Pregnancy during interviews?

[doomlaut]

Wondering if anyone can offer some insight.

I am a 29 year old MS3 at an upper mid-tier private allopathic US school with a strong ophtho home program. 244 Step 1, only passes during pre-clinical years, honors in Neurology, General Surgery, Anesthesiology, Urology, Family Medicine, excellent in Internal and Psychiatry (spots in third year electives are via lottery so no luck getting third year ophtho spot). Strong comments so far for Deans Letter, especially from surgery. Co-author in a chapter for an ophtho handbook, and involved in one or two ophthalmology projects with hopeful but not definitive publication prospects. Not even close to first author. Second author for one non ophtho poster/publication. Several significant international work experiences prior to starting school.

Overall, I feel that I am a decent candidate, but I certainly do not feel that I am guaranteed a spot in this upcoming match.

My husband and I both feel ready to start a family. I have been told over and over that fourth year is the best time to have a child for a multitude of reasons. I also am about to enter my 30s and would not feel comfortable pushing off pregnancy until after residency.

My question is, given my scenario as a decent but not phenomenal candidate, am I foolishly hurting my chances of matching by being visibly pregnant at ophthalmology interviews? Or would most reasonable program directors not be influenced by this one way or another?

Any insight would be very appreciated! Thanks so much in advance, and thanks for having this be such a positive community for information and discussion.

---

Members don't see this ad.

 

[DrZeke]

Wondering if anyone can offer some insight.

I am a 29 year old MS3 at an upper mid-tier private allopathic US school with a strong ophtho home program. 244 Step 1, only passes during pre-clinical years, honors in Neurology, General Surgery, Anesthesiology, Urology, Family Medicine, excellent in Internal and Psychiatry (spots in third year electives are via lottery so no luck getting third year ophtho spot). Strong comments so far for Deans Letter, especially from surgery. Co-author in a chapter for an ophtho handbook, and involved in one or two ophthalmology projects with hopeful but not definitive publication prospects. Not even close to first author. Second author for one non ophtho poster/publication. Several significant international work experiences prior to starting school.

Overall, I feel that I am a decent candidate, but I certainly do not feel that I am guaranteed a spot in this upcoming match.

My husband and I both feel ready to start a family. I have been told over and over that fourth year is the best time to have a child for a multitude of reasons. I also am about to enter my 30s and would not feel comfortable pushing off pregnancy until after residency.

My question is, given my scenario as a decent but not phenomenal candidate, am I foolishly hurting my chances of matching by being visibly pregnant at ophthalmology interviews? Or would most reasonable program directors not be influenced by this one way or another?

Any insight would be very appreciated! Thanks so much in advance, and thanks for having this be such a positive community for information and discussion.

The politically correct response here would be, "oh no that's nobody's business". But the reality is that people to judge and they sometimes ask those "taboo questions". You may say that you won't take time off for your pregnancy. But my thought is that they might not believe you. They have to consider the possibility that you might take time off in prelim year. Many women have fantastic plans when having children but not all are able to follow through. For example I am aware of one program where a resident had to repeat a year because they had a child during residency and things got overwhelming. There is nothing wrong with that, she's a mother and that comes first, but it affected the residency program and faculty do want to look out for their programs. I know another that had a child during 3rd year residency and they did not need extended time off.

I felt when I was interviewing that ophthalmology is still somewhat conservative. Everyone was very nice, but most of the prominent faculty are male. This is probably medicine in general and academia in general. There are less than a handful of female chairmen.

Programs worry about losing a resident for a year especially when the average program is 4 people. It would be easy enough to replace you since tons of people want an ophtho spot, but who wants to go through that. I'm not saying you would do that, but people will look at your bump and make their own judgements.

I understand your personal reasons for wanting to be pregnant before 30, but unless someone has deemed you as having fertility difficulty and needing to be pregnant before 30 I would wait till after interviews. I know people that have babies during residency. It's harder, but you can do it. Also, I know many women who have children in their mid 30s. I know the statistics, but I worry this will impact you negatively.

 

[Dusn]

I don't see why it would be a problem. You'd be having the baby near the end of 4th year of medschool which is the best time. If I were the program director I'd probably be happy you're having the baby well before ophtho residency starts. If you wait then you're having the baby during residency; then you might be wondering if it will impact fellowships, not being able to sleep much before your earliest surgeries, the stress of residency, etc.. it never ends.

The only problem is that you'd be flying all over for interviews while pregnant which doesn't sound like much fun. Also you'd want to be very sure that you don't deliver while in a city far from where you live or have family, especially, as sometimes happens, you end up delivering much earlier than expected. This is not to scare you because I do think 2nd semester 4th year medschool is probably the best time

 

[Dusn]

.

