Maternity leave during residency

[nope80]

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Just curious but how much maternity leave did your residency/fellowship programs offer? And what is the typical time frame in which one lets their program know about their news - as in how early is too early and when is too late?

 

[jdh71]

Just curious but how much maternity leave did your residency/fellowship programs offer? And what is the typical time frame in which one lets their program know about their news - as in how early is too early and when is too late?

Well. From what I've seen this a bit of a interesting topic. In my experience most places will essentially allow you about as much maternity leave as you want - based on state and federal laws there is so much that they HAVE TO allow - within "reason". If you want three to six months it shouldn't be a huge problem as long as it is worked out in the schedule before hand. With that said . . . per the training rules you will have to extend your residency and fellowship to make up for those months when you were on maternity leave. If you want to be at home and be a mommy to an infant? GREAT!! But that's not clinical time, so don't expect to be able to finish on time.

Now, some places will attempt to bundle up your "electives" in such a way so that you might be able to squeeze out a month, maybe two without having to use vacation or extend training beyond when you would have been done had you not done the maternity leave. Though, most places will probably make you use vacation, and will also be very strict about missed clinical time.

One more thing to bear in mind, your absence from any program for an extended period of time, especially in fellowship, SCREWS the other people in your training program. There is always "X" amount of work that needs to be done. In residency, this usually amounts to X/30, so you can get usually move things in such a way that the burden isn't too bad, spread around, but in fellowship it's more like X/3 of X/4 . . . so plan wisely, because most people are not sociopaths and try to help each other out, but good will only extends so far when it starts to prolonged impact other people's free time and time with their spouses and children for instance.

Just remember you are not an island, and in training your choice to have children WILL affect other people. So plan, plan, plan, plan. It may not be "fair", but life isn't. Good luck.

 

[nope80]

thanks for the thorough response. i completely agree w everything you posted. when do people typically tell program - as soon as you know or is it appropriate to wait a little?

 

[jdh71]

thanks for the thorough response. i completely agree w everything you posted. when do people typically tell program - as soon as you know or is it appropriate to wait a little?

I mean you obviously don't have to tell everyone, but I think letting your PD know you're going to try would be good even before, but you should definitely let them know as soon as you know you are pregnant (and we are all docs so we know that sometimes it doesn't take, but the PD should be in the loop because we all hope it does take, right??) because that gives them time to prepare and try and arrange something.

 

[VentJockey]

When I was rotating as a medical student in an unnamed program, one of the female residents got pregnant. She announced it at morning report, and announced who the father was--one of her fellow residents. Everyone was fine with it. Then she got the quantitative HcG, and that changed her opinion of who the father was....to a different one of the residents. It was quite the spectacle. No one was mad at her. I think everyone was highly amused by the whole situation.

 

[drkristy85]

When I was rotating as a medical student in an unnamed program, one of the female residents got pregnant. She announced it at morning report, and announced who the father was--one of her fellow residents. Everyone was fine with it. Then she got the quantitative HcG, and that changed her opinion of who the father was....to a different one of the residents. It was quite the spectacle. No one was mad at her. I think everyone was highly amused by the whole situation.

i don't get it?

 

[Crayola227]

i don't get it?

the quantative gave her a different timeframe for conception.... hence, different father was deduced

I think the moral was be careful about your pregnancy announcments

 

[Crayola227]

I mean you obviously don't have to tell everyone, but I think letting your PD know you're going to try would be good even before, but you should definitely let them know as soon as you know you are pregnant (and we are all docs so we know that sometimes it doesn't take, but the PD should be in the loop because we all hope it does take, right??) because that gives them time to prepare and try and arrange something.

I disagree here that you should NOT tell them you are trying. Make this seem like an accident, but one that wouldn't be stupid for a doctor to have. You can't tolerate hormonal methods and your uterus has shoved out IUDs in the past... so condoms, the condom broke, and surprise! Plan B doesn't always work. Or whatever, in hindsight I see that's contrived.

