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Popping one out during residency (aka baby fever)

Discussion in 'Emergency Medicine' started by forfinity08, Dec 15, 2008.

  1. forfinity08

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    So I did a search and couldn't find much, probably because of the taboo nature of the question. However, I am hard pressed to believe that I am the only woman applying for EM residency who realizes that her prime egg-ripening years are fearfully close to the "35yo" cut-off for an amnio.
    Basically, I am considering having a baby within the next 5 years of my life, many of which will be occupied by a residency.

    I have seen pregnant residents in other specialties around the hospital, but what about EM? What are the baby friendly residencies? Is 3 years better or 4? And how does the whole thing work, are you really screwing over your fellow residents by taking maternity leave?

    Just overall confused and curious. Any thoughts?
     
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  3. Old_Mil

    Old_Mil Senior Member
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    I think that EM would be a little tougher when it comes to the baby thing than other residencies just based on the nature of the shift work.

    For instance, say you have a week of nights coming up. What do you do for child care at 2am?
     
  4. DogFaceMedic

    DogFaceMedic Member
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    Actually I have seen several EM programs that are very supportive to pregnant EM residents. The flexible shifts can be a challenge, but the key is family support when you are at work.
     
  5. forfinity08

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    Luckily I have a supportive spouse who has a sane real job that allows him to be home every day at 2am. I know the schedule is tough, but there are plus sides too. Having nights means spending days with the baby. Either way, some family support is going to be necessary.

    Has anyone here done it or know anyone who has? I wish I could know the PD's opinions on this at interviews, but would never dare ask the question. Anyone else?
     
  6. Jarabacoa

    Jarabacoa non carborundum ilegitemi
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    If you pawn off work on your colleagues because of your personal life, there is going to be hard feelings.

    During residency, I got called in by my fellow resident. His wife was on call, and got called in to cover. So I got called in to work his shift while he watched their kid. On the surface, I did it without complaint, but inside, I was thinking, "Why does your wife being on call affect my life?"

    The 2 woman in my class who had kids were pretty miserable, but somehow survived. One ended up hating her job with a passion and towards the end of residency talked frequently about hating the ER, and having it as her goal of working urgent care. The other was notorious for being late almost every shift, and calling in sick all the time. She burned her bridges and ruined her reputation early in residency and didn't seem to care. Both seemed surprised that they couldn't just take 2 months off from residency and still graduate on time. What they ended up doing was actually not getting any vacation the last 2 years of residency and not getting electives in exchange for graduating with the rest of us.

    Their situation was probably a little bit different in that they were both married to residents. Having an ER schedule, with working nights, holidays, etc., paired with a spouse who has a much busier schedule, and whose days off were rarely the same as your own, pretty much precluded an even semi-normal home life. If you have a spouse with a career, you pretty much have to rely on a third-party to raise your kid, whether that is a Nanny that gets paid $50,000 a year, a family member, or whether you get what you can afford, some lady named Rosalita who communicates with your kid predominantly through Spanish.

    In med-school, two of my attendings were married. One was an OB-Gyn, and the other was a surgeon. They had such crazy schedules that they had a live in Nanny, as well as a 40 hour per week maid that took care of their house. I would imagine that arrangement cost upwards of $60,000-$70,000 per year (not reasonable on the average resident salary).
     
  7. Venko

    Venko True to self
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    I cannot speak for other places, but at Mayo, many residents have children. One of the female R3s had her first child this past year. It does extend your residency from 3 years to likely 3 1/2 yrs. Many of the male residents' wives have had children during residency. Annie (Sadosty, the PD) is very supportive of family and the need for a complete life. As for a resident who does not have children I don't think negatively toward my colleagues who do have children in residency, its a tremendous portion of life! The bottom line, there are many family friendly residencies in the nation, and you can definitely be a resident physician and a mom (or dad). If this is an important thing, I would ask about it on your interviews to get a feeling about the residency attitude toward family expansion.

    Oh, as an aside, our schedule is such that we do a solid month every year of overnights so that in general you don't have them the rest of the year.

    Best of luck in your travels,
    ThymeLess.
     
  8. Jarabacoa

    Jarabacoa non carborundum ilegitemi
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    There is no residency who is not supportive of family expansion. My wife and I had a child (my third) during residency and they were supportive. I took 2 weeks off, one from toxicology, and one from an elective. It really didn't affect my residency. No residency is going to be supportive if you don't give your rotations, especially time in the ER, 110%.
     
