Pregnant & can't start new residency on July 1st

[dpmd]

A match violator? Not being able to start is not a match violation. Its not that uncommon - i even started late and it was not that big of a deal.

Having no intention to start on the start date could be considered a violation.

The listing of an applicant by a program on its certified rank order list or of
a program by an applicant on the applicant's certified rank order list
establishes a binding commitment to offer or to accept an appointment if a
match results and to start training in good faith (i.e., with the intent to
complete the program) on the date specified in the appointment contract.
The binding commitment shall be deemed to ohave been honored so long
as the applicant enters and remains in the training program through the first
45 days after the start date of the relevant appointment contract. The
same binding commitment is established during the Match Week
Supplemental Offer and Acceptance Program (SOAP) if a program
offers a position by listing an applicant on its preference list and the
applicant accepts that offer. Absent a waiver from the NRMP, failure to
honor this commitment by either party shall be a breach of this Agreement
and may result in penalties to the breaching program or applicant, as
described in Section 8.0

Not saying the program will take this stance, but I can see how they could if she says she needs the first two months off.

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[Piebaldi]

Having no intention to start on the start date could be considered a violation.
Not saying the program will take this stance, but I can see how they could if she says she needs the first two months off.

When it comes to medical issues, it becomes a much more grey issue. When I was a med student there was an intern who fell on the parking lot on the first day of residency and broke his femur! Lol. Sorry, but so he was unable to "start" but it's not like he was purposely refusing to work just because he's a jerk or lazy or something.

If I get hit by a truck on my first day of internship and can't start I'm sure that the progrma wouldn't be like oh let's label them a match violator. I'm sure that it's more of a grey situation with medical stuff.

 

[dpmd]

When it comes to medical issues, it becomes a much more grey issue. When I was a med student there was an intern who fell on the parking lot on the first day of residency and broke his femur! Lol. Sorry, but so he was unable to "start" but it's not like he was purposely refusing to work just because he's a jerk or lazy or something.

If I get hit by a truck on my first day of internship and can't start I'm sure that the progrma wouldn't be like oh let's label them a match violator. I'm sure that it's more of a grey situation with medical stuff.

Pregnancy is not the same as getting hit by a truck right before internship. Though if you got hit by a truck right after your last interview and were informed you needed to be off work for enough time that you would not be able to start on time, but did tell anyone until after you certified your rank order list (meaning you lied while certifying since you had no intention to start on July 1, which means you had no intention to adhere to the commitment you are certifying you would adhere to) they might not see it as favorably as they would if you got injured after that point

 

[rokshana]

When it comes to medical issues, it becomes a much more grey issue. When I was a med student there was an intern who fell on the parking lot on the first day of residency and broke his femur! Lol. Sorry, but so he was unable to "start" but it's not like he was purposely refusing to work just because he's a jerk or lazy or something.

If I get hit by a truck on my first day of internship and can't start I'm sure that the progrma wouldn't be like oh let's label them a match violator. I'm sure that it's more of a grey situation with medical stuff.

dude! there is a difference between getting struck by a car the day before you start and being pregnant for 9 months and know your due date is 3 days before you are going to start (yes, there are those that drop a baby not knowing they were pregnant, but that is not the case here.


are you just wanting to argue for argues sake...the thread you started on quitting your job seemed to have degraded to that...don't do that here.

 

[Apollyon]

When I was a med student there was an intern who fell on the parking lot on the first day of residency and broke his femur!

Now that's how you do it! Worker's Comp before even walking in the door!

Just an anecdote - there is a local lawyer that broke his neck on his motorcycle - quad now. Since he had some legal papers in his saddlebags, somehow it got made to work that this was Worker's Comp. Bought him this wheelchair that does everything except order pizza!

 

[dpmd]

Now that's how you do it! Worker's Comp before even walking in the door!

Just an anecdote - there is a local lawyer that broke his neck on his motorcycle - quad now. Since he had some legal papers in his saddlebags, somehow it got made to work that this was Worker's Comp. Bought him this wheelchair that does everything except order pizza!

Fall in the hospital parking lot could be a cha-ching kind of event if you don't mind destroying your ability to quietly get through residency there.