In any case, purposeful or not, anything that shifts the schedule or puts burden on the program will get you resentment. If you are MAKING A CHOICE inconvenient to them AND they see it coming.... well, there's more than one way to fix a schedule or deal with a resident down....

You tell them you're trying for a baby, and then two weeks later they email everyone saying they're looking at hiring another resident off-cycle for whatever fancy pants reasons and please put the word out. Meanwhile, they start amassing a case for why you should be let go, put you on probation, and sure maybe somewhere in this story you get pregnant, get your leave, but then you get washed out. Sure, the timing looks fishy, you could sue, but since you gave them the tip off they were able to see it coming and made a great case to justify your termination in a way that would stand up in court, or force your resignation. Unfair? Yes. Illegal? Only if you can prove it in court. Very rare outcome? Yes. Very very bad outcome, like career ending? Yes.

So don't tell them off the bat that they should consider re-hiring before you can become an inconvenience. And like jdh, think long and hard before becoming an inconvenience. Yes, your uterus is an inconvenience in your career.

TLDR
don't tell them you're trying to have a baby they will just hate you for it
but yeah when it happens tell them ASAP
your uterus is a massive inconvenience to your medical career, sorry

 

[Crayola227]

When I was rotating as a medical student in an unnamed program, one of the female residents got pregnant. She announced it at morning report, and announced who the father was--one of her fellow residents. Everyone was fine with it. Then she got the quantitative HcG, and that changed her opinion of who the father was....to a different one of the residents. It was quite the spectacle. No one was mad at her. I think everyone was highly amused by the whole situation.

and by amused you mean amused and then ultimately relieved because while they had all been amused by sleeping with her it was less amusing when they found out that not only was she sleeping around the program (the amusing part), but apparently was doing it sloppily enough not to know which act of unprotected intercourse knocked her up, so then really it was that they were then relieved not to be the father

the ladies in the program probably found this amusing.... but probably not in a "laugh with you" kind of way

my disdain here isn't for sleeping around so much, as it is for sleeping around your program, as well as the fact that for her to really be that unsure of the father and an unplanned pregnancy implies some less than ideal health practices (unplanned pregnancies should be discouraged from public health/folate perspective alone) which will always make Dr. Crayola frown

 

[Raryn]

I disagree here that you should NOT tell them you are trying. Make this seem like an accident, but one that wouldn't be stupid for a doctor to have. You can't tolerate hormonal methods and your uterus has shoved out IUDs in the past... so condoms, the condom broke, and surprise! Plan B doesn't always work. Or whatever, in hindsight I see that's contrived.

In any case, purposeful or not, anything that shifts the schedule or puts burden on the program will get you resentment. If you are MAKING A CHOICE inconvenient to them AND they see it coming.... well, there's more than one way to fix a schedule or deal with a resident down....

You tell them you're trying for a baby, and then two weeks later they email everyone saying they're looking at hiring another resident off-cycle for whatever fancy pants reasons and please put the word out. Meanwhile, they start amassing a case for why you should be let go, put you on probation, and sure maybe somewhere in this story you get pregnant, get your leave, but then you get washed out. Sure, the timing looks fishy, you could sue, but since you gave them the tip off they were able to see it coming and made a great case to justify your termination in a way that would stand up in court, or force your resignation. Unfair? Yes. Illegal? Only if you can prove it in court. Very rare outcome? Yes. Very very bad outcome, like career ending? Yes.

So don't tell them off the bat that they should consider re-hiring before you can become an inconvenience. And like jdh, think long and hard before becoming an inconvenience. Yes, your uterus is an inconvenience in your career.

TLDR
don't tell them you're trying to have a baby they will just hate you for it
but yeah when it happens tell them ASAP
your uterus is a massive inconvenience to your medical career, sorry

Holy jeebus the paranoia.