  9. JBlue

    JBlue Member
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    I have two children and am an intern. I had my second child in my last year of medical school. I don't think it is so bad. If you can wait, I would just because you can enjoy them more but if you feel ready I would say that 2nd or 3rd. year would be best. You will absolutely need a supportive spouse and family is a huge plus. We have no family around us but we have an au pair who costs us about $1700/month and lives with us. It is AWESOME. She does an amazing job and helps out with everything. I don't have to worry about childcare if the kids are sick etc. The cost is not much more then regular daycare. It is also really nice with an ED schedule because I can change her schedule around to suit my schedule. I would never call off of work due to my family unless it was a real emergency. You have to do your job and in some ways put your training above all else (within reason of course). I have seen many competant resident moms and I would say that some of the stories on this post of parents flaking out are the exception rather than the norm. I love having a family in residency and I wouldn't want to do it without it. I think it gives me perspective and I love coming home to them. I do have less time to study than my childless co-interns but again it all works out. Good luck!
     
  10. sarahinromania

    sarahinromania New Member
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    I did a similar scoping out of my baby-producing options during residency. What I found was that male residents with children tended (for whatever reason) to feel more overwhelmed by and negative toward having kids in residency. The female residents who had kids all said, "Residency is a great time to have kids, go for it." I even had female attendings say that it was one of the best times to have kids.

    As far as baby-friendly residencies, from my interview experiences they tend to be more community hospital based with a slower pace. I think the best way to investigate this while interviewing is to go to resident dinners and casually ask what proportion of residents are single vs. not and if anyone has kids. It's possible that your asking the question may be transmitted back to the PD, but it's a fair question and that's an appropriate place to ask it.

    Timing during residency: I don't think it matters 3 vs 4 years. What does matter, methinks, is that it would be harder to have a newborn as an intern when you have a lot of call nights and such. Also, to avoid pissing off your colleagues by dropping off the face of the planet suddenly during maternity leave, it might be beneficial to have a year or two to prove yourself as a hard worker who does not slack.

    Also, for everyone's convenience, when you find out you are adequately pregnant, tell your program director around the time you're telling your parents. The faster s/he knows, the better the schedule can be arranged for everyone's sake.
     
  11. roja

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    There is NEVER a good time to have a kid. During residency you will be tired. During fellowship, you will be tired. During 'attendingship', you will be tired.

    Life is always busy. Always tiring. You can try and maximize your lifestyle, but in truth, you should have a kid when you are ready to have a kid.
     
  12. bulgethetwine

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    You may or may not feel like it is a great time for you personally - I've heard some who say it is fine, they're glad they got to do it, and others who were so tired that it nearly killed them.

    But I will tell you this -- the residents that say it is a "great time to have kids" forget that many residents in your class will resent you for the schedule interruptions, the extra call, the "preferential treatment" when you're getting bigger, slower, or itchy that is likely to occur. Even if you think now that your disruption will be minimal -- that you'll be the super resident who won't let the rest of the class down -- you won't care when you're 8 months pregnant and it's all you can do to get through a day. You'll take the preferential treatment then.

    Finish your residency and have kids when you're an attending so that those covering you while you're on maternity leave at least getting compensated for it. If you really think that your clock is ticking, then consider taking a full year off so that someone can take your place.

    Sorry.
     
  13. Hercules

    Hercules Son of Zeus
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    It sounds like there have been some very negative opinions on here about having kids during residency, so I feel the need to contribute. I am one of the chiefs and have sole scheduling responsibilities at my program, UAB. 3 of the 6 graduating seniors (2 females) this year have had or will have a child this year. I think it is very doable as long as you notify your scheduler way in advance (please please do this). When our two female reisdents told me about their pregnancies, we just set the yearly schedule up in a way that gave them the time they needed without impacting any of the other residents. Your scheduler should know better than to have them scheduled for shifts 2 days before their due date. Deliveries rarely occur out of nowhere though our patients may claim otherwise. With 9 months to plan ahead, you can usually work it out where your colleagues aren't picking up all the slack.

    Some programs are more family-friendly than others. I don't think it has as much to do with the type of program (community, county, academic) as the program itself. We are a busy academic program that is very family friendly.

    I would also agree with Roja: there is never a convenient time to have children. I have a 2 1/2 year old daughter and one more on the way. There's never a good time, but they're a lot of fun once they're here.
     
  14. turtle md

    turtle md Hardware Included
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    I had 2 kids during training, but my wife doesn't work, so my situation is different. We had 1 female resident, a chief, who had her baby the final year. But she planned it out well, so nobody else's schedule was affected. She basically took all of her vacation time and elective time around the due date and after, then hired help to continue once she went back to work.

    It can be done. But it will be tricky. But remember - this is a job. You have a life, and need to live it. Do what you need/want to do. Just try to time it to not affect your colleauges...
     