 

[Piebaldi]

Fall in the hospital parking lot could be a cha-ching kind of event if you don't mind destroying your ability to quietly get through residency there.

I'm sure the intern did not mean to do it on purpose.

 

[Apollyon]

Fall in the hospital parking lot could be a cha-ching kind of event if you don't mind destroying your ability to quietly get through residency there.

My comment was more light hearted in intent. Your comment is much darker. As above, I would guess that the person didn't do it on purpose.

 

[dpmd]

I'm sure the intern did not mean to do it on purpose.

Didn't say they did. Just saying choosing to sue for a big settlement for it would be possible but probably not if you want to avoid making your residency awkward.

 

[LucidSplash]

Now that's how you do it! Worker's Comp before even walking in the door!

Just an anecdote - there is a local lawyer that broke his neck on his motorcycle - quad now. Since he had some legal papers in his saddlebags, somehow it got made to work that this was Worker's Comp. Bought him this wheelchair that does everything except order pizza!

That’s ok Alexa can order pizza now.

 

[MediCane2006]

I would take a good hard look at deferring graduation for a year.

I know you said you have supportive family, but having a newborn is a HUGE life adjustment. And that’s leaving aside all the physical trauma of giving birth.

To rush your return to work, and then to jump right into the emotional meat grinder that is intern year (oh btw, also starting 4-8 weeks behind) while also having a new baby at home, seems incredibly foolhardy. Intern year is hard enough without missing your baby, stressing about child care, and dealing with the physical/emotional reality of the fact you just brought a new human being into the world....

....IN ADDITION TO WHICH, your PD and faculty (regardless of legality) are likely going to be fairly annoyed that you “oh by the way”’d the fact that you would be missing the first 1-2 months of intern year, and you’ll be starting the year with the That Resident target on your back.

I’m not saying it’s impossible. If there is one thing residency has taught me it’s that there are people out there capable of emotional and physical feats of strength that to me are unimaginable. I’m just saying that maybe before setting yourself up for failure, make sure you have absolutely ruled out other options.

Lastly, I will just offer the caution that the majority of people who I have seen fail out of intern year are the ones who underestimated it or overestimated their capability to deal with additional life stressors (mental illness, dependent family members, children, pregnancy). I think you are in a position to make an alternate strategy with deferring graduation and coming back next year full-strength with a good childcare plan set up. Either way, best of luck and wholehearted congratulations on the new addition!!!

 

[Raryn]

A match violator? Not being able to start is not a match violation. Its not that uncommon - i even started late and it was not that big of a deal.

Going into the match knowing you would be unable to start on time is actually a violation, yes. You certify in the match agreement that you'll be able to start on time. The NRMP if notified could potentially ban the OP from the match for up to several years for participating with no intention of starting on July 1. They probably wouldn't (it's bad PR), but they easily could.

If the OP's due date was a month and a half sooner or later she'd be fine - but this is exactly the *worst* possible time to have an infant.

Personally, she only has three options

1) Gamble - don't tell anyone, match somewhere, and *immediately* on match day email the program and let them know. They won't have finalized any sort of schedule yet, so it's likely they'll be able to move some things around and let her start on leave. She may or may not be requested to go to as much of orientation as possible the week or two before her due date. At my program, we'd had interns who started with a month of vacation for whatever reason - it was doable.

Of course, the program won't be happy, but it's *possible* to not know you're pregnant until you're three or four months along - and they might not ask. I certainly would never mention the child was the result of IVF. Waiving the match entirely probably won't happen. But that's a probably at best - and if the program was feeling upset enough, they could request a waiver of the match (which will probably be granted) and report you as a match violator (a potentially career ending move).

2) Be upfront - email the programs and let them know today. This gives them a big heads up - but does bring up the possibility that they'll decrease OP's ranking (or drop her entirely).

3) Delay the whole process a year.

Unfortunately, with (practically) all residents in the country starting work on a single day, there's no easy solution.

 

[dpmd]

Going into the match knowing you would be unable to start on time is actually a violation, yes. You certify in the match agreement that you'll be able to start on time. The NRMP if notified could potentially ban the OP from the match for up to several years for participating with no intention of starting on July 1. They probably wouldn't (it's bad PR), but they easily could.