 

[dantt]

Wondering if anyone can offer some insight. I am a 29 year old MS3 at an upper mid-tier private allopathic US school with a strong ophtho home program. 244 Step 1, only passes during pre-clinical years, honors in Neurology, General Surgery, Anesthesiology, Urology, Family Medicine, excellent in Internal and Psychiatry (spots in third year electives are via lottery so no luck getting third year ophtho spot). Strong comments so far for Deans Letter, especially from surgery. Co-author in a chapter for an ophtho handbook, and involved in one or two ophthalmology projects with hopeful but not definitive publication prospects. Not even close to first author. Second author for one non ophtho poster/publication. Several significant international work experiences prior to starting school. Overall, I feel that I am a decent candidate, but I certainly do not feel that I am guaranteed a spot in this upcoming match. My husband and I both feel ready to start a family. I have been told over and over that fourth year is the best time to have a child for a multitude of reasons. I also am about to enter my 30s and would not feel comfortable pushing off pregnancy until after residency. My question is, given my scenario as a decent but not phenomenal candidate, am I foolishly hurting my chances of matching by being visibly pregnant at ophthalmology interviews? Or would most reasonable program directors not be influenced by this one way or another? Any insight would be very appreciated! Thanks so much in advance, and thanks for having this be such a positive community for information and discussion.

 

[backrow]

The "correct" answer is no, it shouldn't be a factor; HOWEVER, everyone has biases whether they realize it or not.

Ophthalmology is already hard enough to match, do you really want to give even one person even the remote chance of it effecting their decision?

My suggestion is not to not get pregnant; however, many women don't really show for many weeks and sometimes can hide it for even longer. Since the ophtho match is early you can plan for that to avoid being obvious during interview season.

The harder one may be the intern year interviews....

 

[DrZeke]

I don't see why it would be a problem. You'd be having the baby near the end of 4th year of medschool which is the best time. If I were the program director I'd probably be happy you're having the baby well before ophtho residency starts. If you wait then you're having the baby during residency; then you might be wondering if it will impact fellowships, not being able to sleep much before your earliest surgeries, the stress of residency, etc.. it never ends.

The only problem is that you'd be flying all over for interviews while pregnant which doesn't sound like much fun. Also you'd want to be very sure that you don't deliver while in a city far from where you live or have family, especially, as sometimes happens, you end up delivering much earlier than expected. This is not to scare you because I do think 2nd semester 4th year medschool is probably the best time

I disagree. Usually I agree with things on this forum, but Im pretty sure most of the people that post on this forum are male. They may not realize or want to believe some of the experiences that women have in medicine and ophthalmology. It's unfortunate, but true, people may judge you on your pregnancy at interviews. They may even question your commitment to the field. It's fine when you already have kids and you are achieving success or a super star academic, but if you're about to have your first child, it may add some unnecessary questions and concerns to your application.

Though it is different, when women interview for fellowship they are sometimes asked about if they are planning on starting a family and when. So even tho many people never ask such taboo questions, don't give them a reason to ask them/wonder in their head.

Another point which nobody wants to think about is what if you have a complication, or need to take time off that affects your intern year. This will mean coming to the program a year late...

Last point I would like to make is... If you really want to have a baby in 4th year and want to go on interviews with a bump, then just do it and accept the possible consequences. Accept that it may affect your chances. I think it's not the best idea, but maybe having a baby is more important than matching. And maybe you will match with a bump.

 

[Eyefixer]

OP, listen to DrZeke, he nailed it. GL

 

[doomlaut]

Thanks everyone for the thoughtful and insightful replies! Really appreciate the time you've taken.

 

[eye love lamp]

I disagree. Usually I agree with things on this forum, but Im pretty sure most of the people that post on this forum are male. They may not realize or want to believe some of the experiences that women have in medicine and ophthalmology. It's unfortunate, but true, people may judge you on your pregnancy at interviews. They may even question your commitment to the field. It's fine when you already have kids and you are achieving success or a super star academic, but if you're about to have your first child, it may add some unnecessary questions and concerns to your application.

Though it is different, when women interview for fellowship they are sometimes asked about if they are planning on starting a family and when. So even tho many people never ask such taboo questions, don't give them a reason to ask them/wonder in their head.

Another point which nobody wants to think about is what if you have a complication, or need to take time off that affects your intern year. This will mean coming to the program a year late...

Last point I would like to make is... If you really want to have a baby in 4th year and want to go on interviews with a bump, then just do it and accept the possible consequences. Accept that it may affect your chances. I think it's not the best idea, but maybe having a baby is more important than matching. And maybe you will match with a bump.

