I'm really disappointed in the "attempts" to justify farming out kids here. Ton of myopia going on here. No wonder our economy/country is looking like crap.

Apparently somehow you consider nannies the root of our economic problems. Please pass along whatever you are smoking ... perhaps then we could understand your arguments.

The more I've thought about this, the more convicted I am to say,
The real options are:
1. Do not have kids and either wait to have them (like 3yrs min.) or wait and adopt. Or, just plain do not have kids.
2. If you do, make the true sacrifice and not do a residency on your terms. Once you do have a child, your world is turned upside down and you would want to do everything for them and won't be able to, leaving you bitter and angry.
3. Do not farm your kids out to someone else. Why even be a pseudoparent? It is really a joke that you would be considered one. Yeah, you birthed a human, but come on, that kid will not be truly yours, b/c by the time those formative years are over, you'll be neck deep in paperwork, making Benjamin's and keeping up with the Jones'. And, you'll raise a kid w/o your values, your world view and ultimately one that has a closet full of skeleton's to drag around.

I love all this "you" and judgmental language. I'm proud to say carry with and live my father's values every day.

Just to reassure everyone, it is still your child ... and yes my child is truly mine.

The fullfillment of parenthood comes from being with the kids and watching their light turn on at rolling over/laughing/crawling/walking/talking/reading/... and sharing that with them. I would have hated to know I missed all of that. Knowing "autie ____" gets to let you know, "Jim Bob can crawl and you need more diapers" when you get home at 10p.

I still experience these things with my child, just because I'm not there for the first time hasn't mattered so far. There is a first time for me and my daughter to experience it together. I would love to be there for my kid to crawl, and awesome if I can be. But, medicine may not let me, I've accepted that. However there WILL be a first time I see my kid crawl ... do you really think it is that much of an emotional difference ??? ... I argue not. My child didn't coo for the first time with me around, but it was still truly an amazing experience when I finally heard it ... an experience I never will forget.

If you haven't figured this out McSnappy, its not the QUANTITY of time it is the QUALITY of time that makes it.

Simple reality ... dual physician couples WILL require help with childcare during residency ... and you know what, they aren't bad parents and they didn't have children for your superficial *****ic reasons. I mean seriously, you caught me, I had a child because I felt left out at parties.

In summary, you are a complete troll with your inflammatory and inciteful language. I've got a great family, a surgeon as a father who I love immensely, a brillant medical student wife who is the most wonderful mother, and a child that beams and smiles whenever I see her. So, I suggest you "grow a pair" and realize there are many paths to being a successful parent.
 
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How about you grow a pair and accept the responsibilities of a career medicine.

Having been raised by a surgeon as a parent in the days of Q2 call with no cap AND having a child myself while working 2 jobs throughout medical school while earning AOA membership, and the wife who is also in AOA I feel somewhat knowledgble on this topic.

I can tell you I don't love my father any less because he was gone probably > 70% of the time when I was 0-6 years old. He still was a great Dad and I had so many more opportunites as a child because of his career in medicine.



Apparently somehow you consider nannies the root of our economic problems. Please pass along whatever you are smoking ... perhaps then we could understand your arguments.



I love all this "you" and judgmental language. I'm proud to say carry with and live my father's values every day.

Just to reassure everyone, it is still your child ... and yes my child is truly mine.



I still experience these things with my child, just because I'm not there for the first time hasn't mattered so far. There is a first time for me and my daughter to experience it together. I would love to be there for my kid to crawl, and awesome if I can be. But, medicine may not let me, I've accepted that. However there WILL be a first time I see my kid crawl ... do you really think it is that much of an emotional difference ??? ... I argue not. My child didn't coo for the first time with me around, but it was still truly an amazing experience when I finally heard it ... an experience I never will forget.

If you haven't figured this out McSnappy, its not the QUANTITY of time it is the QUALITY of time that makes it.

Simple reality ... dual physician couples WILL require help with childcare during residency ... and you know what, they aren't bad parents and they didn't have children for your superficial *****ic reasons. I mean seriously, you caught me, I had a child because I felt left out at parties.

In summary, you are a complete troll with your inflammatory and inciteful language. I've got a great family, a surgeon as a father who I love immensely, a brillant medical student wife who is the most wonderful mother, and a child that beams and smiles whenever I see her. So, I suggest you "grow a pair" and realize there are many paths to being a successful parent.


