Paternity leave

[ditch doctor]

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So, I matched! Yay! However, my wife is pregnant and due late-July/early-August. What is the best way to handle this situation with PD/administration. I have a pretty strong work ethic, so I kinda feel bad that I'm going to be like, "Hey, so, um, I know I just started 2 weeks ago, but I need time off next week." But I also have a very strong "family ethic" and don't plan on letting my wife/family down since we're moving to somewhere where we have no established support system.

I want to balance taking care of my wife/family/"being there" vs. being a pain in the ass to the program. Anyone have similar situations? Any PD's that would like to chime in as well, you're advice is most apreciated.

Also, what is a reasonable amount of time to ask off once my baby is born?

 

[Haemr Head]

The first step is to find out the program's policy on paternity leave and parental leave. All programs have one as this is an RRC requirement. Most also have the following rules so choose but choose wisely:

1. You need to provide at least 30 days notice.
2. Paternity leave is unpaid leave.
3. The program has the right to extend your training to meet the RRC requirement of 36 months of residency training.

Since most programs are just starting to put together the master schedule, you could consider asking to use vacation time or to be assigned to a soft rotation during that period. However, the sooner you get on the phone and work this one out with your PD, the better. The PD can make this happen if you work with her/him.

Speaking from personal experience, you need to carefully decide what you and your wife really need. Like you, my wife was isloated from her support systems when my son was born during my internship year. I really bonded with my son because when I staggered hme from every other night call, we both slept like babies. In those days, if I had brought up paternity leave I probably would have been fired as soon as the PD finished laughing and got up off the floor. Thankfully, times are much better today. It admit it was rough, but looking back I can see I really wasn't needed at her bedside 7x24. Fellow residents are always understanding and willing to help out.

Personally, rather than taking paternity leave, I would try to keep my salary going, not loose training time, and still be with my wife and child as much as possible. Just don't rotate on ortho or surgery that month. Your family *always* comes first and nothing is worth a divorce, so ultimately you have to do what you have to do.

 

[The White Coat Investor]

I have a pretty strong work ethic, so I kinda feel bad that I'm going to be like, "Hey, so, um, I know I just started 2 weeks ago, but I need time off next week." But I also have a very strong "family ethic" and don't plan on letting my wife/family down since we're moving to somewhere where we have no established support system.

Don't be a wuss. 🙂 I mean, really. You're not going through labor. How much recovery time do you really need? Assuming you don't have any other kids, I don't quite understand why you need a significant amount of leave just because you have a new kid. I was ready to go back to work 2 days after each of my kids were born. My wife was breast-feeding so it wasn't like I was real useful, you know what I'm saying? If you really feel like you want to take some time off aside from a couple of days while your wife is in the hospital, I would just arrange to take a week or two of leave. The whole concept of 6-12 weeks paternity leave is a joke IMHO. Why is the first month of your child's life any more important for you to be there for than the third or the eighth?

It is irritating enough when your fellow residents have to take maternity leave. To have to take a month of Q3 call instead of Q4 call for someone taking paternity leave would just piss me off.

Another good suggestion is to just ensure you aren't on a tough rotation for the month or two after delivery. At least then it will be easier to help out.

 

[Sweet Tea]

You can take the year off and give me your spot.

Well, it's an idea anyways. 😉

Congrats on the new little one! I hope you get some time off.

 

[SoCuteMD]

Don't be a wuss. 🙂 I mean, really. You're not going through labor. How much recovery time do you really need? Assuming you don't have any other kids, I don't quite understand why you need a significant amount of leave just because you have a new kid. I was ready to go back to work 2 days after each of my kids were born. My wife was breast-feeding so it wasn't like I was real useful, you know what I'm saying? If you really feel like you want to take some time off aside from a couple of days while your wife is in the hospital, I would just arrange to take a week or two of leave. The whole concept of 6-12 weeks paternity leave is a joke IMHO. Why is the first month of your child's life any more important for you to be there for than the third or the eighth?

It is irritating enough when your fellow residents have to take maternity leave. To have to take a month of Q3 call instead of Q4 call for someone taking paternity leave would just piss me off.

Another good suggestion is to just ensure you aren't on a tough rotation for the month or two after delivery. At least then it will be easier to help out.

