Moms in surgery?

[icare4u]

I just HATE to ask this question, b/c I know I'm going to get slammed...I just can't think of anything else I want to do. Surgery is it for me. I can't imagine doing anything else. But...I'm single now, going to be married soon, and you know what? One of these days, I'm PROBABLY GOING TO WANT KIDS! I'm probably going to want a family.
Is there any way you can be a good mother/wife and be a good surgeon a
at the same time? My fiance is very supportive in every way and wants me to do whatever I want, he doesn't think I'll be happy doing any other kind of medicine, and i just don't, either.
Any input would be greatly appreciated.

 

[Sweet Tea]

I'm a surgery intern, also getting married soon, and I have the same concerns. Best of luck to you!

 

[Pilot Doc]

I just HATE to ask this question, b/c I know I'm going to get slammed...I just can't think of anything else I want to do. Surgery is it for me. I can't imagine doing anything else. But...I'm single now, going to be married soon, and you know what? One of these days, I'm PROBABLY GOING TO WANT KIDS! I'm probably going to want a family.
Is there any way you can be a good mother/wife and be a good surgeon a
at the same time? My fiance is very supportive in every way and wants me to do whatever I want, he doesn't think I'll be happy doing any other kind of medicine, and i just don't, either.
Any input would be greatly appreciated.

Three big points

1) The questions of being a good attending/good mom and good resident/good mom are very different

2) How much money do you need to make

3) Join womensurgeons.org (unofficial motto "you can have everything you want, but not all at once) and get on their email list

Regarding #1, attendings have exceptionally broad control over their life and practice. It will take adjustments/sacrifices to your income/location/case mix, but you can definitely have a "family friendly" lifestyle no matter how you define that.

Residents are the exact opposite. With the exception of FMLA mandated maternity leave, you have no control and almost no flexibility in your hours. As a parent you will be dependent on others for substantial amounts of child care, particularly for sick days, unanticipated situations, etc. That requires either a) a flexbile spouse 2) family in town or 3) money

Regarding #2, as you might expect, the more money you have and the less you need to make, the smoother things run. If you can take a private practice job that pays $100K for 3 half days a week, life becomes much easier. If your husband makes enough to pay for a nanny while you're a resident, life becomes much easier.

Regarding #3, the Assn of Women Surgeons is a great, great resource for women surgeons, especially if you don't have mother/surgeon mentors available at your institution.

A few other random thoughts - when you say surgery, do you mean general surgery?


Also, keep your eyes out for non-traditional options, you have a sweet spot of 5-15 years when your kids are young and your time with them is particularly valuable. Maybe you can work part time as an attending just to keep your skills up for several years and return to full time practice once the youngest hits middle school (or elementary school)

Other questions?

 

[icare4u]

Ahh, just what I wanted to hear. My fiance is an engineer, wants to go to law school while I'm in residency, then do patent law, so bright future for him, plus he is soooo patient/good-hearted, and takes care of me just like my parents did. The first guy I ever met that cares more for me than he does for himself.

Are there really jobs out there that you can do on a part-time basis and keep your skills up so that you can still be part of "the real world" with kiddoes, if that time comes? Is $100K a reality in that kind of situation?

Am going to have to go through gen surg first, b/c I'm a pretty mediocre student, and just pray I can get into that. So I'm willing to go anywhere for residency as long as there is a law school somewhere nearby. I'm going to have to apply very broadly, but hopefully it will be somewhere in or around Texas. (Home state)

Any suggestions? It's time to apply!

 

[Pilot Doc]

Ahh, just what I wanted to hear. My fiance is an engineer, wants to go to law school while I'm in residency, then do patent law, so bright future for him, plus he is soooo patient/good-hearted, and takes care of me just like my parents did. The first guy I ever met that cares more for me than he does for himself.

Are there really jobs out there that you can do on a part-time basis and keep your skills up so that you can still be part of "the real world" with kiddoes, if that time comes? Is $100K a reality in that kind of situation?