Great argument. However, it breaks down, unless your father was a single parent.

And no, nannies are not the root of all evil. It is the, I can pay for it, therefore it must be ok attitude/value that permeates society w/out the value of personal sacrifice. The value, that it is only about what we want that matters most, me first, you second.

I'm sure your wife is a wonderful person and so are you. However, the big difference here is you both will enter residency after that first year/two/three of life of your daughter and the OP was going to have one during internship or shortly thereafter. Big difference. Therefore, I still stand by my options over daycare. And a quality half-hour or so or less or not at all prior to bedtime is not quality for me. Maybe for you, it is.
 
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The OP asked about au pair/nanny options for 60-80 hour weeks. So I wrote about that. Feel free to point out options I overlooked, or errors in the content.

Believe it or not, mechanically working out a feasible schedule for child care is, in fact, not the sum total of my philosophy of child-rearing. That would involve that emotions business you alluded to but again was not of interest to the OP.

The OP asked how to manage to raise young children when both parents are residents. Your ideas are just ridiculous. You can't afford two nannies on two residents salaries. Two residents are not a "power couple" able to pay for the the "night service nanny" you suggested. Using daycare maximally? Yeah right! You won't have an ounce of mommy guilt with that I'm sure. You have a very idealistic (not to mention elitist) idea of what parenthood is.

Raising children is the hardest thing I have ever done and I am dreading starting residency in four months. But, with my children being older and my partner not being a resident, who am I to give the OP any useful advice?
 
Excuse me, don't mean to bother you, but you appear to have a bit of sand in your vagina.
 
Great argument. However, it breaks down, unless your father was a single parent.

And no, nannies are not the root of all evil. It is the, I can pay for it, therefore it must be ok attitude/value that permeates society w/out the value of personal sacrifice. The value, that it is only about what we want that matters most, me first, you second.

I'm sure your wife is a wonderful person and so are you. However, the big difference here is you both will enter residency after that first year/two/three of life of your daughter and the OP was going to have one during internship or shortly thereafter. Big difference. Therefore, I still stand by my options over daycare. And a quality half-hour or so or less or not at all prior to bedtime is not quality for me. Maybe for you, it is.

So how many kids do you have and what do you do for their care?
 
So how many kids do you have and what do you do for their care?

4, my wife stopped her job about 2mo prior to #1, then worked nights ~30h/wk after the second as we transitioned (me softening my schedule to get pre-reqs) prior to med school, then home for 3 & 4. Now, 3 in school, 1 home. Med school was ~easy to arrange care. My hours and flexibility seemed workable.

My wife will start back to work during internship. In another year or so, my eldest could bbsit for a couple of hours, so that will help too. She/my wife will need to put in about 30h/week.

For those out there w/out a superior S.O., I don't know how they do it and remain healthy.
 
I try to stay out of these threads since I don't have kids, and since they always seem long on vitriol and short on information. That said, I remember someone mentioning MomMD as a resource for more informed and more sympathetic advice; maybe that would be useful to the OP.
 
"its the quality not the quantity" is one of those trite sayings meant to comfort people, just like "beauty is only skin deep"
 
A couple of points that I would like to address:

Cost of Living: In 98% of this great country, $50,000 is at or above median family income, and it can easily buy a family into the local middle class, however that is defined. I have personally supported a wife and children on less than this amount in a Miami Suburb with a reasonably comfortable lifestyle (if not a little bit cramped). If you can't support a spouse and a kid on $50,000 in all but the most expensive of cities in the US, you are wasting money somewhere. I can do it here, and this is NOT a cheap city. I buy my own health insurance. We have two cars, both in good condition. This can easily be ONE resident's salary. The fact is, that resident's are now paid better (not on an hourly basis, but overall) than the average American. One resident's salary is now roughly equal to the average family income in many regions.

Childcare: I'm sure that it is doable, but you will seriously need to examine your long term priorities. Children are hard. People can call it "sexist" all they want, but the vast majority of people in previous generations had someone who stayed at home and handled things. This isn't saying that it has to be that way, or that a father or grandparent couldn't accomplish a very similar result, but I can't imagine how I would get through if my wife were working a resident's schedule. When she was working, she had a flexible job and would schedule herself when I was off.

