Having a baby during residency

[dwil75]

I am currently a first year resident and just found out I am pregnant. While my husband and I are very happy about it, I am concerned about how to manage this. Specifically, we don't have a family support network in the area to help us, and we are both very uncomfortable leaving a small baby in daycare 60+ hours a week. Is it possible to leave residency in order to raise a family and return a few years later when children are young school aged? Is an at-home child care provider affordable on two resident salaries, and if so, how easy is it to find one? Has anyone ever worked out some kind of part-time position with their PD after having a child?

I'm sure hundreds of others have found ways to cope with this challenge, and ask for any constructive, friendly advice anyone can give from real experiences, especially those, like us, who don't have grandparents or other family nearby to help, and don't want to put an infant child into full time daycare.

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[Blade28]

Wow this is a tough situation. Are you in a residency program that allows for a year-long leave of absence? Can you go into the lab to do research for a year or two? How much maternity leave time do you get?

 

[orientedtoself]

you should look into your program's maternity leave policy. at my program, you get four weeks of paid leave, and you can take more unpaid leave, but you need to make that time up at the end of residency. how old do you want your baby to be before daycare?

 

[drbon]

I'm not a resident yet, but will be in July. My husband and I will both be interns (if the Match turns out well of course!!) Now, our 1 year old is in day care, but of course our hours are much less than they will be and if he's sick (which he is A LOT being in day care) we can take off. We're planning on getting a nanny once we start residency. It's tough, most charge anywhere from $400-$600+ a week, and that's a pretty big chunk of a resident's salary, but I think it's doable if you stick to a strict budget otherwise (and maybe defer your loans, which we'll prob have to). There are also au pairs who live with you and are paid considerably less, but they have 40 hour week working caps and can't spend more than 10 consecutive hours per day in childcare. The good thing is you will be a PGY-2 and may have less hours than an intern (??). You should look at your budget, look at craigslist for ideas of nanny salaries in your area, and figure out what you can afford. Sometimes there are people who take care of a handful of kids in their homes and they tend to charge less also. Just some ideas....
It's def stressful, but a baby is sooo worth it. When I've had a horrible day at the hospital, I come home and my son makes me laugh and forget about all my worries

 

[drbon]

you should look into your program's maternity leave policy. at my program, you get four weeks of paid leave, and you can take more unpaid leave, but you need to make that time up at the end of residency. how old do you want your baby to be before daycare?

oh and P.S. Judging from the way my son's been sick from day care (basically non-stop with something all winter long, day care is not a good idea for residents unless you have someone who can stay home with the baby when he has a fever or conjunctivitis or super-rotavirus and he's not allowed at school.

 

[ms. a]

Congratulations!! That is very exciting news for the two of you!

First of all, I am not yet a resident. However, I am a 4th year med student and entered medical school with a 1 year old, who is now 5. We have no family within 1,500 miles of us. I know how you feel about day care. It terrified me. It brought me to tears thinking about leaving my beautiful daughter there, where people wouldn't be 100% focused on her at all times. Five years later, I can't imagine not having her there. She loves the place. She does so much more there than any single provider can do (mom, dad or nanny). She has learned so much more than had she been at home. She is so much more able to handle being around other kids than some other children I know that don't attend day care. Even though she's an only child, she has a core set of kids that she has grown up with, and who are pretty much like her siblings - siblings that she gets to take a break from at the end of every day. She goes 5 days a week, usually 7:30am to about 4:30 or 5pm. I'm not trying to push day care on you or anything, but I just want to try and reassure you that there are some fabulous places out there full of people who really will love your kid. It really can be a great thing.

That said, with you both being residents, you'll probably need some sort of nanny, either to supplement a day care for early mornings/late evenings/overnight call/weekends. You can get live in or live out. The salary for live-in is cheaper, however, you also have to cover room and board, so it kind of evens out. Plus, you're sharing your house with that person at all times. There are tons of nanny agencies in all major cities that do all the reference checking and background checks for you. Obviously, you'll want to get a reference for a good agency, probably from attendings in your area (chances are pretty good you'll find one that has a nanny). You can also look into an au pair. One classmate of mine went through Au Pair Care for 2 au pairs (they only stay one year at a time) and had pretty good luck with them. There are several other au pair agencies, as well.

Good luck!

 

[ms. a]

P.S. Certainly, day care can be a big source of infection (sorry to hear about your son drbon!!), but it's not universal. In the 5 years my daughter has been in day care, she's been sent home about 5 times, if that.

 

[SoCuteMD]

Michelle Au, other of The Underwear Drawer blog and comics has blogged extensively about her experience as Mom, wife, and 1/2 of a 2 resident couple. I know they had a nanny at one point and she's written about it. A nanny on a two-resident salary is doable, but will cut into a number of other "luxuries."

I think taking years off is an exceptionally bad idea. It's going to be tough to come back and you'll be way behind the learning curve. Some PDs work out "shared" residency positions where two residents may work half of the schedule, but this requires a willing PD and another person in a similar situation.