Are you SERIOUS? Gah...you and people who think like you are the reason medicine is still a good old boys' club.

Maybe he'd like to be home to, oh, I don't know, HELP OUT HIS WIFE WHO JUST POPPED AN 8 POUND BEING OUT OF A FAIRLY SMALL ORIFICE? Just a thought.

 

[SoCuteMD]

Idea for the OP: If either of your mothers are well enough to travel they might welcome the chance to come help you out. My mom said that her mother-in-law (who was a mother to 7 kids) came to help her out when both my sister and I were born and she was an absolute Godsend. My dad wasn't a resident, but he was a newly minted associate at a major law firm (similar situation, really).

 

[zinjanthropus]

wow - i can't believe that un-supportive comment up there...what year is this? anyway, I'm a married male and I will certainly take some time off when that time comes...in some countries this is has become the rule, not the exception. In Finland, dads get 5 weeks PAID paternity leave.

 

[Miami_med]

I've never had a kid in residency, but I did have a kid not in residency, and I think that the amount of time you need is probably the same 😉 . As a father, you'll definitely want to be around for the birth and the next couple of days. Some programs give a few days of paid leave, and this is honestly all that you need. Aside from that, and making the very poor assumption that your wife doesn't need a C-section, you probably won't need to be around 24/7. If you can swing it, try to be on a rotation with no call for the first little bit. EM is probably ideal. Your whole family will be on a weird sleep schedule, so it won't matter when your hours actually are.

No matter how supportive you try and be, if you are not your wife's mother, you will risk being in the way. She will be more sleep deprived than you and will not appreciate you being in the way. This is NOT because she won't have time, because babies don't do much, and she'll have plenty of time to do things at home. She'll do everything and get bored in the 20 minute intervals between screaming. The shortness of the intervals will prevent her, and you when you are at home, from getting any real sleep. That will be the difficulty.

Congrats and good luck.

 

[The White Coat Investor]

Are you SERIOUS? Gah...you and people who think like you are the reason medicine is still a good old boys' club.

When you are forced to take numerous additional 36 hour calls for someone who cannot work for whatever reason you will understand the perspective.

I stand by my opinion that extended paternity leave is silly. Maternity leave, on the other hand, is much more important. What do you really think fathers do during the first few months (assuming the mother doesn't head right back to work?) I can tell you what I did...nothing! Between all the grandmothers visiting I was just in the way. All of a sudden my wife was no longer holding down an outside job and had more than enough time to accomplish her half of the chores and take care of the child. We both lost sleep (her more than me), but that's what happens when you're the one with the breasts. It ain't sexist, its just practical.

I'm not sure what you mean by a "good old boys' club." My med school class was >50% women and my residency class was 40% female. At least one field (OB/GYN) is now made up of a majority of female practitioners.

 

[DropkickMurphy]

Are you SERIOUS? Gah...you and people who think like you are the reason medicine is still a good old boys' club.

Maybe he'd like to be home to, oh, I don't know, HELP OUT HIS WIFE WHO JUST POPPED AN 8 POUND BEING OUT OF A FAIRLY SMALL ORIFICE? Just a thought.

Wow, SoCute....right on....way to put your foot up his fairly small orifice. 👍

 

[DropkickMurphy]

I'm not sure what you mean by a "good old boys' club."

She can correct me if I'm wrong, but I think that was her way of saying you're coming across as a self-righteous PITA.

 

[Aloha Kid]

Loook the answer is simple. If you are on a rotation that allows you to do that, then by all means go for it. But if you're taking a 30 day leave to be with your kid & wife on a rotation that needs a resident to pull shifts to cover cover your butt, then expect resentment. The only legitimate way to do this is notify your program now so they can not include you int he schedule for the time you are out. Expect to make it up. If you are considering less time off, maybe you can do shift swapping with another resident.

I agree 100%, your family is the most important thing in your life. Consider however the lives of other residents who have to work for you just so you can spend time with your own family. They are equally as important as you are. Many will be forced to leave their own family and likely on a rotation they expected to be easy. Someone will always pay if not done properly.

You are the father in your home. If you are like most traditional families your wife has a lot cut out for her but don't you expect to have it easy. Your main job will be to get out and provide for your family. You bring home the money so your wife and kid at home will be taken care of. Doing anything to put your status at risk as the bread winner will be more devastating to your family than you not being there for 30 days.