  15. Apollyon

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    One of our residents got pregnant my senior year, and milked it for all it was worth, and I personally got screwed on the schedule because of it (and late notice, at that - such as, "oh, by the way, the month starting tomorrow is switched with the one after"). Hers (apparently) was unplanned.
     
  16. LadyGrey

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    I think your timing will depend on the rotation schedule of the particular residency. Although in most places intern year sounds like the worst time to reproduce, some programs actually have a rougher second year (because of a lot of call-heavy off-service months versus lighter off-service months first year).
     
  17. EMforme

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    Yes, you CAN have a baby during residency and do well and not be hated and thrive. Some of the posts on here are from people who went through residency a while ago and most are from men (more men than women go into EM still).
    I am a M4 who is on the interview trail. My husband and I want to have our first baby during residency - ideally the second year. I have asked at every place because it's a big criteria to me. I always ask the residents - it's inappropriate to talk about benefits on a job interview. Usually family comes up at some point in the conversation. If not, I ask how many married vs. single. Then, I will ask if any women have had babies during residency. (At one place, the intern didn't know of anyone! That place just sank several levels. :) )
    At one place, the PD of all people outright in my interview told me (I didn't bring it up AT ALL) that if I wanted to have a baby that was great. He said - we love babies. We're having 5 this fall, and 5 this spring!
    OK, I have to board a flight.
    Bottom line - try not to do it intern year. Tell them early. Be a team player. Women have to reproduce - men can't. They most understand this - single men are probably the least likely to be understanding. But it really shouldn't affect them. (Some say that a larger program - i.e. more residents - makes it less likely to affect others with your pregnancy.)
    OK, gotta run!
     
  18. DrMom

    DrMom Official Mom of SDN
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    we had a pregnant resident who picked up shifts for people during her pregnancy and then whoever she worked for earlier picked up that many of her shifts during maternity leave.
     
  19. Apollyon

    Apollyon Screw the GST
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    Yeah, ours didn't - AT ALL.
     
  20. AmoryBlaine

    AmoryBlaine the last tycoon
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    I gotta weigh in on the side that would urge caution. I think it would be exceedingly difficult to manage unless there was a full-time stay at home spouse.

    I totally agree with the above in that any preferential treatment is going to be resented. If that makes us sound catty and mean then so be it. Most of the residents I know who have had kids (male and female) have had a rough time.

    I think it brings up a good point, if you want to know what the experience will be like it might be a good idea to talk to the OTHER residents in the class and not just the happy parents.
     
  21. DrMom

    DrMom Official Mom of SDN
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    but its not a bad plan and it avoids all of the resentment issues. everyone who took part in this did so voluntarily.
     
  22. bulgethetwine

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    First, your reference to "most comments are from men" actually is something you could not possibly know. It's an anonymous forum. You're showing your bias just as sure as you think the other posters are.

    Second, you and your husband seem to already have it planned out when you want to have your baby, regardless of what program you match at, what the schedule looks like, etc. So don't give me the happy crap that you want to "be a team player" and "let them know in advance".

    Third, women don't "have to reproduce". And even if *YOU* have to reproduce, you DON'T have to do it during residency.

    Fourth, don't assume that when someone, i.e. single men, don't agree with your point of view, it is a comprehension problem (they "won't understand"?). I'm married and I still have the same opinion. It's not that I don't understand where you're coming from. It's that I think it's self-centered.

    Hey, if you want to have a baby, more power to you. And if you find yourself in a program where the disruption to the program and the other residents is minimal, then by all means GO FOR IT! But if that isn't the case, don't try and cling to the "it's my right to have a baby" and do it anyway.

    Take a year out, or do it when you're an attending so I get paid for covering your shifts when you're at home being tired or off in the back pumping.
     
  23. BabyMaMa

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    I had a baby during residency and there have been bumps along the way, but I wouldn't change it for the world...Look for a residency with in house daycare. My hospital has 24-7-365 daycare. I have been able to breastfeed my baby and have the baby nearby.

    I know my fellow residents are probably not happy if I have to be off with a sick kid...but you have to rearrange your priorities as mom and as doctor. And I worked up to the day I delivered. Being a mom has definitely made me a better doctor.

    Bottom line, having a baby is a personal decision and you have to decide what time is best for you and your spouse. In medicine, there is NO perfect time and being a mom will change you.
     
  24. AmoryBlaine

    AmoryBlaine the last tycoon
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    What makes you say that? I'm not trying to start a war just genuinely curious.
     
  25. roja

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    Unfortunately, some people will milk whatever they can to not work. Pregnant, family, illness, whatever. I think this is more reflective of the person and not the situation (aka pregnancy).

