We had our first right after first year and our second is due right before fourth year. It can be challenging, especially during some 3rd year rotations, but you have to make some sacrifices to make it work. Some things that I did:
1. During 2nd year, I used my afternoons to study and was home from about 5:30-7:30 every day that I could in order to have meals with my family and then put my daughter to bed. After that, I would often go back to school to study (can't do it at home)
2. Become very efficient with your time. When you have scheduled study time, don't go somewhere where you will be around a lot of distracting people. During scheduled study time...study...study hard.
3. I went to classes and paid attention so that I could get by with less out-of-class studying. The opposite may work for others (skip lecture to get more daytime studying).
4. My daughter still takes naps in the afternoon. This is a great time to study. When I am home, I am home. I don't study at home.
5. Have your family come to see you, eat dinner, etc. while you are on call. Most attendings have families of their own and respect the fact that you want to spend time with them. I wouldn't recommend rounding with your kids, but I think they like to see you take your lunch or dinner breaks with family if it doesn't interfere with your work.
6. Sundays are my time with my family. I try very hard not to study at all on Sunday. This means you have to keep up with the studying all of the time and can't fall back at the beginning of the semester and try to catch up a few weeks before exams. Plan consistent study time so that you won't have to be away from them for days on end.
hope that helps. Let me know if you have questions.