Am going to have to go through gen surg first, b/c I'm a pretty mediocre student, and just pray I can get into that. So I'm willing to go anywhere for residency as long as there is a law school somewhere nearby. I'm going to have to apply very broadly, but hopefully it will be somewhere in or around Texas. (Home state)

Any suggestions? It's time to apply!

Digressing a bit, I have heard that patent law is a very specialized field, a career in which requires getting a job with a patent firm straight out of law school. This might narrow his law school options and your residence options post-graduation. I'd want some rather authoritative data on this for planning purposes. Also of interest is how his first 5-10 years in practice will be. Is patent a cutthroat 100hr/week life or something easier? Does it pay well enough to let you take a relatively low paying job etc.

But getting back to the part time surgery jobs. Jobs I can think of that would have options like that

1) VA
2) Military/HMO
3) Large multispecialty clinic - they often have a hard time recruiting/retaining surgeons b/c their high overhead makes paying competitive salaries impossible.
4) First assisting only - you essentially function like a really well trained PA who surgeons can leverage as a way to run multiple rooms simultaneously or just do complex cases. I do know of a woman who does this. Don't have details of hours/pay, though
5) work somewhere no one else wants to go. There are plenty of hospitals/groups in rural areas that are desperate for surgeons. Ideally they want someone who will come in and be a workhorse, but for the right price, someone will take you on your terms. Whether you will be able to find patent law jobs in those cities/towns is another issue.

The key thing to keep in mind is to offer a unique/desirable service. Maybe you want to join a 4 man group and only work three 1/2 days a week. If you offer to take call every third weekend, they'll be much more likely to hire you, etc.

 

[icare4u]

Thanks for the info, Pilot Doc...lots of food for thought. But not much time for digestion, though, b/c I'm taking my Step 2 Friday, and I've got to get back to World questions! This is just a much happier subject...Will be getting back to you with more questions. Thanks again! Wish me luck...better yet, pray for me!

 

[Blade28]

Am going to have to go through gen surg first, b/c I'm a pretty mediocre student, and just pray I can get into that. So I'm willing to go anywhere for residency as long as there is a law school somewhere nearby. I'm going to have to apply very broadly, but hopefully it will be somewhere in or around Texas. (Home state)

Great advice already posted earlier in this thread. I just wanted to add that it's good to keep an open mind - definitely apply widely in around a year or so, when you're looking at residency spots. It'd be tough to just limit yourself to one state (Texas).

Good luck on Step 2!

 

[icare4u]

Oh, no, I'm getting ready to apply now, as soon as I get this test behind me. I'm a 4th year. And I know you're right, I'm not going to limit myself to Texas, though I certainly am hoping that's where I end up. Any ideas on places to apply that are not so competitive? (Low step 1) Hoping for better results on Step 2.

 

[bailey39]

Hi there-- It's not easy, but it can definitely be done. I say this having a mom who is a surgeon. She definitely slept less than many other moms I knew (called out in the middle of the night, many evenings in the OR followed by algebra marathons with us, returning to the hospital after putting us to bed sometimes), and we didn't see her as often for dinner as most other kids. But I don't think my sister and I consider ourselves having suffered for that. And she was also a single parent for the last ~19 years. We had live-in nannies (I have very positive opinions on this, if it's done well), which was great and definitely necessary so that someone was home when my mom was in the OR at 3am or available to drive us to dance, piano, swimming, etc.

Also, on my surgery clerkship, both of the female chief residents had kids (one had 2, the other 1) and one of the attendings told me she started had a child in residency (at the same hospital) as well. Moreover one of my classmates is currently starting a gen surg residency with a baby, and she did all of her Sub-Is while pregnant.

That said, knowing quite well what the life entails, I'm having a hard time trying to decide whether I want the same. As I said, it's definitely possible but not simple. Best of luck!

 

[AlexQ]

somewhat related issue:
what are your thoughts about wearing engagement rings on interviews?