Best of

 

[Blade28]

It's tough, most charge anywhere from $400-$600+ a week, and that's a pretty big chunk of a resident's salary, but I think it's doable if you stick to a strict budget otherwise (and maybe defer your loans, which we'll prob have to).

Wow I had no idea it was that expensive! That's around $2k a month?! After taxes, you don't pull in much more every month.

 

[Sharkfan]

ms a., which daycare in Houston is this, and how expensive are we talking?? (If you don't feel weird semi-advertising for it...)

 

[gutonc]

I am currently a first year resident and just found out I am pregnant. While my husband and I are very happy about it, I am concerned about how to manage this. Specifically, we don't have a family support network in the area to help us, and we are both very uncomfortable leaving a small baby in daycare 60+ hours a week. Is it possible to leave residency in order to raise a family and return a few years later when children are young school aged? Is an at-home child care provider affordable on two resident salaries, and if so, how easy is it to find one? Has anyone ever worked out some kind of part-time position with their PD after having a child?

I'm sure hundreds of others have found ways to cope with this challenge, and ask for any constructive, friendly advice anyone can give from real experiences, especially those, like us, who don't have grandparents or other family nearby to help, and don't want to put an infant child into full time daycare.

If you're both in the same residency program (and it's something family friendly like IM/Peds/FM/Path/Psych/EM) you might have the option of sharing a position w/ you spouse so that you basically switch off blocks/months w/ each other. This might be tough to do during your intern year but much easier after that. My program has a couple, technically PGY2 although their class is PGY3) that had a baby at the end of intern year. She took 3 mos off, he finished up the year. Since then they've split a position and only very rarely had to deal w/ child care (occ they both have clinic the same day).

As for day care, our now 10 month old went into day care @ 5 mos of age and it's the best thing we could have done for all 3 of us. YMMV of course but both my wife (a civilian) and I would have gone insane if we were full-time caregivers. Sure, there are the q2-3 week viral URIs that cause a sleepless night (and the 4 days of croup which really sucked) but it's not the end of the world. Plus, you'll get the chance to spread some good stuff back into the mix. I was the sentinel case of a rotavirus infection that swept through daycare...thanks Vets.

 

[Winged Scapula]

In response to the OP:

it is possible to take a LOA, but if you are taking years, then I suspect nearly every residency program will require you to repeat your intern year as you will be too far out from clinical medicine.

 

[orientedtoself]

you have the right to 12 weeks of unpaid maternity leave per fmla. you could take your 12 weeks and then request a couple of outpatient electives after that.

 

[ms. a]

ms a., which daycare in Houston is this, and how expensive are we talking?? (If you don't feel weird semi-advertising for it...)

Unfortunately, mine isn't open to the public and the cost structure is unique. I'll PM you.

However, several classmates of mine have day cares that are around the med center and are very, very happy. Usually, for an infant room, they're paying around $1000, then costs go down with each older room, around $50-75 each time.

Yeah, a good, full-time nanny will run you $2,000 a month - at least.

 

[Brunette1981]

I knew a GS/plastic surgery couple (worked with each separately during my MS3 block) who had two nannies due to their hours and an infant. The husband (GS) complained his daughter didn't recognize him yet but knew his wife and the nannies.

I don't know how they afforded it but one nanny alone (if not + daycare) may not be enough for 2 residents because many prefer to work normal business hours rather than resident hours.

 

[gutonc]

you have the right to 12 weeks of unpaid maternity leave per fmla. you could take your 12 weeks and then request a couple of outpatient electives after that.

FMLA only kicks in after 12 months w/ an employer. Your program/hospital may have a more lenient policy or your state (Oregon is one such place) may have a state program that takes precedence over the federal program.

 

[Pinki]

Also not a resident, but I step up to offer advice as a 4th year who had two children during med school and a husband who works as an architect, so pretty regular professional hours. Nearest family of any sort is 1000 miles away. It's totally doable, you just need to plan accordingly.

We have done both a nanny and now a small, non-chain (i.e. not KinderCare) daycare, and I have to say without a doubt, daycare wins out for us. We live in metro Phoenix and pay 950 a month for EACH child - so that's close to 2K/month for TOP quality childcare with preschool enrichment for my older daughter. We did it on the up and up, i.e. not under the table and our nanny was 600 a week plus taxes, social security, etc.

With daycare, you have professional, compassionate, nurturing care, developmentally appropriate learning situations and most importantly, accountability. With a nanny, you're at the whim of another person's personal, health, financial life.

If you do change your mind and consider daycare, I suggest you get on a waitlist NOW! Top notch centers have 18 month + waiting lists for infant care.

Good luck - welcome to the joys and challenges of parenthood...and you thought residency was hard...there is no 80-hour workweek regulation on being a mommy! But it's soooo much fun!