    I have known many a pregnant women in residency and medical school with better work ethics than the non-child bearing. I knew one who used it to work as little as possible but she had done that BEFORE she was pregnant as well.

    Pregnancy/children are hard in residency. Hell, life is hard in residency. Time wise kids can be harder but I think for many having a kid makes it better. Yes you are tired, but when you have had a string of getting your arse killed at work, at least you have this really amazing thing to come home to.
     
  26. DogFaceMedic

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    Exactly right. Lazy pregnant residents are lazy residents. Male residents resentful of pregnant residents, are resentful people.
     
  27. Hayduke

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    What a horrible thing to say. NO THEY DON'T!
    Given the perspective gifted by our specialty, an applicant should recognize that not only do women not HAVE TO spawn, most shouldn't.

    I say this mostly because I don't want other folks' nether-fruit sucking up my kid's air. I always educate my patients regarding smoking cessation in addition to my request that they please stop breeding.

    That said-
    My residency is 70% female. The majority are married. They are basically grenades with the pins out just waiting to explode with new life. At conference sometimes when it gets quiet you can hear those ovaries crackling with anticipation.
    We support our pregnant peeps (6 since I've been here) and cover their slack after the joyous day.

    I'm supporting them right now with my post call hangover. I have been pulled twice this week to cover for new moms. I am not a petulant or resentful person. However, because they have planned their lives and living standards to the exclusion of the rest of their community, I and my peers get goat screwed every time their kids gets the snivels.

    To the OP-
    If you are hell bent to procreate, please consider those in your interdependent sphere. Be rich enough to cover your daycare or, go the poor route like me and keep a spouse at home with the kid and find inventive ways to liven up beans and rice.
     
  28. DogFaceMedic

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    Seriously?
    People in life have families; get used to it. If a person has genuine resentment against another's growing family, they perhaps should re-analyze their motives as perhaps self-absorbed arrogance.
    I like families.
     
  29. Hayduke

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    Well hello there fellow family liker.
    I am a huge digger of kids, spouses, marriage etc. I see self-absorbed arrogance in those that would assume a free safety net of coverage for their family needs. I have a unique perspective on this.

    My 5 month old NICU grad is on my lap as I write. My partner went through a pretty sh!tty last month of in hospital pregnancy then crash section and scary critically ill kid time. I was at the bedside when not working and am told (by the only one that counts) that my husband/dad status is well intact. My fellow residents were oblivious. There was no way I would have someone pick up my slack. I was fortunate to have such great care for my family just a few floors away.

    This is my own ethic. I don't expect everyone to adhere to this, but I do expect people to make an effort. I agree with you that there are lazy folks that make lazy residents, but I also believe that physicians frankly are harder working, self-sacrificing folks. That is one of the last bastions of work identity that maintains some respect for us. I fear that just as the profession of medicine gets chipped away from the outside, the new 'family friendly' version will erode the identity of the doctor from within.
     
  30. DogFaceMedic

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    It sounds like you are a good dad.
    So, I respectfully disagree with your last assertions. I think "family first" improves the profession by making room for our humanity. Also, I think the Infantry are hard-working and self-sacrificing. The profession, however, is not the reason we live, but rather families.
     
  31. EctopicFetus

    EctopicFetus Keeping it funky enough
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    FWIW I am a chief here and we had THREE female residents have kids this yr between Sept and Turkey day. All are on track to graduate on time.
     
  32. uncwalley

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    At this point in the year, don't expect the interns to know whether or not anybody has had a baby during residency. Most are spending plenty of time roaming the wards and away from their fellow EM residents to know a lot about all their personal lives.
    Residency is a fine time to have kids. They are a time drain as others have mentioned, but not a burdensome one. However, realize you are going into a field that is heavily-doused in teamwork. You have to pull your weight, even if that includes a basketball sized mound on your belly or a rugrat hanging off your leg. You'll miss some time, but know that you will make that time up.
    It is definitely possible to make your pregnancy nearly invisible to others as far as it affects your fellow residents. Schedule light rotations or electives around your due date. Be very willing to cover shifts for others at all times other than during your maternity leave.

    Get a nanny. They are more affordable than you think.
     
  33. Rendar5

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    My perspective as a non-married guy not looking to having kids anytime during residency:

    I'll cover your shifts and not hold it against you if your kid is sick or if you need time off after just having your baby. I can understand that. All I would ask is that you let the chief residents know very very early on in ur pregnancy so that schedules can be made that are more amenable to everyone. And that you make up for it somehow when you're able.
     
