Maternity leave in residency

[Belleza156]

If there are any EM mom's out there, especially if you were in residency during your pregnancy, what is best: extend maternity leave and extend residency or take a shorter maternity leave and try to finish up and graduate sooner.

I'm a PGY3 in a 3 year program, supposed to deliver in February. I am still unsure if I should work shifts up until I'm supposed to deliver or start maternity leave 2 weeks before? If I'm scheduled and go into labor early then those will all be shifts I owe back to a specific person.

If I take only 4 weeks maternity leave + 2 weeks vacation then I should only have 1 month to make up. When I tell nonEM ppl this plan they appear horrified I won't take more maternity leave. I'm trying to schedule 2 nonEM rotations after maternity leave so that I won't be thrown straight into crazy ED shifts. Hopefully, that pans out.

At the end of the day I need to make the decision now before the time comes since the schedule will be coming out soon. I don't have the luxury of seeing how I feel in my 9th month. Anyone who works ED shifts when pregnant, what would you say is the best maternity leave strategy? Take total of 6 weeks which includes my vacation, or prolong maternity leave for 8-12 weeks.

If I finish residency with only 1 month owed back, and I want to take time to be with the baby before going to work as an attending, at what point does my health insurance cut out?

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[Tenk]

A lot of our residents took a couple extra weeks off and had to "pay back" the time at the start of July by doing some extra ED shifts. Ultimately if you can't work, you can't work and you will just have to make up the time later. Regardless, it is not the end of the world and hopefully your program will be accommodating.

Most programs will cut your insurance as your employment ends but some will allow you to buy coverage for a few months until you start your new job at a pretty decent price.

Good luck and congrats!

 

[deleted547339]

If there are any EM mom's out there, especially if you were in residency during your pregnancy, what is best: extend maternity leave and extend residency or take a shorter maternity leave and try to finish up and graduate sooner.

I'm a PGY3 in a 3 year program, supposed to deliver in February. I am still unsure if I should work shifts up until I'm supposed to deliver or start maternity leave 2 weeks before? If I'm scheduled and go into labor early then those will all be shifts I owe back to a specific person.

If I take only 4 weeks maternity leave + 2 weeks vacation then I should only have 1 month to make up. When I tell nonEM ppl this plan they appear horrified I won't take more maternity leave. I'm trying to schedule 2 nonEM rotations after maternity leave so that I won't be thrown straight into crazy ED shifts. Hopefully, that pans out.

At the end of the day I need to make the decision now before the time comes since the schedule will be coming out soon. I don't have the luxury of seeing how I feel in my 9th month. Anyone who works ED shifts when pregnant, what would you say is the best maternity leave strategy? Take total of 6 weeks which includes my vacation, or prolong maternity leave for 8-12 weeks.

If I finish residency with only 1 month owed back, and I want to take time to be with the baby before going to work as an attending, at what point does my health insurance cut out?

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Impossible to say. There is no way my wife could have worked during her last 2 months of pregnancy. But I know women who have worked up until they started having contractions.

What I will say is that you should try to find a way so that the other third year residents aren't the ones covering you. If you can find a way to get the 2nd and 1st years to cover your shifts, that would be ideal. Theres just no way to pay back graduating third year residents and, right or wrong, will likely lead to a lot of resentment.

 

[wonderbread12]

If there are any EM mom's out there, especially if you were in residency during your pregnancy, what is best: extend maternity leave and extend residency or take a shorter maternity leave and try to finish up and graduate sooner.

I'm a PGY3 in a 3 year program, supposed to deliver in February. I am still unsure if I should work shifts up until I'm supposed to deliver or start maternity leave 2 weeks before? If I'm scheduled and go into labor early then those will all be shifts I owe back to a specific person.

If I take only 4 weeks maternity leave + 2 weeks vacation then I should only have 1 month to make up. When I tell nonEM ppl this plan they appear horrified I won't take more maternity leave. I'm trying to schedule 2 nonEM rotations after maternity leave so that I won't be thrown straight into crazy ED shifts. Hopefully, that pans out.

At the end of the day I need to make the decision now before the time comes since the schedule will be coming out soon. I don't have the luxury of seeing how I feel in my 9th month. Anyone who works ED shifts when pregnant, what would you say is the best maternity leave strategy? Take total of 6 weeks which includes my vacation, or prolong maternity leave for 8-12 weeks.

If I finish residency with only 1 month owed back, and I want to take time to be with the baby before going to work as an attending, at what point does my health insurance cut out?