I agree with Zeke here. Not saying that this is guaranteed, but even if you have an uncomplicated pregnancy and a healthy child, what will your focus be on during residency? Are you going to be looking at the door everyday at 430? Will you stay late to work up interesting cases or finish consults or will you continually boot them into the next day? Will you be going home to read/study/do research/be productive or will eyeballs leave your brain the moment you step into your car?

Even if you had a child, I probably wouldn't mention it on interviews. Mentioning a potential mid-residency birth would be even harder.

 

[Gracile]

I agree with Zeke here. Not saying that this is guaranteed, but even if you have an uncomplicated pregnancy and a healthy child, what will your focus be on during residency? Are you going to be looking at the door everyday at 430? Will you stay late to work up interesting cases or finish consults or will you continually boot them into the next day? Will you be going home to read/study/do research/be productive or will eyeballs leave your brain the moment you step into your car?

Even if you had a child, I probably wouldn't mention it on interviews. Mentioning a potential mid-residency birth would be even harder.

I understand there is bias towards pregnant applicants but should a person really put starting a family on hold because of the belief they'll lose focus in residency? There are several residents in my current program who have children and are far better than residents without children. One in particular reads extensively daily and has a toddler. Having a child does not mean you can't concentrate on ophthalmology and stay late as long as the individual takes responsibility and ensures adequate patient care.

 

[ophthope]

We have entrenched such a ridiculous and absurd method of training physicians that the best advice you'll get here is to avoid having a child until after residency. You could be a PhD doing cutting edge research and people wouldn't doubt your ability to do you work well and be committed to your field just because you were pregnant or had a young child. Want to design missles for Lockheed Martin? I'm sure they'd be glad to have a talented young mother on the team. But unfortunately, you went to medical school. Anything that distracts from 24/7 devotion to patients and learning everything you can about disease is seen as a negative. Unless you are living an unhealthy life comprised of little to no time away from work, minimal sleep, and constant devotion to your chosen field... well you aren't doing everything you could to be the best resident possible now are you? Because with all of the call you're going to take, all of the grand rounds / posters / small papers / other presentations / pimp preparation you're going to be expected to do, and all of the scut work prepping things for attendings you're going to have slog through, not to mention the voluminous tomes of information you'll need to somehow assimilate through rigorous study and testing; well there's not much time for anything else. And if you do need time off, the work falls to another already overworked resident to pick up the slack and take twice as much call. Because it's 2015 and I guess we still think this is the best, most efficient, healthiest way to train physicians.

So it's not you, it's the broken way we're trained that makes people wary of taking on a pregnant mother, regardless of whether or not they can actually legally use that as criteria. Nobody would ever dare speak about you being pregnant, but you can't keep it out of everyone's minds.

If you can 'sneak in' a kid late fourth year after matching and then take maternity leave during intern year that may be ideal for you if that's what you want. But it would be difficult to care for a one year old as PGY2 Ophthalmology resident. You really don't understand just how busy Ophtho call is until you do it. Dermatology is the only specialty where call doesn't seem to matter (as long as you aren't at a burn center I suppose). Ophtho call is surgical, you will be in the hospital when you are on 'home call.' 'Home call' is a misnomer. You'd have to have a really, really good support system for that. And you'll need to be studying pretty much as soon as the little one goes to bed in order to keep up with the pace of learning because we really do a ton of reading compared to other specialties. The board exam basically expects you to be a pathologist for ocular tissues.

 

[eye love lamp]

We have entrenched such a ridiculous and absurd method of training physicians that the best advice you'll get here is to avoid having a child until after residency. You could be a PhD doing cutting edge research and people wouldn't doubt your ability to do you work well and be committed to your field just because you were pregnant or had a young child. Want to design missles for Lockheed Martin? I'm sure they'd be glad to have a talented young mother on the team. But unfortunately, you went to medical school. Anything that distracts from 24/7 devotion to patients and learning everything you can about disease is seen as a negative. Unless you are living an unhealthy life comprised of little to no time away from work, minimal sleep, and constant devotion to your chosen field... well you aren't doing everything you could to be the best resident possible now are you? Because with all of the call you're going to take, all of the grand rounds / posters / small papers / other presentations / pimp preparation you're going to be expected to do, and all of the scut work prepping things for attendings you're going to have slog through, not to mention the voluminous tomes of information you'll need to somehow assimilate through rigorous study and testing; well there's not much time for anything else. And if you do need time off, the work falls to another already overworked resident to pick up the slack and take twice as much call. Because it's 2015 and I guess we still think this is the best, most efficient, healthiest way to train physicians.