This is Internal Medicine, not a surgery program circa 1970. The mean program has 15 spots/year, and most academic programs are significantly larger than that. It's not THAT much of a hardship to rearrange a call schedule 6 months in advance to adjust for a planned maternity leave and my program does it for 2-3 residents every year. Some of them even choose to take a few months. No repercussions other than the ACGME/ABIM mandated delay in graduation if you lose more than 30 days in any given year. The same is true programs at other institutions I'm familiar with. We also have a couple people taking paternity leave every year, though that is more commonly just a couple weeks. I don't know what the maximum paternity leave they can take is, as I haven't had any kids myself.

If you get pregnant and want to have the child in residency, congratulations. Let your program, including PD and whatever chief is in charge of scheduling, know ASAP what your expected due date is once you're pregnant. There's no point to tell them if you're just trying, because scheduling around maybes is just silly. It might take you six months to get pregnant. No one will ask you if it was intentional or what birth control you were using. That's nuts. Expect them to reschedule your more intense rotations to either before or after your third trimester so that you still have the same amount as your co-residents. You will probably lose some elective time, and if you take >30 days (not including using up your vacation time) you will have graduation delayed.

I don't know wtf kind of malignant program Crayola went to, but please understand that her attitude is not at all reflective of the norm.

 

[jilliumm]

Just curious but how much maternity leave did your residency/fellowship programs offer? And what is the typical time frame in which one lets their program know about their news - as in how early is too early and when is too late?

Chief here. Our program culture is to tell a chief ASAP so that your schedule can be modified to make it as feasible as possible for you to take the time off you want and come back to light rotations. I had a baby PGY3 year and told our scheduling chief as soon as I knew (5 weeks prego). I took 6 weeks off and came back to 2 months of research. It was awesome.

I like to know if folks are trying if they want to tell me. That way it's on our radar and we can try to make a schedule that is easily modified to accommodate a pregnancy with minimal disruption to other resident's schedules. You can't plan for you own fertility, though, obviously.

 

[rokshana]

Holy jeebus the paranoia.

I don't know wtf kind of malignant program Crayola went to, but please understand that her attitude is not at all reflective of the norm.

GOES to...evidently she is an intern in an EM program in boston...

 

[Crayola227]

GOES to...evidently she is an intern in an EM program in boston...

Nope

Just said I knew people there
and that I had done a fair number of ED rotations

 

[Crayola227]

Holy jeebus the paranoia.

This is Internal Medicine, not a surgery program circa 1970. The mean program has 15 spots/year, and most academic programs are significantly larger than that. It's not THAT much of a hardship to rearrange a call schedule 6 months in advance to adjust for a planned maternity leave and my program does it for 2-3 residents every year. Some of them even choose to take a few months. No repercussions other than the ACGME/ABIM mandated delay in graduation if you lose more than 30 days in any given year. The same is true programs at other institutions I'm familiar with. We also have a couple people taking paternity leave every year, though that is more commonly just a couple weeks. I don't know what the maximum paternity leave they can take is, as I haven't had any kids myself.

If you get pregnant and want to have the child in residency, congratulations. Let your program, including PD and whatever chief is in charge of scheduling, know ASAP what your expected due date is once you're pregnant. There's no point to tell them if you're just trying, because scheduling around maybes is just silly. It might take you six months to get pregnant. No one will ask you if it was intentional or what birth control you were using. That's nuts. Expect them to reschedule your more intense rotations to either before or after your third trimester so that you still have the same amount as your co-residents. You will probably lose some elective time, and if you take >30 days (not including using up your vacation time) you will have graduation delayed.

I don't know wtf kind of malignant program Crayola went to, but please understand that her attitude is not at all reflective of the norm.

I liked your post Raryn. It's a good balanced view.

So the chances of being attacked while you walk to your car at 8 pm at night in the largely empty Walmart parking lot is pretty low. Safety experts would still advise that you already have your car keys out, that there is even a way to carry your keys in such a way to make them a good stabbing weapon to the eyes of an attacker, and to have a mini-flashlight or LED with you and to light and check the backseat of your car for an intruder lying in wait, that is assuming you don't do the best thing which is be escorted to your car by security or even just a regular employee.
I imagine that to some extent how seriously you take low-likelihood highly-horrible possible risks in life is definitely skewed by experience.