If the OP's due date was a month and a half sooner or later she'd be fine - but this is exactly the *worst* possible time to have an infant.

Personally, she only has three options

1) Gamble - don't tell anyone, match somewhere, and *immediately* on match day email the program and let them know. They won't have finalized any sort of schedule yet, so it's likely they'll be able to move some things around and let her start on leave. She may or may not be requested to go to as much of orientation as possible the week or two before her due date. At my program, we'd had interns who started with a month of vacation for whatever reason - it was doable.

Of course, the program won't be happy, but it's *possible* to not know you're pregnant until you're three or four months along - and they might not ask. I certainly would never mention the child was the result of IVF. Waiving the match entirely probably won't happen. But that's a probably at best - and if the program was feeling upset enough, they could request a waiver of the match (which will probably be granted) and report you as a match violator (a potentially career ending move).

2) Be upfront - email the programs and let them know today. This gives them a big heads up - but does bring up the possibility that they'll decrease OP's ranking (or drop her entirely).

3) Delay the whole process a year.

Unfortunately, with (practically) all residents in the country starting work on a single day, there's no easy solution.

Good point about orientation. I forgot about that and that is certainly something that could be difficult if she can't attend certain parts (I was s/p radioactive iodine treatment for my orientation and my doc recommended I not be around pregnant folks or kids for a little while longer but when I discussed with my program what to do there were some mandatory orientation things that would have been extremely difficult to make up and could potentially result in me not starting on time so I ended up going to most of it and just sticking to a far corner of the room)

 

[Piebaldi]

I would take a good hard look at deferring graduation for a year.

I know you said you have supportive family, but having a newborn is a HUGE life adjustment. And that’s leaving aside all the physical trauma of giving birth.

To rush your return to work, and then to jump right into the emotional meat grinder that is intern year (oh btw, also starting 4-8 weeks behind) while also having a new baby at home, seems incredibly foolhardy. Intern year is hard enough without missing your baby, stressing about child care, and dealing with the physical/emotional reality of the fact you just brought a new human being into the world....

....IN ADDITION TO WHICH, your PD and faculty (regardless of legality) are likely going to be fairly annoyed that you “oh by the way”’d the fact that you would be missing the first 1-2 months of intern year, and you’ll be starting the year with the That Resident target on your back.

I’m not saying it’s impossible. If there is one thing residency has taught me it’s that there are people out there capable of emotional and physical feats of strength that to me are unimaginable. I’m just saying that maybe before setting yourself up for failure, make sure you have absolutely ruled out other options.

Lastly, I will just offer the caution that the majority of people who I have seen fail out of intern year are the ones who underestimated it or overestimated their capability to deal with additional life stressors (mental illness, dependent family members, children, pregnancy). I think you are in a position to make an alternate strategy with deferring graduation and coming back next year full-strength with a good childcare plan set up. Either way, best of luck and wholehearted congratulations on the new addition!!!

I apologize and sorry for hitjacking the thread. But I will ask a question for myself in the topic of pregnancy.

I would like to have a kiddo sooner rather than later. I'm in my 30's. Finished residency, but planning a fellowship for 1 year starting in July.
I don'tknow if I can physically carry a pregnancy or not. If I can, what would be the best time for pregnancy? Obviously in the next few months would put me pregnant in the middle of fellowship which is no bueno. Then again if i get pregnant midway through fellowship then that would put me with a big belly towards the end of fellowship which might be more manageable but then i would be unemployed as im on maternity leave until i start working again.
suggestions?

 

[Raryn]

I apologize and sorry for hitjacking the thread. But I will ask a question for myself in the topic of pregnancy.

I would like to have a kiddo sooner rather than later. I'm in my 30's. Finished residency, but planning a fellowship for 1 year starting in July.
I don'tknow if I can physically carry a pregnancy or not. If I can, what would be the best time for pregnancy? Obviously in the next few months would put me pregnant in the middle of fellowship which is no bueno. Then again if i get pregnant midway through fellowship then that would put me with a big belly towards the end of fellowship which might be more manageable but then i would be unemployed as im on maternity leave until i start working again.
suggestions?