 

[bandit5095]

I am not quite at that point in my life, but I seem to always look into the future to much so I was wondering what would be the most woman friendly residencies (for a woman who really to have a family?)

Also this may sound crazy, but I am a first year medical student and I am thinking of switching to a PA merely so that I can have more of a family life? I am top of my class thus far in medical school, so am really struggling with moving "down" so to speak, but I also know that I really want to be a mother and am thinking that becoming a PA and not having to worry about going through a residency may then be a better route for me. I know PA is NOT a doctor but it may allow me to be a part of the medical field which I love and still have a family.

Is it possible to really have time for a family and become a doctor? And is it completely crazy to be thinking of changing to a PA? I know I ultimately have to make the decision, but would love to hear what others (some of which have starting families in residency) think. Thanks a lot

 

[orientedtoself]

see this thread for a discussion of specialties friendly to dr. moms. also would recommend checking out mommd.com- lots of advice on balancing career and family.

as far as the pa vs md thing, that is a decision you are going to have to make yourself. as an ms1, you are not too far in the hole as far as debt goes. quitting medical school could be an option if you choose.

I am not quite at that point in my life, but I seem to always look into the future to much so I was wondering what would be the most woman friendly residencies (for a woman who really to have a family?)

 

[renogirl]

Hi
I wnated to respond to your question because I remember the panic I felt 10 years ago when I got pregant 3 weeks into internship. (Try cutting coffee, being pregant and working a 36 hour shift every 3rd night)

I finished my PGY1 year and took an indefinite leave of absence from the categorical program. I went back when my daughter was one to finish out the 4 weeks to get the intern certificate (in my state you only need 1 year to get a permanent medical license). I ended up having another baby and now 9 years later, I am trying to figure out what to do with my life as a licensed, not board eligible MD. My program director told me that it will be extrememly difficult to get back into a residency. I have to repeat intern year again.

There are not a lot of jobs for a non board eligible MD. I am considering teaching or maybe a pharmaceutical position.

Think carefully before you take a leave of absence. It is difficult to get back in as a PGY2 and if more than a few years go by, you will have to repeat PGY1. You will get through the worst year while you are pregant. Each year gets progressively easier. By the time, the baby is 1, you will almost be a third year where half your year is electives. I really wish I had just finished the residency. I actually think my kids would miss me more now if I go back to residency because they are older and I am so involved in their lives.

Good luck. Have a healthy, happy pregnancy!

 

[Blade28]

There are not a lot of jobs for a non board eligible MD.

Moonlighting? Locum tenens? Urgent care?

Consulting? Biotech? Pharma (as you mentioned)? Research?

 

[lilnoelle]

I'm not a resident, but I do have two children in daycare and the price quoted above seems very high for one child. I think it depends a lot on your location and the type of daycare you use (or if you use a nanny). I'm in Kansas City and daycare runs somewhere around $175 a week for an infant. It gets cheaper as your child ages. I pay $255 a week for my 2 year old and 4 year old and love my current situation. My children are in an in home daycare that is run by a grandma and grandpa that have done daycare for over 10 years. The daycare has about 6 kids (two of which are my children) and the providers are just great. Honestly, they're probably better with my kids than I am. The only thing that would be better as far as I'm concerned would be for my own parents to watch them.

A nanny or au pair is probably more realistic since both your husband and you will be residents. Most daycares that I'm aware of are open from around 6:00 am to 6:00 pm. There are some daycares that offer alternative hours, but its not all that common.

 

[ajlmd]

I have a few friends who got through surgical residency far away from home with a child (and either no spouse or one that couldn't stay home.) Being that your spouse will also be earning a resident salary, I think I'd hire a nanny, realizing that it will take a good portion of one person's monthly income to support this. You can either defer or put your loans in forebearance (basically not have a payment throughout residency.)

From the experience of my friends that have been through this, though it's not easy, it is doable; plus, sometimes nannies will help out around the house (one of my friend's does laundry and cleans.)

 

[Blade28]

You can either defer or put your loans in forebearance (basically not have a payment throughout residency.)

I think most every resident has to do this. They don't pay us enough to do otherwise!

 

[jfr9]

This has been really helpful to me. I'm about to start my intern year and am pretty scared about leaving my 1-year old!

We started daycare about 2 months ago at a great program run by our school/hospital. It is pro-rated depending on salary (every resident should look for one of these).

I was terrified to leave him -- I am fortunate in that my husband works from home (he's a writer) so we only use it part-time. I want to confirm what many have said -- I thought it would be terrible for him, when it's the best think ever! He has become wonderfully social, learned tons of new words there, and is thriving.

I always say, my children would never want me to have a job that I didn't love just so that I could spend all day long with them for 5 years of their lives. I really believe that I am a better mother for doing what I always wanted to do, and loving my job -- I just make sure to keep the order correct: family first, work second. The hours may be currently devoted more to work, but I know that is temporary, and so does my family.

I definitely plan on having another baby in residency -- radiology allows for that.