 

[njbmd]

I just HATE to ask this question, b/c I know I'm going to get slammed...I just can't think of anything else I want to do. Surgery is it for me. I can't imagine doing anything else. But...I'm single now, going to be married soon, and you know what? One of these days, I'm PROBABLY GOING TO WANT KIDS! I'm probably going to want a family.
Is there any way you can be a good mother/wife and be a good surgeon a
at the same time? My fiance is very supportive in every way and wants me to do whatever I want, he doesn't think I'll be happy doing any other kind of medicine, and i just don't, either.
Any input would be greatly appreciated.

Most of my female colleagues have children or are planning on having children. If your residency has research years, they are a good time to plan a pregnancy. If not, then plan your pregnancy while you are studying for specialty boards.

In general, doing a fellowship makes for a more predictable lifestyle (even Trauma Surgery). Good fellowships that are very compatable with family-life are Breast/Oncology, Endocrine, Minimally Invasive, Pediatric Surgery and Plastics/Hand. Your hours will be more predictable and there will be less emergency call.

Even my friends who have elected to remain in General Surgery have supportive partners who share call duty or belong to larger groups where call is Q8d or Q12d. They structure their cases around their family life and still have solid practices.

Do not enter surgery with the idea that you are going to do this specialty on a part-time basis. It does take a more than a few years of just steady operating to hone your technique and establish yourself. If you are starting off part-time, you extend this "honing" period.

 

[pillowhead]

In general, doing a fellowship makes for a more predictable lifestyle (even Trauma Surgery). Good fellowships that are very compatable with family-life are Breast/Oncology, Endocrine, Minimally Invasive, Pediatric Surgery and Plastics/Hand. Your hours will be more predictable and there will be less emergency call.

Pediatric Surgery? Really? When I did a Ped Surgery rotation as a med student, the two fellows (one a PGY-9, the other a PGY-10 ) were routinely pulling 100+ hour workweeks and the occasional 110 hour work week. The Gen Surg residents preferred trauma surgery at the large country hospital compared to pediatric surgery because ped surg was well known for having the most work, the most consults (because kids who need central lines go to the OR--can't exactly expect a 3 yr old to sit still for a subclavian) the worst hours, and the most ED visits in the middle of the night because in general, folks just have a lower threshold for calling the specialist with a potentially sick kid than a potentially sick adult. Was my school's program the exception and ped surg really isn't that bad in other places?

 

[Hallm_7]

Two anecdotal stories that might serve as inspiration:

1. I personally (not professionally) know of a surgeon husband/patholoist mother who make the time issue work. One of the things they did early on was to hire a teacher fulltime to teach their kids at home, so it was a type of homeschool but they followed a curriculum very closely. This immediately solved the problem of having to get kids to/from school and also allowed them to have "parent time" if mom or dad had to be in the hospital that night. I'd also bet the kids are getting an education far superior to that or their peers in traditional public or private schools (although the social aspects might not be the same).

2. I grew up in a small community. We had a VERY small hospital (25 beds) but had access to a couple larger hospitals (300-400 beds) within 20-30 minutes. I worked in the small hospital for a summer b/w high school and college and saw the surgeon work some. He would do a couple operations a day at most and then be done. There were several days he did none. The hospital was happy with this because they didn't really have any other options. I'm sure he was happy because he tailored his practice to how he saw fit. Any trauma was immediately flown out, and most emergent cases were sent away as well. No doubt his income was nowhere near what it would have been 20 minutes down the road, but he chose it.

I know the CEO of this hospital and in talking to her I get the feeling that they are absurdly flexible in their demands with potential physicians because they need to be. I'm sure there are similar opportunities around the country. Maybe you could live 20 minutes outside a major city and have the hubby drive 20 minutes into town and you drive 20 minutes away from the city to get to one of these hospitals.

Good luck!