Perhaps 30 days is exagerrated. 1 week may be reasonable. Again, asking in advance will help, but you can never gaurantee baby will be out by then. You can gaurantee your wife will be an emotional wreck one week prior to delivering. Most residencies and your fellow co-workers will be very understanding for perhaps 2 and maybe 3 days off. Heck, I don't know you but even I would be willing to take a shift for you.

As a previoius comment mentioned, medicine is still the good old boys club. Doctors cannot afford to be sick. Unfortunately, you see many common examples of docs not being with their family, or doctors finishing their shift with belly pain and then getting admitted to the hospital for appendicitis afterwards. It has been this way for ages, but changes are slowly happening. We are not there yet. All things considered, there are very few professions that will allow someone to make 250,000 a year and then allow them to call off work for a week just because they have a cold. Sometimes, "sucking it up" is the right phrase.

 

[txterp98]

First off, congrats! On matching and on the pregnancy!

Let your program know now about the timeframe of the expected birth of your child. They can schedule you on blocks where you have vacation built in and then you can act accordingly. Maybe vacation scheduled for the last week of July and then the 1st week of August? Typically, the blocks with vacation built in are the lighter blocks anyways so your schedule shouldn't be too bad if you do end up having to work a little during that time.

Good luck and congrats again!

 

[NinerNiner999]

What do you really think fathers do during the first few months (assuming the mother doesn't head right back to work?) I can tell you what I did...nothing!

I would like to nominate ActiveDutyMD for father of the year 👍

To the OP - do what is right for your family and your newborn child. Help and support your wife. Call your PD this week and let him/her know you will need the time. They will likely be able to schedule you for vacation time or an easier intern year rotation without call. Don't listen to jackasses like ADMD. You are doing the right thing...

 

[ditch doctor]

Yeah..... I really just wanted like a week off when my kid was born, paid or unpaid. I just wanted it to be on my-- well, my kid's-- schedule, not a set vacation week.

However, I would support any of my fellow residents if they wanted an extended leave. Male or female. Would I like it? Nope. However, would I resent it? Nope.

Admittedly, I haven't ever had to work call q3, so I can't comment on that. I was, however, a firefighter/paramedic in an high-volume, urban service for 10 years before I went to medical school, and can't imagine it's too much worse than 60-72hrs/week for a month straight when we had gaps to fill in our schedule due to people being out for whatever reason. And, oh yeah, while going to school full time.

Now, granted, it was optional and I did get overtime. Either way, I didn't bitch or moan about it. Shoot, at least you don't have to also clean the hospital on top of all your other work while you're there.

 

[zinjanthropus]

I would like to nominate ActiveDutyMD for father of the year 👍

To the OP - do what is right for your family and your newborn child. Help and support your wife. Call your PD this week and let him/her know you will need the time. They will likely be able to schedule you for vacation time or an easier intern year rotation without call. Don't listen to jackasses like ADMD. You are doing the right thing...

man, it is great to see this post from a senior level resident...glad to see my chosen field isn't stuck in another century after all..

and i think the first sentence says it all..."what is right for your family"
for me, taking an extended period off probably won't be the thing I do, but who the hell am I to (or ADMD) to decide what's right for another dad.

 

[Sweet Tea]

I think a week off isn't going to put the other residents out too much, even if you are on a rotation where you have to take call. I hope it all works out for you!

 

[lilnoelle]

I think it really just depends on the family (mostly the new mom) as to whether paternity leave is necessary or not. The difficult thing is that a new mom will probably not know what they need until they are in the situation. I'm not a resident (just a med student) but I am a mother of two (18 months and 3 1/2) and I actually find myself identify with the "good ol boys" that you guys found offensive. I breastfed as well and felt that my hubby was really no good to me as far as helping with the kids until the babies reached about 3months and their feeding schedule spread out more. Even my mom, who stayed with us a week after the babies were born, found herself sitting around because all she could do was cook and clean during that time. Obviously someone to cook and clean is helpful. And I suppose if you have a baby who is extremely collicky, an extra hand will be helpful when the baby is not eating.
My husband didn't take more than a few days off after each of my babies' births, and that was fine with me. In fact, I sent him to work while I was in the hospital too.
So, thats one point of view, but I'm not every woman. A lot of women want more support than I need and would want their hubby around. In those situations, it would be good to take time off.