  34. Jarabacoa

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    Just keep in mind that having children is inherently, incredibly, completely unpredictable. Some women are like pioneer woman, working till the day they squat down in the field and pop it out. They then sling the kid over their back and keep working. Some women are incapacitated with morning sickness, running in the back room every 30 minutes, puking their guts out. Some women have a vaginal delivery and are up walking around the next day. Some have c-sections and are invalids for weeks. Some develop abscesses, sickness, some have babies in the NICU for weeks or months. Some women gain 25 pounds and look like supermodels the day after delivery, some gain 60 lbs, despite wathcing what they eat, and looking like cushing's disease textbook pictures the day after delivery.

    Of the 2 woman attendings who had children during my residency, both were on bedrest the last 3 months of their pregnancy, working minimal shifts, doing little administrative duties, and forcing the rest of the staff to work 3-4 extra shifts per month for 5 months (Yes, there was general malcontent with the male staff over this arrangement)

    Some babies are colicky terrors, who demand attention 24/7, and seem to know exactly when you are awake so they can sleep, and seem to sense exactly the moment that would be most frustrating and demoralizing for you to wake up. Some babies are lumps on a log, cooing, and gurgling on demand, sleeping the night away, and being absolutely, positively adorable.

    Some kids seemingly have ironclad immune systems, laughing away, and casually destroying every virus, or bacteria that comes their way. Other kids are invalids from cradle to high-school graduation, picking the worst possible times to get sick/hospitalized, and force you to miss work consistently because no daycare in their right mind would want the virus-riddled, snot-soaked, coughing, febrile, screaming nightmare.

    The best situation would be to have your spouse stay home while you go to residency and take care of the kids. He can go back when the kids are more grown if he wants to, right? If that isn't possible, then keep in mind that you are pulling in 2 salaries, compared to other residents who just have one. Live within your means and get help from a Nanny, family member, or whatever.
     
  35. Speed Racer

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    Being pregnant during residency is insane....

    now that I have grabbed you with my inflammatory comment.....

    Honestly, If I was preggers with a kid I would be deathly afraid of getting stuck by a needle, kicked by a drunk, or having the stress of the job land me in hospital.

    Why not have spots pre-designated for women OR MEN..who want to start families. Basically splitting the responsibility of one into two. Maybe a 5 year track instead of three. That way you have all the time to birth and raise your child proper and not have them hate you when they are 30.

    Just a thought....but work and careers mean nothing if you do not have family and I think our generation has been sold a bill of goods that you are allowed to have it all...I'm sorry, unless your Superman, having one of the hardest and most demanding jobs in society and raising and nurturing a child(ren) are not entirely mutually exclusive, but its close.....IMHO of course...
     
  36. AmoryBlaine

    AmoryBlaine the last tycoon
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    I heartily agree. I mean residency isn't supposed to be family friendly, it's supposed to be patient friendly. This obsession with lifestyle fields in medicine is not healthy for the individual or the field as a whole.

    I like to fancy myself quite the hard worker, maybe my fellow residents aren't sitting around bitching about how much work I leave for them but I doubt it.

    Quite frankly I don't see how one can be a great resident and a great parent all in one, there just aren't enough hours in the day. Notice I didn't say that one couldn't be a good resident and a good parent, or a good resident and a great parent, or a great resident and a good parent.

    This really isn't met as a sort of personal attack on anyone, just a statement of fact. It can apply to other areas as well, most of us probably couldn't be great residents and simultaneously be virtuoso composers.

    The argument that becoming a parent somehow makes you a better doctor is, I think, a shaky one. Does it imply that NOT becoming a parent leaves you deficient in some way? Or it is just another way to be well-rounded? I mean, learning three new languages might technically make me a better doctor as well but these things are incredibly difficult to quantify. When someone makes a statement like "I think that having a baby made me a better doctor" I would be inclined to ask the follow up, "are you even prepared to consider that having a baby made you a worse doctor?" If not then we are not really dealing in facts...
     
  37. uncwalley

    uncwalley Member
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    From your posts, I'm gonna assume you don't have children, so you are certainly speaking on a subject that you don't truly understand. On another note, your assertion that the obsession with lifestyle is not healthy isn't backed up by anything tangible.
     
  38. DogFaceMedic

    DogFaceMedic Member
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    I heartily disagree. Family friendly makes us better. That does not mean we all should have children. But families is what makes most of us who we are. I think the reason most young docs don't like peds is because they do not understand parents. In ER that translates in not understanding most of the population. Therefore, they are poorer physicians for not appreciating parenthood, whether as a parent or at least making the effort to be empathetic.

    To add to the fire: the best residents are parents.

    I prefer Marcus Welby to House.
     