There is no reason that a female professional has to be the primary caregiver parent. I think that it is a little bit difficult to have no primary caregiver parent. It's the power couple thing that makes it complex. Money for a flexible form of help may be necessary if you are both working 80 hour weeks. Remember when picking your specialty, that you and your husband may have the capacity to be superwoman and superman, but do you really want to have to be all the time? I see some of my classmates, and its sad to see a few that clearly have the capacity to be superwoman who might have chosen not to be with some early reflection. Not that they don't have the right or capacity, but not everyone wants that kind of life.

Even the most severe student loans can usually be handled via different repayment plans for no more than about $3000/month. That means that you have to make a net pay of ~$40,000/year when you are done. That's a lot less than 80 hours a week for a physician in the right specialty in the right place. Beyond that, how much you work vs. how much you are home may be a lot more controllable than you currently think with this more modest obligation.

Best of luck.
 
Each person would handle this differently. As a former resident w/ two small children and a husband who worked as many hours as I did I may have some helpful info. I think you really need to look hard at living close to relatives. Unless you have some secret stash of money, you will go broke paying babysitters, nannies and daycare fees. I think each person needs to do what they feel is right, but it seems like you could consider making the sacrifice to move where family help could be easily found.

I will tell you that other residents (unless you pick a very family friendly program-which you better be really sure about) will resent you very quickly. Of course your children are your top priority, but in residency everybody pulls their own weight. If you call in sick or are late too many times or don't seem to be on the same academic level as other residents you will pay for it. Program directors can put you on probation and you will be forced to decide if you should finish residency or be a good mom. Don't think that they will forgive and just cut you some slack. You are held to the same standards as everybody else regardless of your child being in the hospital, colicky babies, or broken bones on the playground.

I'm sure you will figure out how to work it out, but I know that I could not have done it without both sets of grandparents and my sister. We had one single mom in my program who had her sister move in with her to finish the program. I don't know what specialty you're going into, but you'd better give it some serious thought.
 
Just in case I wasn't controversial enough, I'll add one more point.

Sure, the uncaring parents who have children only as a status symbol and foist them off on the first available nanny will have a number of issues to deal with later in life, but so will the child whose mommy never went to college and instead stayed home to pop out 6 kids by the time she's 30 because she considers being a stay at home mom a "career" that society values more than the big bad female physician who dares to have both a real career and a family. There is more than a hint of sexism to all of this, as historically men have been able to have their cake and eat it too with a wifey to bake cookies and watch the kids while they furthered their careers, in medicine and otherwise. Now that women are having the same opportunities, society needs to readjust and find ways to accomodate parents so both men and women can have the fulfillment of family and career. Few American companies (again, medical or otherwise) have seen fit to do this by offering flexible job positions, daycare options, and appropriate maternity leave, although this seems to be very slowly changing. Many Euopean countries provide 4-6 months (or more!) of paid maternity leave to their workers, while the US provides a measly 12 weeks of unpaid leave. The problem to me lies as much or more with our refusal to value working parents (male and female) as with a minority of selfish people who have kids for the wrong reasons and hire out their care.

This argument makes no sense whatsoever. You cannot argue on one hand that you can do it all, and then argue on the other hand that the problem is that the government isn't making people give you special treatment for your own choices. This mentality irks me to no end. There is no reason that your employer should have to pay you for time off because you decided to have children at that time. Women are intelligent adults. Physician women are intelligent adults who chose to go into a profession in which they knew that long hours into the early 30s were a requirement. Other people should not have to pay for you to take time off. This isn't some universal American refusal to value families. It is the fact that people hire you to work and generate income, and when you are at home nursing your baby, you are not generating any income. It is perfectly reasonable to forego this income for personal family priorities, but it really isn't everyone else's responsibility. You cannot argue that it is those evil employers that don't care about families because they won't pay you to take time off from a job for which they hired you. In this case, you are arguing that because your personal life interferes with your ability to do your job, that your job should bend. That is a bit self-centric, and if anything, is the truly sexist argument on this thread. If everyone is truly equal, make an arrangement to take whatever time you need for your personal reasons, but don't expect to be compensated for it.