 

[I am Hans]

Pediatric Surgery? Really? When I did a Ped Surgery rotation as a med student, the two fellows (one a PGY-9, the other a PGY-10 ) were routinely pulling 100+ hour workweeks and the occasional 110 hour work week. The Gen Surg residents preferred trauma surgery at the large country hospital compared to pediatric surgery because ped surg was well known for having the most work, the most consults (because kids who need central lines go to the OR--can't exactly expect a 3 yr old to sit still for a subclavian) the worst hours, and the most ED visits in the middle of the night because in general, folks just have a lower threshold for calling the specialist with a potentially sick kid than a potentially sick adult. Was my school's program the exception and ped surg really isn't that bad in other places?

It must be site specific because I had the same experience as you...Peds Surg had the most emergency cases, the most urgent cases and add-ons. As you note, the ED was less likely to send a kid with an equivocal abdominal exam home than an adult, so the consults were non-stop. Don't get me started about trauma in the summer time. IMHO, Peds Surg was not a lifestyle choice - either as a fellow or an attending.

Same goes for Plastics and Hand. Too much trauma call. If you're in a community aesthetic practice or only take elective Hand cases and no trauma, it could definitely be a lifestyle choice, but generally the training period is in an academic center where trauma call is required.

Otherwise, I agree with njbmd: Breast, Endo, MIS, Surg Onc, Colorectal...these are all more lifestyle oriented, even Trauma surg can be done on a shift basis. As she so rightly noted however, anyone contemplating a less rigorous or part/time schedule may find that obtaining the skills or respect within the community early on a difficult process, as well as finding a practice or employer who will accept you. It is one thing to hire a surgeon with 30+ years experience to work part-time, it is definitely another to hire someone straight out of residency to do the same (many attendings will tell you it can take 5-10 years to feel comfortable...extend that if you are working part time).

 

[Pilot Doc]

Otherwise, I agree with njbmd ... As she so rightly noted however, anyone contemplating a less rigorous or part/time schedule may find that obtaining the skills or respect within the community early on a difficult process, as well as finding a practice or employer who will accept you. It is one thing to hire a surgeon with 30+ years experience to work part-time, it is definitely another to hire someone straight out of residency to do the same (many attendings will tell you it can take 5-10 years to feel comfortable...extend that if you are working part time).

I think njb and Hans are a little pessimistic. Unless you make surgery your one and only priority in life - and some people do - your career will be a series of compromises. Can you be competent at CT 2 days a week - probably not. Can you do breast and hernias and endoscopies - sure.

Whether the things you can do well in a part time practice float your boat is an important question. Those things are generally not what draw people to GS.

As for getting that part time job - it's all about marketing yourself. Groups that have 10 applicants per position aren't likely to hire you. Groups that have been looking for 3 years and are about to hire their 2nd headhunter will be much more receptive. Again - it's a compromise.

As for the timing of your children - research is good; internship is bad. I'd encourage you to have them at a time of your choosing and not your chairman's.

 

[njbmd]

Pediatric Surgery? Really? When I did a Ped Surgery rotation as a med student, the two fellows (one a PGY-9, the other a PGY-10 ) were routinely pulling 100+ hour workweeks and the occasional 110 hour work week. The Gen Surg residents preferred trauma surgery at the large country hospital compared to pediatric surgery because ped surg was well known for having the most work, the most consults (because kids who need central lines go to the OR--can't exactly expect a 3 yr old to sit still for a subclavian) the worst hours, and the most ED visits in the middle of the night because in general, folks just have a lower threshold for calling the specialist with a potentially sick kid than a potentially sick adult. Was my school's program the exception and ped surg really isn't that bad in other places?

Fellowship like residency is demanding. After fellowship and in practice, many Pediatric Surgeons have great partnerships and a manageable lifestyle. Most fellowships, excluding Breast Surgery, have long hours but fellowship is quite different from practice. My pediatric surgery colleges (attendings) have a very manageable lifestyle likely because the senior residents and fellows are taking care of many of those "middle of the night" emergencies.