 

[The White Coat Investor]

man, it is great to see this post from a senior level resident...glad to see my chosen field isn't stuck in another century after all..


I would like to nominate ActiveDutyMD for father of the year
.

All right, all right. I apologize for any insensitivity. The wuss comment was meant to be a joke, that's why there was a after it.

My point of view is this. I also worried about my first baby born at the end of my intern year. I arranged to take 1-2 weeks of leave shortly after the birth. I was in the way. My wife requested that from now on if I take time off, that I schedule it AFTER all the grandmothers have trooped in and out. I found that after two days off, I was ready to go back to work and my wife was ready for me to go back.

All that being said, my program director would have arranged for me to have 3 months off if I wanted it. The first month would have been my vacation for the year, the last two months would have been tacked onto the end of my residency. My wife certainly did not want me to take any option that involved a longer residency. Your co-workers won't resent taking a call or two for you, but they will resent taking a whole month worth of calls for you.

Much of your decision as to how much leave you take will come down to your wife. If she is hyper-needy maybe you should request 2-4 weeks off. If you just want to be available and supportive, arrange for 1-2 weeks at some point in the first month or so. My wife is a little bit of a special case. My 3 month old and I spent yesterday afternoon watching her do a triathlon. As you can tell, she's pretty independent.

 

[NinerNiner999]

I've got nothin but love for ya ADMD 😀

 

[Haemr Head]

This discussion reflects the conflict that goes on between training for a vocation, meeting basic family needs, and how support is delivered to new families. The first difficult point I would ask everyone to concede to is that residency is training for a vocation NOT a job. You are going to Top Gun for 3/4 years, not to happily ever after.

Now you can't really fault the PD or the program for tending to place vocation ahead of personal life. It's their job. Of course one can assume that providing support for raising a family might enhance educability and dedication to one's career. But the natural assumption is that the more time one dedicates to training, the better the result.

So you and your wife are the only ones who can really balance the decision. The structures are there to allow you to use the time as you see fit. Just realize that there is a cost to every hour spent away from your training.

As a good old boy, I'll define a meaning for the good old boy network: gender differentiation in the pathway to professional leadership. This exists. However, with rare exceptions it is not a conscious back room decision, it is the process of how one ascends to leadership in medical specialties.

Problem number 1: Surviving residency. I( strongly doubt that the divorce rate in residency is not equal for both genders. In my experience female residents have a divorce rate that is 10 fold greater than their male counterparts. This reflects on the greater needs of the male spouse, as we are certainly the emotionally weaker sex. A divorce in residency does not exactly do wonders for one's ability to focus on one's career.

Problem 2: The most important time for launching a career is right after residency. It takes more hours/week to begin to learn a whole new career in academics or admin, carve out an area of expertise, and still cover the clinical work. In the early thirties many families are just getting started and it is the time parents need to devote the most time to the family. Guess who's career gets put on hold the majority of the time. The chairmen usually hand out academic and administrative plums based on productivity. It is much much harder to turn on the turbo jets after the window of opportunity is passed. Of course there are notable examples of people who have beaten the system: Judy Tintinalli, Ann Harwood, or Michelle Biros, to name a few. But the path is often harder and gender neutral processes fail to account for the greater need for support caused by starting families.

Problem 3: Who should pay to allow young faculty to start families? As my Dad use to say: There ain't no money tree. Someone needs to foot the bill for the time spent away from revenue generating activities. Ask a single member of the department if he/she should contribute a substantial portion of their income/time so that another faculty member can raise a family, and you will get very different answers and attitudes. Rarely do they suggest that the faculty member with leave time should be given an award and leadership in the department. Every department tackles this problem differently but it is extremely tricky to create a process that allows parents to get a family going, not loose academic ground, and retain the good will of all of their peers. People sadly are people.

 

[turtle md]

My son was born in August of my intern year. Once I knew where I matched, I contacted the program coordinator (the PD is less likely to be able to help) and asked if she could schedule me such that I would have my easiest rotations in August and Sept. I then scheduled a couple weeks off, one in each of the easier blocks. So we had the baby, I took a week off and nobody had to cover me. Then went back for a couple weeks and then another week off, again, vacation, so no one had to cover. I took an extra week during anesthesia/ultrasound for "paternity" leave, but no one had to cover for me then.