The Europeans also have work hour restrictions in some countries per week that resemble a call shift on some more stringent medical specialties. Europe is nothing like here. It's nice that some people think that humans shouldn't be burdened with more than 32 or 35 or 38 hours a week of actual work, but I am not one of them. There is no reason that we need to coddle the entire country. We don't need people rioting over here over the atrocity of being able to be fired a year into a job if your employer feels that you aren't doing a good job. We can leave that in France.
 
Just in case I wasn't controversial enough, I'll add one more point.



This argument makes no sense whatsoever. You cannot argue on one hand that you can do it all, and then argue on the other hand that the problem is that the government isn't making people give you special treatment for your own choices. This mentality irks me to no end. There is no reason that your employer should have to pay you for time off because you decided to have children at that time. Women are intelligent adults. Physician women are intelligent adults who chose to go into a profession in which they knew that long hours into the early 30s were a requirement. Other people should not have to pay for you to take time off. This isn't some universal American refusal to value families. It is the fact that people hire you to work and generate income, and when you are at home nursing your baby, you are not generating any income. It is perfectly reasonable to forego this income for personal family priorities, but it really isn't everyone else's responsibility. You cannot argue that it is those evil employers that don't care about families because they won't pay you to take time off from a job for which they hired you. In this case, you are arguing that because your personal life interferes with your ability to do your job, that your job should bend. That is a bit self-centric, and if anything, is the truly sexist argument on this thread. If everyone is truly equal, make an arrangement to take whatever time you need for your personal reasons, but don't expect to be compensated for it.

The Europeans also have work hour restrictions in some countries per week that resemble a call shift on some more stringent medical specialties. Europe is nothing like here. It's nice that some people think that humans shouldn't be burdened with more than 32 or 35 or 38 hours a week of actual work, but I am not one of them. There is no reason that we need to coddle the entire country. We don't need people rioting over here over the atrocity of being able to be fired a year into a job if your employer feels that you aren't doing a good job. We can leave that in France.

Miami med,

Where did you see me argue that "I can do it all?" I don't think anybody can "do it all" when it comes to parenting. My point was that, although I would love to take time off to be with my children when I have them (and hopefully will be able to arrange to have some time off), the reality of my debt obligation is such that I will not be able to do this for an extended amount of time. I made this point in response to the argument that some were putting forth that the only reason for a physician to work full-time and have kids was to fund some kind of materialistic lifestyle; I will need to work at least close to full-time to pay off my loans and live a comfortably middle-class- not extravagant- lifestyle (which I do feel I am entitled to after 8 years in school + 3 years of residency). I am going into pediatrics, not rumored to be the most high-paying of fields, so to meet my loan burden, pay a mortgage, feed a family, and save for college/retirement after taxes will require me to work more than part-time. I am fortunate, as I said earlier, to have a partner who has more flexibility in his career than I do and will be able to assist with childcare, but I do not think that those who are not fortunate enough to be in this situation (e.g., two resident households) should be told that they are selfish and materialistic for wanting to have a family and needing to use daycare/nannies to do this so they can actually work and pay back their loans. Not everybody who doesn't decide to stay home full-time with little Johnny is obsessed with "keeping up with the Joneses."

I also fail to see how it is "sexist" to argue that there should be better support for families in the workplace. Your arguments rest on the idea that parenting has no intrinsic social value beyond that to the parents themselves, and therefore should be solely their responsibility to deal with, which I would disagree with. I do feel that our country should value its members (male and female) who choose to get an education and be productive members of the workforce and would also like to have a family by accomodating that with reasonable maternity/paternity leave and ideally better daycare options and flexible work hours (e.g., jobshare). In ye olde days, women stayed home and were mommies and daddies went off to work and earned the money; while some may feel this was a preferable arrangement, I personally feel it deprived both sexes to some extent- women of the ability to pursue job/educational goals, and men to devote more time and energy to parenthood. I would like to see society move towards encouraging fulfillment of both of these valuable things for both genders. Now that most adults, men and women alike, want to pursue education and a career as well as a family, it is reasonable that our society adapt to accomodate this as these are all positive things and worth encouraging in a healthy society.