It's TMI but I've.... had really bad things happen to me in more than one way more than once in my life, and yeah, it shows. Anyone who's been the victim of such malignancy no longer sees rare possibilities but rather is rebuilding from the destruction, usually after being told "but it won't happen to you." So they are the people you see passionately advocating for people to carry pepper spray to the car (I do) and to approach a program (especially a new program, so this goes out more for kids trying to at least get an internship and hence be employable under their belt) with kid gloves.

You won't know what kind of program you're in for at least a few months, and you can always get blindsided even further in. I just urge extreme caution from the outset. If you get nothing else from these boards or my posts, it's just that human weakness is not exactly well tolerated in medicine, therefore your job is to hide it as much as possible until you feel safe and can slowly, carefully, thoughtfully reveal it when you must.

So yeah, admittedly my view is the most paranoid out there. Consider me one of these safety experts on TV telling you to buy a windshield breaker/seatbelt cutter that is secured to driverside door on the off chance your car goes off a bridge into water and you need to escape the vehicle. That's what the safety experts would tell you to have in your car.

 

[ArkansasMed]

I liked your post Raryn. It's a good balanced view.

So the chances of being attacked while you walk to your car at 8 pm at night in the largely empty Walmart parking lot is pretty low. Safety experts would still advise that you already have your car keys out, that there is even a way to carry your keys in such a way to make them a good stabbing weapon to the eyes of an attacker, and to have a mini-flashlight or LED with you and to light and check the backseat of your car for an intruder lying in wait, that is assuming you don't do the best thing which is be escorted to your car by security or even just a regular employee.
I imagine that to some extent how seriously you take low-likelihood highly-horrible possible risks in life is definitely skewed by experience.

It's TMI but I've.... had really bad things happen to me in more than one way more than once in my life, and yeah, it shows. Anyone who's been the victim of such malignancy no longer sees rare possibilities but rather is rebuilding from the destruction, usually after being told "but it won't happen to you." So they are the people you see passionately advocating for people to carry pepper spray to the car (I do) and to approach a program (especially a new program, so this goes out more for kids trying to at least get an internship and hence be employable under their belt) with kid gloves.

You won't know what kind of program you're in for at least a few months, and you can always get blindsided even further in. I just urge extreme caution from the outset. If you get nothing else from these boards or my posts, it's just that human weakness is not exactly well tolerated in medicine, therefore your job is to hide it as much as possible until you feel safe and can slowly, carefully, thoughtfully reveal it when you must.

So yeah, admittedly my view is the most paranoid out there. Consider me one of these safety experts on TV telling you to buy a windshield breaker/seatbelt cutter that is secured to driverside door on the off chance your car goes off a bridge into water and you need to escape the vehicle. That's what the safety experts would tell you to have in your car.

....

This has to be the most paranoid response I've read since being a member and really doesn't reflect most programs ideology. Would hate people to hold off having kids after reading this post thinking this crap really happens... None of my fellow peers have been chastised to this level for having children in medicine. Hell, I've heard of a PD let a male resident leave for an extended time to be with his wife in another city and just call jeopardy for a few months. No one held it against him. Reading this is as if a paranoid schizophrenic wrote it (no offense).

95%+ programs are going to be supportive of you having children in residency. Most people are not sociopaths and understand that resident happiness is strongly tied to family. This isn't the good 'ol days.

Please go and have families. Live your life and understand that having kids during med school, residency or as an attending will be hard. Don't lose out on probably one of the best joys in fear you will be chastised (you will have a massive lawsuit on your hands FYI).

 

[Crayola227]

Well you'll have to tell your bosses about the pregnancy to the extent you might get dragged into procedures where they use fluoro. And you will need some schedule flexibility for appointments. At a university program they are going to have you mostly doing floor work anyhow, which is better for you. I know plenty of people that gave birth intern year -- their successes all turned on what kind if support system they had at home - ie can you pop out the kid, just leave it with someone (family member, ideally) and then run back to work after whatever maternity leave is allowed?