We are planning on a second, and once a date is known, I will arrange my schedule such that I work alot before and way after, but have an easy time for a month or so to help if needed or just comfort...

Anyway, just my 2 cents...

 

[ditch doctor]

My son was born in August of my intern year. Once I knew where I matched, I contacted the program coordinator (the PD is less likely to be able to help) and asked if she could schedule me such that I would have my easiest rotations in August and Sept. I then scheduled a couple weeks off, one in each of the easier blocks. So we had the baby, I took a week off and nobody had to cover me. Then went back for a couple weeks and then another week off, again, vacation, so no one had to cover. I took an extra week during anesthesia/ultrasound for "paternity" leave, but no one had to cover for me then.

We are planning on a second, and once a date is known, I will arrange my schedule such that I work alot before and way after, but have an easy time for a month or so to help if needed or just comfort...

Anyway, just my 2 cents...

This is exactly what I envisioned.

 

[ERMudPhud]

I have two perspectives on this. First I had to schedule around someones maternity leave when I was chief. Unfortunately she wanted 3 months of maternity leave, her vacation weeks spread out over the rest of the year, didn't want to "waste" her electives and other easy rotations on maternity leave and wanted no or very little extension of her residency beyond everyone elses graduation date. It was a giant pain in the ass and very easily could have had a huge impact on everybody elses work load.

On the other hand, I remember my own experiences. The people who say that if your wife is breastfeeding you are just in the way are assuming the best case. My daughter was a forceps delivery with a huge cephalohematoma and a clavicle fracture. She was on home bili lights. The little varmint wouldn't eat. Every two hours we would wake her up to feed her. While my wife would try to nurse her I would have to sneak a feeding tube into her mouth to supplement the weak nursing. It was definitely a two person job. Then my wife would pump while I put the baby back down. We would rest for an hour or so and start all over again. After two weeks of that she had barely met her weight goals and we were exhausted. There is no way I could have worked at the same time. Along with that my wife developed a touch of postpartum psychosis, probably from sleep deprivation, so I was afraid to ever leave her alone. It took about 6 weeks before our lives got to a point where I could even consider doing anything else.

Call the PD now. Try to put easy or elective months before and after the due date. Sprinkle your vacations in there as well. Hopefully the rotations around the due date will be ones where you won't be missed or could even work part time (Tox, Anesthesia, or others depending on your program). Accept the fact that you may have to make them up later if you have to skip them know and accept that the rest of your year might be kind of brutal.

Good Luck

 

[margaritaboy]

I really doubt this will be a problem. I agree with the above. Call the PD right now. Better to have it out in the open rather than dropping it on people at the last minute.

Our program has birthed five kids since last July, two of which were from our interns. In the vast majority of cases, taking some time after the birth of a child is totally accepted and expected among your peers.

 

[roja]

Well, I'm a little late in responding but thought I'd throw in my .02.

I am thrilled to see a lot of support from those on the board.

The idea of supporting ones family is lovely and important. However, just to toss another view of things (aside from the obvious helping out), it is quite possible (and seems to be) important that the OP wants to take time so he can bond with his child. To begin developing a relationship with his child. (not to mention the assumption that breast feeding will happen, maybe not). Even if there is no bottle feeding, there is still rocking to sleep, changing diapers, burping, changing clothes, bathing. All small and important parts of bonding with one's child. I imagine that in addition to helping his wife, the OP wants to be home with his child to experience his child.

I had my daughter two days after my surgery rotation. I had six weeks off. My husband worked from home the entire time, not just to help out (my mom was living with us to help out) but because he believed it was important for a father to bond with his child.

So, if you want to take time off, talk to your PD. Recognize that you might have to work harder before/after. And you may piss off one or two residents, but I certainly hope you are at a place that respects families and one's personal life. 🙂 The goal of residency is to educate and train you. If you are miserable and unhappy you won't be a good resident and most importantly, you won't learn.


good luck and congrats.

 

[a_ditchdoc]

Roja is married with a kid? How did I not know that??? Go figure...