Depends on the fellowship.

 

[Crayola227]

Good point about orientation. I forgot about that and that is certainly something that could be difficult if she can't attend certain parts (I was s/p radioactive iodine treatment for my orientation and my doc recommended I not be around pregnant folks or kids for a little while longer but when I discussed with my program what to do there were some mandatory orientation things that would have been extremely difficult to make up and could potentially result in me not starting on time so I ended up going to most of it and just sticking to a far corner of the room)

so you decided to actually put people at risk of harm, including any women who may or may not have known they had fetuses in the room, rather than inconvenience yourself or your program with your start date

hats off to you for your perseverance, if only others could follow this example

 

[Piebaldi]

Depends on the fellowship.

Pain.

 

[NotAProgDirector]

I have faced this exact situation before. There are several issues to consider:

1. From a schedule standpoint, for most IM programs this isn't a huge deal. Most categorical programs are going to include some elective, outpatient, or other non-call time. As I'd know right up front that you need this leave, I'd simply arrange your schedule such that your less stressful time is put at the front of the schedule. This adversely affects no one, except you -- as the second half of your year is going to be more busy. It's possible that a program's schedule would be so tight that they can't handle missing an intern for 2 months -- but in my opinion that's their problem, it's best to plan for a bit of wiggle room. Other fields might have a very tight schedule where it would be a problem, IM is usually not a problem.

2. Exactly "what happens" depends upon whether you can actually start before you have your baby. Remember that orientation probably starts in mid June. If you can get to orientation (esp if you can get through orientation), then you can probably claim disability for your maternity leave and get paid. The program can't not hire you because you're about to have a baby. If you actually go out in the middle of orientation, I have no idea what happens -- you might not actually be "hired" then. If you have the baby before orientation, then you will need a late start. In that case, you won't have any pay / benefits until you start. Again, because my intern schedule iincludes some elective or outpatient time, I can relatively easily start you late, the other interns would be on the call blocks, and your call blocks would come later. Sounds like you'd have insurance through your husband, so this might not be an issue.

3. Could a program waive your match because you deliver before orientation starts? Probably not for this reason. As long as your pregnancy leave wasn't going to be very long, I highly doubt the NRMP would allow a waiver. In any case, I highly doubt any program would ask for one. It would make terrible press. Totally different issue if you were to say you wanted 6 months of leave to start.

4. Is starting late bad for you? Not really, especially if you're only going to start 6 weeks late. We have interns start late all the time, and it's really not a problem.

5. Is taking only 6 weeks off for a new baby a good idea? That's an impossible question to answer. I've had residents who come back after 6 weeks with no issues. I've had residents have marked emotional distress even after 12 weeks. As already mentioned, you'll need a 100% solid child care plan. In fact, you'll need two child care plans -- one for backup in case the first fails. Once you're at work, you need to be reliable.

6. The other problem to worry about (unfortunately) is pregnancy complications. If you develop something that requires bedrest, you might not be able to finish medical school (although these types of complications usually occur late in pregnancy, so hopefully will not be a problem). But if your graduation is delayed, that would obviously result in you losing your match.

7. Even if, somehow, you match somewhere and then can't start, get a match waiver, and then apply for the match the next year, you're going to be fine. You'll tell this story, and no one will care. In fact, I'd be pretty upset at a program that dropped you for this unless your start was delayed more than 4 months. And if your delay becomes that large, something has happened where you'd probably be better off delaying a year anyway.