Just one attending's attitude on the matter if you were curious.
Representative? I dunno. Ask yourself.

 

[22031 Alum]

Going to repeat what I have said earlier. @Crayola227 is not having a normal residency experience by any stretch of the imagination, and their posts should be read with that in mind.

Most programs that have even a modicum of respectability, want their residents to succeed. Even the more malignant programs don't want to end up on the ACGME's radar by constantly losing residents for ANY reason, shady or not. That isn't to say there aren't programs that don't care, and who see their residents as worth nothing more than the work they can do. It's just that these programs are not the norm- think IMG mills who take advantage of those who came for lack of other options.

 

[Crayola227]

I have been there, exactly. I found out I was pregnant on the second day of R2 year (in surgery) and it was equally unplanned. For all the smug idiots out there, there is an enormous difference between accepting theoretically a risk that heterosexual sex leads to babies versus actively attempting to conceive one.

Firstly, what specialty is your husband in? The flexibility or lack thereof of his schedule will make all the difference. My husband is a corporate litigator gone for weeks at a time at trials, so that colored my experience. My surgical friends who had babies in residency were married to: 1) a house-husband; 2) attendings x 3; 3) a medicine resident [they were able to arrange their call so they were never on on the same night]; 4) a work-at-home realtor; 5) an engineer with banker's hours; 6) a banker with banker's hours. Most of them had family in the area-- and many of the attendings had live-in help. So they had dramatically better experiences.

Secondly, accept the fact right now that once your 28d maternity leave is up (which is what the Surgery RRC allows-- your program might give you 6 weeks, but you will have to make up the extra 2 weeks in the future by either graduating 2 weeks late or giving up all of your vacation one year) that you will, at most, be providing approximately 5-10% of the child care. You will need to make some kind of formal-- likely commercial-- arrangement to cover the other 90-95%. Surgical schedules are absolutely not conducive to regular daycares, which at best are only open for 12 hours a day and never on weekends or holidays. Nannies are usually contractually limited to working a total of 50 hours a week. Again, depending on your husband's flexibility and the availability of family member to provide *routine, reliable, free* child care, you should expect at minimum to pay for both daycare and an early morning/evening/weekend nanny. This is very expensive (I was paying $3500/month, 100% of my salary). If your husband & family are able to shoulder the load, wonderful-- just accept the fact that your bonding with the baby will be on your golden weekends, and in the evenings after s/he sleeps and in the AM before s/he awakens.

Thirdly, obviously you will work up until the day the baby is born, barring medical complications of pregnancy. The only modifications to your duties you need are being excused from the OR during fluoro procedures when you're on vascular. Personally at the very end of pregnancy I found being in the OR very difficult, physically-- it was difficult to approach the table and the heat from the bair hugger would vasodilate everything in the abdomen which made me quite light-headed. But as in intern in an academic program, that's less of a concern. 🙂

Fourthly-- by all means, take your research time early. Since you mentioned you're in an academic program, I assume you're looking at 5+2. If your program is remotely flexible, you could even consider going out into the lab after your first year. Since your baby is due in April, you'll go back after mat leave in May, and you'll only have 8 weeks max to scramble for child care before you go out into the regular banker's hours lab time. Might be a godsend.

You are not the first person to make it work, but please do not think that it's easy, and please do not think that residents in other specialties' experiences are remotely applicable to yours. You will find yourself in horrible zero-sum Catch-22s all the time-- fun things like "it's 6:30, my daycare is closing in 10min, if I don't pick up my child they call CPS at 7, but my patient is coding and night float isn't here yet." It's not PC to say this but it's true: you will be a worse resident because you have a kid. Is it worth it? I definitely think so, and I'm extremely grateful for my happy little accident.

 

[Aralc]

This thread is why you need to ask these questions before you put in your rank list. Honestly, I let the PDs know when I was interviewing - I figured that if it made a difference in how they ranked me, I didn't want to go there. I matched first choice.