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First, congrats!

I'm not much help on the specific timeline your asking but I will say that I believe you'll end up wanting more time with your new one. They are so fragile and little, unless you have your mom, spouse, or some close relative taking care of your new infant it'll just be that much more difficult. There's no perfect time because the whole maternity/paternity leave expectations in this country but alas you have to make a choice.

If you have a good support system you can do what you want and you'll feel comfortable. If you are relying on daycare, you'll start to loathe your shifts. We delayed as much as possible but it just had to happen and I still hate some of my shifts. Also, don't forget about pumping breast milk during shifts. Makes life all the more difficult but your little one will be worth it. Enjoy!

Oh yeah I wish someone prepped me but be prepared for no one to care that you have an infant to go home to even though it will be on your mind most the time

 

[msgsk]

I agree with most of what was written here - my wife had a baby during her ER residency. Different situations for everyone but being on your feet near the end of your third trimester can definitely make you deliver a week or so earlier than you are expecting. Numerous female ER docs have told me they delivered a little earlier than expected because of the excess walking. If you don't mind that (ie have a complication-free pregnancy) then I would try to work beforehand until the delivery date to make up as little as possible afterwards. If you have an elective or off-service month that isn't mandatory for graduation, see if they'll let you use that month to make some shifts up. You'll want to spend as much time as possible after the baby is born breastfeeding and eating his/her cheeks.

 

[21isFun]

Impossible to say. There is no way my wife could have worked during her last 2 months of pregnancy. But I know women who have worked up until they started having contractions.

What I will say is that you should try to find a way so that the other third year residents aren't the ones covering you. If you can find a way to get the 2nd and 1st years to cover your shifts, that would be ideal. Theres just no way to pay back graduating third year residents and, right or wrong, will likely lead to a lot of resentment.

This exactly. I saw this happen in our residency, because the classmates not only had to pick up the slack of being down a resident in the class (extra night shifts each month, seeing more patients since juniors were filling a senior shift, etc), but also weren't going to be paid back in the end. Definitely leads to some resentment. And it seemed to be amplified when people came back from leave and were taking extra breaks to pump, and would disappear 2-3 times per shift to pump-leaving others to deal with critical patients or deal with problems with patients that weren't their problem. It made people remark that a 2 month maternity leave dragged out to a 6-8 month impact on the program. Right or not, people weren't happy that someone else's decisions were making their lives harder, and there would never be any restitution of sorts. Just be prepared for some to be supportive and others not so much.

 

[Anonymous M4]

Take the time. Work until you can't. Take all the time with baby. I took 2 months and am extending by 1 month no biggie. But it still wasn't enough for me.

 

[Belleza156]

This exactly. I saw this happen in our residency, because the classmates not only had to pick up the slack of being down a resident in the class (extra night shifts each month, seeing more patients since juniors were filling a senior shift, etc), but also weren't going to be paid back in the end. Definitely leads to some resentment. And it seemed to be amplified when people came back from leave and were taking extra breaks to pump, and would disappear 2-3 times per shift to pump-leaving others to deal with critical patients or deal with problems with patients that weren't their problem. It made people remark that a 2 month maternity leave dragged out to a 6-8 month impact on the program. Right or not, people weren't happy that someone else's decisions were making their lives harder, and there would never be any restitution of sorts. Just be prepared for some to be supportive and others not so much.

I wish there was a way I could plan ahead and warn the chiefs to have contingency plans in place because even though I have a due date who knows if the baby comes out sooner or later than expected. They are trying to put me on the schedule 6-8 weeks after my due date. I tried to tell them I didn't feel comfortable going back to the ED that soon and I was worried I wouldn't be able to pump given the amount of patients we have coming in. My PD said he'd put me on toxicology and admin after maternity leave but it seems the schedule won't work out that way.

My mom went into labor at 36 weeks while in in an IM residency (so already genetics are against me, apparently there is a genetic correlation). I read that many residents also tend to go into preterm labor, especially if on call. I won't be on call, but at 8 months I've been scheduled for 10 nights out of 17, and change day to night 3 times. I doubt there will be any more consideration afforded to me at 9 months. So I I'm definitely getting a bit panicked.

I'd like to avoid the inevitable resentment, but I doubt that will be possible.

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[shoal007]

10 nights out of 17??? and you're switching back and forth. that sounds god awful. might as well do them all nights.

