My wife is a 2nd year resident. We have 2 kids. One of which we had at the end of her 4th year (and she actually took the first month of internship off on leave-and sacrifed her elective rotation as well as all of her vacation time). He is almost 2 now and is a handful. Residency has been tough. With two kids, a new house, I work as an engineer... I don't know how we do it, but we do... My kids go to daycare. I pick them up around 5:00 when I am done. I do the dinner, the diapers, the baths, etc. My wife on a good day makes it home for a late dinner (after 7:00). Sometimes it is 9:00, sometimes she does the overnight thing... Some months are better than others, some months really suck (one month I did not see her at all except when she was sleeping). The house is a mess, chores often get left undone... When I am busy at work, I have to sacrifice... (I can not do overtime, etc...) even though my paycheck pays the bills. (Her paycheck is a joke for the time she puts in...) Her residency has been in the center of many arguments, because it has been really hard. But... we still get by... It is a bumpy road... financial issues, kids issues, STRESS... (lot's of it) but we have managed to get by so far and raise our kids, and keep a marriage going happily. 4 years of Med School and 2 years of Residency down, 1 more year of Residency and 3 years of Fellowship to go. (6 down, 4 to go)
It can be done! Good Luck!