  39. ccfccp

    ccfccp Stays crunchy in milk!
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    I guess I better run out and have a kid then so that I can make sure to get the most out of my residency. :rolleyes:

    Does that statement seem as ludicrous to anyone else as it does to me? Focusing more on lifestyle (whatever you take that to mean...) means that you do so at the exclusion of time at work. Unfortunately, sacrificing time at work means seeing fewer patients overall. There are only so many hours in the day. To me the whole point of residency is to see as many things as many different ways as possible so that I'll be prepared when it walks in the door and no one else is around. If you're missing shifts because of outside interests (be they family, or babies, or to compete in the national championships of the speckled newt wrangling competition) then it seems to me that it will negatively impact your experience.

    Interestingly, it seems like most of the people coming out in favor are students and most that are against are residents who have had this happen multiple times. I'm certainly not against people having kids during residency, but magically pretending like it doesn't effect your coworkers seems naive.
     
  40. BlondeDocteur

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    As someone getting married soon (29), graduating med school at 30, and planning on 7 years of residency + superfellowship, I have accepted the fact that my reproductive years completely overlap with my training years.

    I plan on having children (hopefully plural) in residency, but I don't plan on raising them much. Shock and horror greeted that comment, no doubt. But as a poster above said, it's true that the "you can have it all" line is an absolute myth. You can have it all-- satisfying profession + satisfying family life-- you just can't have it all at the same time. It requires delayed gratification, some creative rethinking, and prioritization.

    I will, of course, hire a nanny (or two), which as PPs acknowledged are not nearly as pricey as they sound. Most bi-resident couples I know (who make $90-$100K in New York, which is like the poverty line) have at least one. And contrary to the anxiety-soaked middle class myth that dominates discussions on mothering in this country, children can both be cared for by a nanny and still recognize their mother when she comes home at night. Hiring an au pair does not immediately require starting a savings account for later therapy sessions or expensive military boarding schools.

    I'm not applying to EM but rather to one of the surgical subspecialties-- which, due to the small resident classes, are practically the most difficult fields to take any time off in-- but I think the advice above about pulling your weight is both 100% correct and blindside-ingly obvious. It is pure, unadulterated entitlement to think that the rest of the world should be negatively impacted by the sacred, personal, private, but at the end of the day entirely arbitrary decision you made to have a child.
     
  41. DogFaceMedic

    DogFaceMedic Member
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    Yes, you can have it all.
    As to the argument that families take away from studying: let's take that logic further and eliminate vacations and all days off. With a little hyperbole, the point is that life has to balance with work. People can sacrifice their personal life to be more competitive, but that seems to undermine the whole point of life. Then to demand everyone else sacrifice their personal life, is implicitly contrary to the premise most of you preached during interviews: "I just want to help people."

    A program is better when it understands how to balance life and work for the faculty and residents. Residency and medicine requires hard work and dedication, which may seem the hardest thing in the world to youngens who only know college life and residency as their first real job. But, it isn't that hard to do.

    As some of the above posts demonstrate, some people resent other's families and is why women cannot talk about children until they have been accepted to a program.

    Family first.
     
  42. Hercules

    Hercules Son of Zeus
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    I want to point out yet again, that if proper warning is given to your chief/scheduler, this statement is usually going to be false. We had two female residents in my class that delivered earlier this year. It hasn't affected any of us. That's not a naive notion; it's a fact.

    The other assertion that has been made on here that you may somehow become a bad resident because you can't study as much, just doesn't hold up. If studying is important you'll make time to do it whether you have a family or not. For most of us with children in residency, it's not your work that suffers-- it's hobbies, watching tv, etc. Having children definitely cuts down on the amount of free time you have to spend in a day. I watch less tv, spend less time at the gym, and generally have less down time in the day than I did in my pre-fatherhood years. It hasn't really affected my studying or my duties as a chief.
     
  43. uncwalley

    uncwalley Member
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    EM residencies don't work like this. You don't get to decide to just spend extra time in the ED to try to prepare yourself better. You work your schedule and that's it. If you choose to read more on your off time, that is up to you. If you miss a shift, you will make it up, especially as Medicare is getting much more strict about how it reimburses programs for residents. If your program gets audited and a resident didn't work the number of shifts he or she was supposed to, the program could be charged with Medicare fraud. I suppose you could moonlight to get some extra time to see different things, but that too is an individual decision and is completely seperate from residency training.
     
  44. uncwalley

    uncwalley Member
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    If you tally the votes for and against for residents or attendings, it actually slightly weighs towards for having kids. The truth is, in an EM residency, you can make it work if you want to make it work and you can be a great resident and a great parent. If you are a particularly whiny or lazy person, you will make a crappy resident regardless of whether you decide to have children or not. If you are particularly motivated person with a good work ethic, you will be an excellent resident, even in the midst of your pregnancy and the trying times after giving birth.
     