Obviously, parenthood involves sacrifice, but I disagree that one parent should have to entirely sublimate his/her career for the good of the family. Other societies- realizing the value of well-cared for children, a happy workforce, and families in general- have arrangements that are more conducive to workers being able to be both productive and good parents. The fact is, most adults will have children at some point and thus benefit from policies such as these; it is hardly a unique situation that only a few members of the workforce would take advantage of while everyone else is left to shoulder the burden for them. Our current lack of support for families mean that many people- women in particular, since it is an irrefutable fact of biology that we must actually grow the kid for 9 months in our bodies, squeeze it out, and breastfeed it- find that it is more cost-effective to drop out of the workforce entirely than to face the realities of turning your child over to a stranger for care after 3 short months and having half your paycheck after that go to daycare. This of course forces the other parent to work longer hours to make up for the parent who is now unemployed or minimally employed, meaning they have less time to be home and help rear their child (particularly true in blue-collar households where neither parent is bringing home a six figure paycheck). I think that is a shame and a waste for both the parents and society; if these people had other options available to them to have children and still maintain employment they would be able to make valuable contributions in both spheres (parenthood and work) rather than be restricted entirely to one or the other. Obviously it is not entirely the responsibility of the government or employers to find this balance for individuals, but I find it equally odd to say they have no role in this or that their policies don't have a huge effect on people's opportunities and choices.

Europe is a lot like here. Developed nations everywhere are dealing with the same problems and finding different solutions. It is of course debatable which is the best, and none will be perfect, but I personally feel that we should develop policies that reflect the reality of a society and workforce composed of both parents working and support that instead of making it more challenging, because we should value parents and the contribution they make to society by raising its next generation. Everyone benefits from this and thus all should to some extent share the burden; this may be a more "socialized" view, however, than you are comfortable with.
 
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I'm sorry, my huge response was getting pretty off-topic from the OP's question. I just found some of the "all households comprised of two working parents are selfish and materialistic" stuff offensive and got way off on a tangent about how I would like the world to be. This is obviously a sensitive topic for many people with strong ideas on either side, and no obvious right answers.

To the OP, I wish you the best of luck in figuring out your family situation; obviously whatever route you choose, it can be done as people here have done it (whether "it" means having a child while you both are residents, or one of you staying at home later to care for the child, or some other solution). I would second the idea though that you are not that old and still have time to plan a family in way that works for you and your partner.
 
I want to echo what Mistress S said: a lot of people have hijacked this forum in order to criticize working parents. I won't waste much energy responding to that. To the OP, if you really want to have children during residency, go for it. Don't let a bunch of haters on SDN dissuade you.

I would recommend checking out this blog: theunderweardrawer.blogspot.com.

The author, who is now an attending, kept a blog of her experience as a resident and parent of a young child. Her husband was also a resident at the time, yet they found a way to make it work. In New York City, no less. And in competitive residencies. They used a nanny from what I remember, but everyone seemed to come out in tact. She's also the author of the now-famous scutmonkey comics you have probably seen and writes with a certain amount of wit. She also has a book coming out. Check it out.
 
Michelle Au's blog is totally awesome and I thought about recommending it, but she was in anesthesia and her husband was in ophtho when they had their first. (He's now a fellow while she's an attending and they just had their second). Obviously those are two fields which are more conducive to lifestyle and childrearing concerns (shiftwork in the one, a 50-hour week in the other) than most medical residencies.

And yes, they had a nanny. On a two-resident salary, living in a decent part of town. Both have loans. Both would laugh uproariously at the thought that they were living an "elitist, power couple" sort of life.
 
I'm sorry, my huge response was getting pretty off-topic from the OP's question. I just found some of the "all households comprised of two working parents are selfish and materialistic" stuff offensive and got way off on a tangent about how I would like the world to be. This is obviously a sensitive topic for many people with strong ideas on either side, and no obvious right answers.

To the OP, I wish you the best of luck in figuring out your family situation; obviously whatever route you choose, it can be done as people here have done it (whether "it" means having a child while you both are residents, or one of you staying at home later to care for the child, or some other solution). I would second the idea though that you are not that old and still have time to plan a family in way that works for you and your partner.

I wasn't criticizing working parents. I was criticizing the mentality that the government should make people pay other people to take time off for personal reasons. I certainly never stated that children have no value (I have them), and there has been more than one period where my wife and I were both working. Employers and employees can work out job share, unpaid leave, or even paid leave if that's the arrangement. I have no problem with any of this. I have a problem with making employers provide paid leave because someone else decided what was better for society. I have a problem with the compulsion.