So it's not you, it's the broken way we're trained that makes people wary of taking on a pregnant mother, regardless of whether or not they can actually legally use that as criteria. Nobody would ever dare speak about you being pregnant, but you can't keep it out of everyone's minds.

If you can 'sneak in' a kid late fourth year after matching and then take maternity leave during intern year that may be ideal for you if that's what you want. But it would be difficult to care for a one year old as PGY2 Ophthalmology resident. You really don't understand just how busy Ophtho call is until you do it. Dermatology is the only specialty where call doesn't seem to matter (as long as you aren't at a burn center I suppose). Ophtho call is surgical, you will be in the hospital when you are on 'home call.' 'Home call' is a misnomer. You'd have to have a really, really good support system for that. And you'll need to be studying pretty much as soon as the little one goes to bed in order to keep up with the pace of learning because we really do a ton of reading compared to other specialties. The board exam basically expects you to be a pathologist for ocular tissues.

You start this post off by saying it's absurd that anyone would insinuate that during residency is a suboptimal time to have a child, yet you end the post talking about how difficult it would be to have a one year old during residency?

You're also nuts to think that women don't get discriminated against in EVERY field just over the very topic of potential pregnancy.

 

[MstaKing10]

You start this post off by saying it's absurd that anyone would insinuate that during residency is a suboptimal time to have a child, yet you end the post talking about how difficult it would be to have a one year old during residency?

You're also nuts to think that women don't get discriminated against in EVERY field just over the very topic of potential pregnancy.

This is a very good point. How different would the narrative be if we were talking about a man with a 3 month old at home during first year of residency?

 

[doomlaut]

Thanks all again for your replies. I should have mentioned in my initial post that my concern is really not as much about childcare during residency (although I'm sure it is an added stress regardless of circumstances) as my husband has the capability to work from home with a flexible schedule and will be the primary care provider. We also have very supportive retired parents on both sides who would be available to help as well. Just worried about being visibly pregnant during interviews affecting match prospects. It sounds like so far the consensus is that it most likely could, which I understand is just a risk I would have to accept if we chose to go ahead and start our family with the timing we choose.

 

[eye love lamp]

This is a very good point. How different would the narrative be if we were talking about a man with a 3 month old at home during first year of residency?

It would be identical.

There's a reason I'm waiting to have kids.

 

[DrZeke]

Except...if nobody asked you about it they wouldn't know. You wouldn't show up to interviews unable to CONCEAL that you plan on having a 3 months old at that time.

I'm going to say it again, even tho nobody wants to hear it and I'm going to be very clear

( /*\ ) vs. <===3

makes a difference sometimes, unfortunately. LOL please don't flag me people.

 

[ophthope]

You start this post off by saying it's absurd that anyone would insinuate that during residency is a suboptimal time to have a child, yet you end the post talking about how difficult it would be to have a one year old during residency?

You're also nuts to think that women don't get discriminated against in EVERY field just over the very topic of potential pregnancy.

I specifically mentioned engineering because that's the field I was in before medicine. In my experience at a Fortune 500 company, women were not discriminated against over the topic of potential pregnancy. My former female colleagues also have not experienced any issues related to pregnancy. Some have even taken a leave of absence for a year with their first child. Nobody gave her credit for that year when it came time to give raises, but the company brought her right back as promised. I'm sure there are various places within any field where people are discriminated against for any potential topic you can imagine. But it's 2015 not 1985.

Also you somehow completely missed what I'm saying about children in residency: I'm saying the way we train ourselves in residency MAKES it difficult to have a child and that's the problem. Yes residency will be a suboptimal time to have a child. But if the way we are training physicians creates an situation where you are all but forced to put off having children until you are 30, it's a problem. We could create a better system.

And other countries have much different conditions for residents and they're still training competent physicians and taking care of patients. Here's the European Working Time Directive for 'Junior Doctors'.

Some highlights other than the maximum of 48 hour work weeks averaged over 26 weeks:

• a minimum of 11 hours' continuous rest in every 24-hour period
• a minimum rest break of 20 continuous minutes after every six hours worked
• a minimum period of 24 hours' continuous rest in each seven-day period (or 48 hours in a 14-day period)
• a minimum of 28 days or 5.6 weeks' paid annual leave
• a maximum of eight hours' work in each 24 hours for night workers.

So yes, I still maintain that the primary problem is that our system is not designed to be reasonable enough for normal people to maintain a good quality of life. I think that's the bigger problem than the shadowy back room patriarchy lowering that glass ceiling for young mothers. The system we use to train physicians creates an obvious problem for young mothers, because the system makes it very hard to accommodate for maternity leave. That's the problem. And it's in every field of medicine.