 

[lilnoelle]

What would you guys say to someone who already has children.. and who's kids will be around 5 and 7 when residency starts? I'm interested in a variety of fields, but surgery is one of my favorites. We don't have family that lives within close proximity of a residency program.

 

[Blade28]

What would you guys say to someone who already has children.. and who's kids will be around 5 and 7 when residency starts? I'm interested in a variety of fields, but surgery is one of my favorites. We don't have family that lives within close proximity of a residency program.

Depends on a number of factors. IIRC, you're starting your MS-II year now? So at least you still have time to see if surgery (especially General Surgery) is right for you. It also depends on how supportive your spouse is - of the residents in our program, the males with children have good support from their (non-medical) wives, though pretty much all of them work as well. The females with children are currently in their lab years, so hard to say how life will be once they re-enter the clinical years.

Not having family nearby will be tough, but if your spouse also works, at least a part-/full-time nanny/babysitter/maid/etc. will be an option.

Talk about it with your spouse, see if he/she understands what going into surgery will entail, at least for the first few years during residency training.

 

[Pilot Doc]

What would you guys say to someone who already has children.. and who's kids will be around 5 and 7 when residency starts? I'm interested in a variety of fields, but surgery is one of my favorites. We don't have family that lives within close proximity of a residency program.

You're at somewhat of an advantage b/c the government will provide free childcare for you approx 8 hrs/day. Your kids will also have more of a life outside the home and perhaps won't miss you as much as a preschool kid would.

That having been said, you should plan on being in the hospital 6am to 6pm or later every weekday with frequent trips to the hospital and/or call days on weekends. And, most importantly, almost no flexibility at all - no field trips, no soccer games, no birthday parties, etc. You can't take a day off, you can't leave for an hour, etc. (To be fair, this is true of almost all residencies, but the going gets easier earlier in other fields.)

 

[icare4u]

Pilot Doc, you're talking about in residency, not as an attending, right? (hope)

 

[Pilot Doc]

Definitely residency. Your hours are long, but perhaps most importantly, you have no control over them. This varies somewhat by program and year of training, but is generally true. As an attending, despite what others think about it you can choose to work part time or, if full time, you can certainly schedule time off more easily.

 

[dralex]

icare4u, congratulations on your upcoming wedding. Many happy times lie ahead for you (hopefully!).
From my personal experience (my wife is a Surgeon and got pregnant in the beginning of her last year of residency) it is very difficult to raise children while you are a resident, especially a surgical resident.
Is it impossible? Of course not. If you have good family support it makes it far more "do-able". Your parents/in-laws would make the best babysitters in the world.
When you have a child your entire life changes in ways that you absolutely can not imagine (unless you are a cold, heartless person). You will feel torn between the work that you love and the even more powerful connection that you will have with your child.
It's going to be tough. My advice to you is to wait until your residency is completed to have children (may or may not be possible for you).
When you get out into the "real world" expect to make some compromises but if you are a strong person and have a supportive husband and family you can achieve anything.
Best of luck to you!

To AlexQ's question regarding engagement ring during an interview.
It is best to not wear any flashy jewelry at all during an interview. A wedding band and simple watch are acceptable. Earings should be stud type (nothing dangling).
Here are some basic rules of thumb to keep in mind (taken from about.com website all common-sense stuff):

Women's Interview Attire

• Solid color, conservative suit
• Coordinated blouse
• Moderate shoes
• Limited jewelry
• Neat, professional hairstyle
• Tan or light hosiery
• Sparse make-up & perfume
• Manicured nails
• Portfolio or briefcase

Men's Interview Attire

• Solid color, conservative suit
• White long sleeve shirt
• Conservative tie
• Dark socks, professional shoes
• Very limited jewelry
• Neat, professional hairstyle
• Go easy on the aftershave
• Neatly trimmed nails
• Portfolio or briefcase

Good luck!

 

[icare4u]

Thanks so much for the info, dralex, your advice is very helpful. And, no, we don't plan on having children quickly, so we should be okay -- barring those little surprises!