 

[Crayola227]

as far as this "moving you up a rank list for your candor" - it varies by specialty and program, but my understanding is that most rank lists are not made in a vacuum by one person, there is often a process that involves more than one person

imho, this just increases the odds that there is someone that takes issue with your pregnancy or other health info that might pose an inconvenience

therefore it is my belief that the odds that this info being shared before the Match does a gorram thing besides hurt you, is much much lower than the chance you just don't get ranked or unfairly ranked much lower (unfairly because it will not be based on your qualifications and abilities, but that the program may have to do something reasonable to accommodate you)

potentially this shunts you into a more "supportive" program, or maybe one that is just malignant in other ways and desperate

I think it's pretty naive and rose glass tinted to think this helps you anywhere

 

[Piebaldi]

I have faced this exact situation before. There are several issues to consider:

1. From a schedule standpoint, for most IM programs this isn't a huge deal. Most categorical programs are going to include some elective, outpatient, or other non-call time. As I'd know right up front that you need this leave, I'd simply arrange your schedule such that your less stressful time is put at the front of the schedule. This adversely affects no one, except you -- as the second half of your year is going to be more busy. It's possible that a program's schedule would be so tight that they can't handle missing an intern for 2 months -- but in my opinion that's their problem, it's best to plan for a bit of wiggle room. Other fields might have a very tight schedule where it would be a problem, IM is usually not a problem.

2. Exactly "what happens" depends upon whether you can actually start before you have your baby. Remember that orientation probably starts in mid June. If you can get to orientation (esp if you can get through orientation), then you can probably claim disability for your maternity leave and get paid. The program can't not hire you because you're about to have a baby. If you actually go out in the middle of orientation, I have no idea what happens -- you might not actually be "hired" then. If you have the baby before orientation, then you will need a late start. In that case, you won't have any pay / benefits until you start. Again, because my intern schedule iincludes some elective or outpatient time, I can relatively easily start you late, the other interns would be on the call blocks, and your call blocks would come later. Sounds like you'd have insurance through your husband, so this might not be an issue.

3. Could a program waive your match because you deliver before orientation starts? Probably not for this reason. As long as your pregnancy leave wasn't going to be very long, I highly doubt the NRMP would allow a waiver. In any case, I highly doubt any program would ask for one. It would make terrible press. Totally different issue if you were to say you wanted 6 months of leave to start
4. Is starting late bad for you? Not really, especially if you're only going to start 6 weeks late. We have interns start late all the time, and it's really not a problem.

5. Is taking only 6 weeks off for a new baby a good idea? That's an impossible question to answer. I've had residents who come back after 6 weeks with no issues. I've had residents have marked emotional distress even after 12 weeks. As already mentioned, you'll need a 100% solid child care plan. In fact, you'll need two child care plans -- one for backup in case the first fails. Once you're at work, you need to be reliable.

6. The other problem to worry about (unfortunately) is pregnancy complications. If you develop something that requires bedrest, you might not be able to finish medical school (although these types of complications usually occur late in pregnancy, so hopefully will not be a problem). But if your graduation is delayed, that would obviously result in you losing your match.

7. Even if, somehow, you match somewhere and then can't start, get a match waiver, and then apply for the match the next year, you're going to be fine. You'll tell this story, and no one will care. In fact, I'd be pretty upset at a program that dropped you for this unless your start was delayed more than 4 months. And if your delay becomes that large, something has happened where you'd probably be better off delaying a year anyway.

Thank you! That's pretty much what I said in terms of a program dropping a resident or asking for a waiver for pregnancy. Like you say, it would be horrible press! "Univ of X fires female resident for having baby."
Can you imagine that?
And just like I said asking for a few weeks off it not that big of a deal. I don't think it's ideal, but not end of the world - like you say the intern can be scheduled for an outpatient rotation or something which someone has to start on anyways, having limited if any effect on the call schedule.

 

[NotAProgDirector]

It might be more complicated for a program with an X+Y schedule. In a 4+2 schedule, most / all of the "4" blocks would be inpatient. There wouldn't be a way to avoid missing an inpatient block. Still, all I need is one intern from the previous year to be off cycle (late start for any reason), and they could cover that block. Again, most programs would find a way to make it work.

 

[Piebaldi]

It might be more complicated for a program with an X+Y schedule. In a 4+2 schedule, most / all of the "4" blocks would be inpatient. There wouldn't be a way to avoid missing an inpatient block. Still, all I need is one intern from the previous year to be off cycle (late start for any reason), and they could cover that block. Again, most programs would find a way to make it work.

You always come to the rescue when we all just rumble about stuff! Awesome.