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[NERDY]

Can you work extra shifts now, so you have fewer to make up when you return?

 

[deleted480308]

I wish there was a way I could plan ahead and warn the chiefs to have contingency plans in place because even though I have a due date who knows if the baby comes out sooner or later than expected. They are trying to put me on the schedule 6-8 weeks after my due date. I tried to tell them I didn't feel comfortable going back to the ED that soon and I was worried I wouldn't be able to pump given the amount of patients we have coming in. My PD said he'd put me on toxicology and admin after maternity leave but it seems the schedule won't work out that way.

My mom went into labor at 36 weeks while in in an IM residency (so already genetics are against me, apparently there is a genetic correlation). I read that many residents also tend to go into preterm labor, especially if on call. I won't be on call, but at 8 months I've been scheduled for 10 nights out of 17, and change day to night 3 times. I doubt there will be any more consideration afforded to me at 9 months. So I I'm definitely getting a bit panicked.

I'd like to avoid the inevitable resentment, but I doubt that will be possible.

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I wouldn't panic....just work the shifts you can safely work before the birth and then don't come back until you feel comfortable doing so. If they delay your graduation they will delay it.....you only get to have this particular kid once

 

[vengaaqui]

Yea, do what you need to do. Trust me, they'll figure a way to make it work. I worked up until the day before I delivered. Just happened to be off the day I delivered but was scheduled for another two weeks of shifts when I delivered early. Life happens. People don't resent others who have major surgery or an MI or whatever that requires them to call off (Or at least I don't). Why do we treat pregnancy related medical things differently?

I will say that if you remain healthy without complications try to work up until delivery to maximize time at home. It's hard running around in the ED in the third trimester, but it can certainly be done (From a mom who had one child in third year of residency and has another due very soon as an attending). Take breaks when there is down time to snack, drink water whenever you can, pee before the trauma rolls in, and for the love of all things holy don't try and lift patients. As far as pumping when you get back, depends on how your ED is split up. I actually found it much easier to pump in residency when ultimately there's still an attending covering the patient than as an attending. Granted I work in a single coverage shop but had to give up pumping at work once I became an attending. Even if that is the case, you too will survive supplementing even if it breaks your heart.

Also, not sure about the insurance question but your HR people or GME office should be able to answer it for you. And if you have to extend your residency, it's not really that big of a deal in the scheme of things even though you may feel a little left out when everyone else graduates on time.

 

[Psai]

Yea, do what you need to do. Trust me, they'll figure a way to make it work. I worked up until the day before I delivered. Just happened to be off the day I delivered but was scheduled for another two weeks of shifts when I delivered early. Life happens. People don't resent others who have major surgery or an MI or whatever that requires them to call off (Or at least I don't). Why do we treat pregnancy related medical things differently?

I will say that if you remain healthy without complications try to work up until delivery to maximize time at home. It's hard running around in the ED in the third trimester, but it can certainly be done (From a mom who had one child in third year of residency and has another due very soon as an attending). Take breaks when there is down time to snack, drink water whenever you can, pee before the trauma rolls in, and for the love of all things holy don't try and lift patients. As far as pumping when you get back, depends on how your ED is split up. I actually found it much easier to pump in residency when ultimately there's still an attending covering the patient than as an attending. Granted I work in a single coverage shop but had to give up pumping at work once I became an attending. Even if that is the case, you too will survive supplementing even if it breaks your heart.

Also, not sure about the insurance question but your HR people or GME office should be able to answer it for you. And if you have to extend your residency, it's not really that big of a deal in the scheme of things even though you may feel a little left out when everyone else graduates on time.

Because you don't choose to have appendicitis

 

[killerleaf]

Check and double check with your program about extending. There are times when that is not allowed when it comes to maternity leave; it is not considered a "good enough" reason to extend.

 

[enalli]

I've seen my coresidents do 8-12 weeks. Some have managed to do 8 weeks without extending residency (using four weeks of vacation plus doing a four-week self-study elective), and some have just decided to extend residency by many weeks. In the end, you should take as much time as you and your child need. Don't cave into pressure to come back earlier than you have to if you don't feel ready.

Check and double check with your program about extending. There are times when that is not allowed when it comes to maternity leave; it is not considered a "good enough" reason to extend.

By federal law it is: https://www.dol.gov/WHD/fmla/

 

[killerleaf]

not if there is not funding for the position. institutions have found ways not to extend a resident. Just double check...99% of the time it can be worked out.