  45. Jarabacoa

    Jarabacoa non carborundum ilegitemi
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    I think that there definitely is huge variation amongst residents with regard to patient volume seen. If you are a patient hog, and tend to leave charting toward the end of your shift, you can see a lot more patients than your fellow residents. If you have an eye on the clock and at 900 pm sharp, you have to go pick your kid up from daycare, you are going to chart as you go and really sandbag it the last couple of hours of shift, so that you can walk out at 855 pm. If you don't have the obligation of going home at 855 pm to fulfill family obligations, you will see patients until the end of your shift if you want to and make sure that no one gets to steal your procedures, just because you are going home. Amongst people with kids in daycare in my residency, the work ethic toward the end of shift was not there, and they were always encouraging everyone to "get out on time!" so they don't look bad running off while everyone else works. Based on numbers in my class that were kept track of by our program director, those with kids in daycare will see 10-30% fewer patients on the average shift.

    I would have to agree and disagree with Amory Blaine about having kids making you a better doctor. I personally believe that having kids does give you a leg up on pediatrics. I think the compassion for parenting, and the everyday knowledge of the way kids behave as well as having seen numerous cases of childhood illness up close is valuable knowledge to a physician. My wife won't take our kid to a pediatrician who hasn't had kids (Of course those pediatricians all reproduce like mad anyway). However, overall, I believe that having 2 careers, and a family during residency, without outside help except for daycare, would make you a clock-watcher, would make studying nearly impossible, and would in the end have a negative impact on your knowledge base and overall preparedness.

    Another aspect of this debate is that outside rotations are generally utterly ruthless, and don't give a darn about personal problems. Your program has promised them a resident for that month, and you'd better come through with flying colors, or your program director will be all over you like flies on poop. That doesn't change anywhere, anytime. Neurosurgeons, cardiologists, surgeons, etc. don't really care that your kid is sick and it is inconvenient for you to work that day.

    People think, "I'll just take 6 months off!" Great, so your residency will be understaffed for 6 months while you are MIA. Then you work 6 months after your fellow residents are graduated and the ED is overstaffed for 6 months because they have to provide you with your extra shifts per month.

    I find it a tad ironic that people generally avoid having kids like the plague in med school, and then get baby fever as residents. Medical school is a much better time to have kids than residency, but people don't want their grades to suffer, and keep them from getting into their residency of choice. Once they get into residency, they don't care at all about their education it seems. Once in residency, they will pretty much graduate unless they repeatedly commit malpractice or become a felon or something, so they quit studying and all of the sudden become "devoted to family". As long as their personal lives and goals aren't disturbed, they don't care. If the future lives of their patients might be compromised by a lack-luster effort, they aren't put off too much.

    Arguably, 95% of medical school knowledge is pretty much useless on a day to day basis in the ER. The true education comes in residency. These 3-4 years are your chance to learn, practice and ask as many free questions as is possible, and seek as many learning opportunities as is humanly possible.

    Again, I will reiterate, that I have nothing against people who have kids during residency, as long as they realize that they really can't have their cake and eat it to. If you have a two career family during residency, for the sake of your training, for the sake of your family, and for the sake of your own sanity, pay for help. Don't expect your program director to baby-sit your kids in their office all day, or think that not showing up at work for personal reasons will be tolerated anywhere. You need a very reliable baby-sitter, family member, or daycare, that is available 24-7, 365 days a year. The alternative is to pawn off work on already over-worked fellow residents. That's not cool.
     
    #44 Jarabacoa, Dec 22, 2008
    Last edited: Dec 22, 2008
  46. ccfccp

    ccfccp Stays crunchy in milk!
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    Wow. I stand corrected. Thrice.

    However, I never said anything about "studying," only about seeing patients. As was mentioned by Jarabacoa above, the majority of your "real" education in residency comes from seeing patients. If you're not there, you don't see them.

    Hey take my digital opinion for exactly what it's worth... zero. I'm a single guy without kids and currently without prospects of having any anytime soon. I too will again reiterate: If you want to have kids, by all means have them. Just be ready for all of the effects (good and bad) this will have on not only your personal, but also your professional life (and possibly the professional life of others at your program) as well. Just remember any hour you take away from somebody else to have YOUR personal life is one hour THEY no longer have for their families or interests.
     
  47. roja

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    I find it interesting that most people would jump away from establishing broad medical interventions based on limited observations (<10) and extrapolate that to all 'similar' patients and yet, no one is raising eyebrows at people doing this based on thier limited experiences of 'residents with kids'.