 

[dpmd]

so you decided to actually put people at risk of harm, including any women who may or may not have known they had fetuses in the room, rather than inconvenience yourself or your program with your start date

hats off to you for your perseverance, if only others could follow this example

Since the risk is based on proximity, after discussion with the program and my doctor that was what we all came up with as a safe compromise (and I skipped ACLS which was going to be held in a small room). But thanks for assuming the worst.

Edited for my ACLS typo

 

[rokshana]

so you decided to actually put people at risk of harm, including any women who may or may not have known they had fetuses in the room, rather than inconvenience yourself or your program with your start date

hats off to you for your perseverance, if only others could follow this example

so long as dpmd was 3- 15 ft away from other people, there usually isn't a problem after the first couple of days...seriously doubt dpmd went the day after receiving RAI...sitting in the corner was probably ok.

 

[rokshana]

Since the risk is based on proximity, after discussion with the program and my doctor that was what we all came up with as a safe compromise (and I skipped ALCS which was going to be held in a small room). But thanks for assuming the worst.

its crayola...she does that.

 

[Raryn]

so you decided to actually put people at risk of harm, including any women who may or may not have known they had fetuses in the room, rather than inconvenience yourself or your program with your start date

hats off to you for your perseverance, if only others could follow this example

Since the risk is based on proximity, after discussion with the program and my doctor that was what we all came up with as a safe compromise (and I skipped ALCS which was going to be held in a small room). But thanks for assuming the worst.

As long as @dpmd was ~6 feet away from any other people and it was anything except big cancer doses given within the prior 1-2 days, this is really a nonissue. Most nuclear medicine people go insane with over-cautious precautions that aren't the least bit evidence based - the vast majority of the time I tell patients they can be back at work a couple days after treatment.

Even patients 150mci given for cancer per the ATA (see table 2) only need to maximize distance from children and pregnant women for a single day. Patients dosed for hyperthyroidism might need two (if given 20mci). I've not given more than that for hyperthyroidism personally.

Edit: As usual, I concur with @rokshana , who happened to beat me to the punch.

 

[dpmd]

so long as dpmd was 3- 15 ft away from other people, there usually isn't a problem after the first couple of days...seriously doubt dpmd went the day after receiving RAI...sitting in the corner was probably ok.

Yeah this was weeks after my hospitalization for the treatment (which the place I got treated required, during residency I had to repeat treatment and they let me be at home isolated to a separate bedroom for it which was so much better)

 

[rokshana]

As long as @dpmd was ~6 feet away from any other people and it was anything except big cancer doses given within the prior 1-2 days, this is really a nonissue. Most nuclear medicine people go insane with over-cautious precautions that aren't the least bit evidence based - the vast majority of the time I tell patients they can be back at work a couple days after treatment.

Even patients 150mci given for cancer per the ATA (see table 2) only need to maximize distance from children and pregnant women for a single day. Patients dosed for hyperthyroidism might need two (if given 20mci). I've not given more than that for hyperthyroidism personally.

Edit: As usual, I concur with @rokshana , who happened to beat me to the punch.

that's because i was lazy and didn't look for the citation to post

 

[Apollyon]

Since the risk is based on proximity, after discussion with the program and my doctor that was what we all came up with as a safe compromise (and I skipped ALCS which was going to be held in a small room). But thanks for assuming the worst.

Well, not to pile on, but you assumed the bad on my quip about Worker's Comp (and I was talking Comp, not suing the hospital).

 

[Crayola227]

its crayola...she does that.

generally I don't, and I'm generally not this directly acerbic to a particular member, I leave that for most of you

but dpmd has done the same thing to me in the past, so sometimes I like to teach by doing

and I still think it's a tad ridiculous that we're beating up on OP matching while pregnant and then notifying her employer, when this sort of example is put forth

 

[Crayola227]

also, I wouldn't have picked on dpmd if I didn't think it wouldn't hurt her feelings and that she couldn't take the point, you all may find me annoying, but I generally don't actually want to hurt people's feelings on here or be mean.