However, you are right, this is off topic. I'll shut up.
 
SDN never ceases to amaze with its slew of people willing to post one-dimensional commentary on issues with which they have little or no knowledge or personal experience.

I've done med school with a small child and will do a tough residency with 2 small, small children. I do worry about finding just the right nanny but I certainly don't fret and overanalyze like many here imply that I ought.

While on q4 sub-internship call, working 90+ hrs/wk, fighting hyperemesis with my 2nd pregnancy, I was still able to pick my older child up from preschool on every day but my call days. I cook dinner EVERY night--either crockpot, cook ahead on weekends and reheat, whatever. It has been a piece of cake to get through med school. Residency will be tougher, but we'll have in-house help, local family, cheap cost of living area and a good dose of realistic expectations.

To whomever is following along, you don't always have to choose career vs. family. I don't truly believe you can 100% have it all, but you can certainly have most of it. I have more energy on less sleep than most of my colleagues, a strong sense of using time wisely, and have already learned how to manage a budget--more than can be said for many of my peers.
 
SDN never ceases to amaze with its slew of people willing to post one-dimensional commentary on issues with which they have little or no knowledge or personal experience.

I've done med school with a small child and will do a tough residency with 2 small, small children. I do worry about finding just the right nanny but I certainly don't fret and overanalyze like many here imply that I ought.

While on q4 sub-internship call, working 90+ hrs/wk, fighting hyperemesis with my 2nd pregnancy, I was still able to pick my older child up from preschool on every day but my call days. I cook dinner EVERY night--either crockpot, cook ahead on weekends and reheat, whatever. It has been a piece of cake to get through med school. Residency will be tougher, but we'll have in-house help, local family, cheap cost of living area and a good dose of realistic expectations.

To whomever is following along, you don't always have to choose career vs. family. I don't truly believe you can 100% have it all, but you can certainly have most of it. I have more energy on less sleep than most of my colleagues, a strong sense of using time wisely, and have already learned how to manage a budget--more than can be said for many of my peers.

Thank you for contributing your personal experience! Great post.
 
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Both would laugh uproariously at the thought that they were living an "elitist, power couple" sort of life.

You are sure you would classify it as "uproariously"

SDN never ceases to amaze with its slew of people willing to post one-dimensional commentary on issues with which they have little or no knowledge or personal experience.

I've done med school with a small child and will do a tough residency with 2 small, small children. I do worry about finding just the right nanny but I certainly don't fret and overanalyze like many here imply that I ought.

While on q4 sub-internship call, working 90+ hrs/wk, fighting hyperemesis with my 2nd pregnancy, I was still able to pick my older child up from preschool on every day but my call days. I cook dinner EVERY night--either crockpot, cook ahead on weekends and reheat, whatever. It has been a piece of cake to get through med school. Residency will be tougher, but we'll have in-house help, local family, cheap cost of living area and a good dose of realistic expectations.

To whomever is following along, you don't always have to choose career vs. family. I don't truly believe you can 100% have it all, but you can certainly have most of it. I have more energy on less sleep than most of my colleagues, a strong sense of using time wisely, and have already learned how to manage a budget--more than can be said for many of my peers.

Thats pretty damn impressive, again not recommended for mere mortals to try at home. What time didd preschool end?

One of the residencies I applied to had daycare in the hospital for residents, which I think is pretty cool
 
Our preschool is part of our campus, runs on daycare hours 630-600p, but has structured curriculum 800a-430. I'm one that gets to the hospital ludicrously early, notes done before rounds so residents can just addend/sign off, then get my work done, pick up an admit or two and out of there by 445-530 most nights.

Next year, we'll need to be more creative, as an intern I won't have quite as much flex in my day as I've had as a student. I've worked parttime throughout med school though, so we've saved up enough to help us afford care that offers lots of flexibility.

I think every hospital on my top 6 of my ROL has daycare in house, but my older child needs a bit more structure in her day then a general daycare, so we'd probably stick to a preschool setting +/- nanny or au pair. It is nice to know that there are in house options, great backup! I also checked for those that offer "sick care." Obviously a parent is the best option to stay home with a sick kiddo, but most daycares want them rash/fever/vomit free for 24-48 hrs before returning and that can get crazy when your kid is well but hasn't met those requirements. Sick care can be really helpful.
 
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