    I have seen single unattached residents exhibit the exact same behavior that is being attributed to parents.

    I have seen parents act like this. I have seen married childless residents act like this.

    Like all things, it is incredibly useless to extrapolate broad vague events to all residents with kids based on limited exposure.

    It boarders on insulting to those of us who aren't like that and to those who might have kids (or get married, or have a sick parent/family member, have a chronic illness, etc etc.).

    *LIFE* happens. It is important for ALL people to learn to balance it. Yes, you will have to work hard. Yes, you should think about your colleagues. Yes, you should have a life.

    ( I didn't see 30% less patients... I saw just as many as my colleagues. I also ran our research program for a year, developed my own fellowship, conducted research, ran critical care conferences and managed to see and hang out with my family (including my daughter) and friends.)


    There will always be VAST variability when dealing with people, life and work ethics. The important thing is to keep it all in perspective, don't assume the worse (or make broad assumptions about a group) and treat your colleagues like you would like to be treated. :)
     
  48. Jarabacoa

    Jarabacoa non carborundum ilegitemi
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    Some very good points Roja. You are right.

    I feel like getting to what I believe is the heart of the issue. Please forgive me for what I'm about to say. I feel it should be said.

    I frequently have the same conversation. It goes something like this "What does your wife do?" Me "She is a stay at home mom" Them... awkward silence followed invariably by "Oh, just a stay at home mom?"

    Understandably, there are some pretty hostile feelings on both sides of the mothering and work issue. On one side of the issue are the women who believe that women and men should have the same standing in the work-place, no matter what. When they hear some of the comments here, they are inflamed and instantly cry sexism, "So women with families shouldn't be in the work-place, huh? They should be bare-foot, pregnant, and in the kitchen?" On the other hand are the men and women who think, "Two careers and kids? Why? How? What is there to gain? Couldn't there be a lot to lose?"

    These sides will never be reconciled. All of our opinions are jaded by bias. My own bias is that I have a wife that stays at home with the kids (6,4, and 1). She is a very smart woman, (out-scored me in all of our numerous undergraduate courses together (we were both biology majors) and could succeed in pretty much whatever career she wanted to. She feels a huge amount of scorn from feminist-type women, who openly and sometimes vocally view her as less than a women and a traitor to their cause for staying at home with the kids. I get defensive when I hear my wife's effort's belittled by statements in effect stating, "Raising a family doesn't take too much time and you can do just as good of a job with two parents working 50-60 hour weeks in their careers at the same time."

    I think that this isn't just about men versus woman in the workplace. One of my attendings was a woman, whose husband stayed at home with the kids. She made more money than he could have at his engineering job, so they decided to have him stay at home with the kids. As a result, she could contribute even more than her male colleagues and serve as the department director.

    It's been voiced above that I'm arrogant for voicing this opinion and that it is bordering on offensive. Sorry, I just wanted you to see it from my perspective, and help you to realize that I feel just as offended and that you are just as arrogant. Those who agree with my opinion will never be voice it publicly as it is not politically correct, especially in the setting of residency programs. The only reason I express it here is because I have purposefully kept my identity anonymous.
     
    #47 Jarabacoa, Dec 23, 2008
    Last edited: Dec 23, 2008
  49. AmoryBlaine

    AmoryBlaine the last tycoon
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    1. You are right about that.

    2. My assertion that the obsession with lifestyle is not healthy is backed up by exactly as much "tangible" evidence as your statement that it isn't.
     
  50. SoCuteMD

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    I would love for someone to stay home with my (future) children. However, with a ridiculous amount of educational debt and (hopefully) a job that I really do think I'll love - it's not going to be me. It's sad to see parents (mostly women) crucified on here for wanting a career and family. One of my friends gave birth after a normal, uncomplicated pregnancy at the beginning of her 4th year. After a few weeks rest and recuperation, she was back to kicking ass and taking names in the ED. Judging by the fact that she's received interviews from every single program she applied to, my guess is that her performance was not affected and she didn't suddenly go from third year superstar to clock-watching mom.

    As for the people who are all pissed off at others for having babies during residency - who the hell do you think you are? So male residents get to have children (since their wives do most of the heavy lifting) but us females will just have to wait while our risk of pregnancy complications and birth defects increases? You get to play with your 5 month old NICU graduate, but should a female in your program encounter the same problems your wife did during pregnancy then she just shouldn't be reproducing?

    SDN makes me very sad sometimes.
     
  51. AmoryBlaine

    AmoryBlaine the last tycoon
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    Bull****.

    Pediatrics is a more popular specialty than emergency med both in terms of US seniors and total number of matched spots.

    And to your second point: bull****.

    That doesn't mean he's a better physician.
     

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