I don't think she intended to do anything harmful, and I can see her point that not being able to participate in some aspects of orientation may be almost impossible to do later in some cases

That said, I was making a point with my post, that some of the attitudes I think we see in this thread, are a little extreme about what a horrible thing it is for OP to match and then discuss with an actual employer the best way to proceed. If it turns out she can't do orientation or meet requirements, that will be sorted with some due time.

Even as aPD said, this really isn't the end of the world for programs. OP is the one who is most likely to suffer here, no matter what she does.

 

[dpmd]

Well, not to pile on, but you assumed the bad on my quip about Worker's Comp (and I was talking Comp, not suing the hospital).

I knew you just meant work comp. I was saying it could be taken advantage of in a more extreme way than that (which can actually also be terribly taken advantage of but I would guess the person it happened to probably didn't do that either).

 

[Crayola227]

gutonc formulated this best when he discussed that this is essentially an ask permission vs ask forgiveness scenario, vs not engaging entirely

I could absolutely see in the ask forgiveness scenario, this ending up with the OP out of a job

I don't see it leading to her being labelled a Match violator and unable to match in the future, that seems highly unlikely.

As Raryn said, I would not mention the details of how this pregnancy happened, it is literally no one's business. And with all the caveats in pregnancy, I think it would be a tough case to make that this is a Match violation for her to sign that she intends and foresees starting July 1. As aPD has pointed out, "starting" work can mean a lot of things. For my program, our employment date started WITH orientation mid-June. Also, the way our dates were structured, if you got through orientation and one rotation the match would have been binding under the 45 day rule (that is what it is, right?)

My own personal experience has been that asking forgiveness is better than asking permission. What's done is done. Sure, it can screw you, and I've definitely been on the side of that. I've also been on the side of asking permission and having every door slammed in my face. So you probably guessed I'm biased, but the issue isn't what we think is right for programs, it's what will help OP keep her family and career together.

How many of you actually have firsthand experience wilfully disclosing pregnancies or health conditions in situations where that could actually lead to the end of your career before it even starts? How many of you have actually done that, and how did it go? Because I will tell you my resounding experience, not only for myself, but for colleagues I know personally well enough for them to confide in me their direct experiences, it's pretty abysmal. The cult of secrecy on certain fronts in medicine, is real. It's an adaptation because the risk is real, and the adaptation mitigates it. Think what you like the best way to address it.

I can already tell you what medical school advisors, deans, program directors have advised me.

 

[gutonc]

Users are reminded to stick to the topic at hand and avoid personal attacks.

 

[heychloe]

It might be more complicated for a program with an X+Y schedule. In a 4+2 schedule, most / all of the "4" blocks would be inpatient. There wouldn't be a way to avoid missing an inpatient block. Still, all I need is one intern from the previous year to be off cycle (late start for any reason), and they could cover that block. Again, most programs would find a way to make it work.

Thank you aPD for noticing my post and replying to it. I was desperately looking your( an IM PD's) point of view.

Thank you for your replies and discussions everyone. I appreciate them all. I understand that people have varying point of views and although I may not agree with all, it's always nice to be reminded of it.
Hope you all have a great year and maybe this discussion will help someone else in the future.
I will remember to post an update as it happens.

 

[Piebaldi]

Thank you aPD for noticing my post and replying to it. I was desperately looking your( an IM PD's) point of view.

Thank you for your replies and discussions everyone. I appreciate them all. I understand that people have varying point of views and although I may not agree with all, it's always nice to be reminded of it.
Hope you all have a great year and maybe this discussion will help someone else in the future.
I will remember to post an update as it happens.

Good luck! Remember us when you name the kiddo!

 

[DokterMom]

Good luck! Remember us when you name the kiddo!

Hmm - SDN... --> Sydney?

 

[Piebaldi]

Hmm - SDN... --> Sydney?

I like it!

 

[Apollyon]

Hmm - SDN... --> Sydney?

Or, like Abcde (pronounced "Ab-sid-ee"), or "Espn" (pronounced "Espen"), or could be "SDNy"!

I mean, I'm just sayin'!

 

[rokshana]

Or, like Abcde (pronounced "Ab-sid-ee"), or "Espn" (pronounced "Espen"), or could be "SDNy"!

I mean, I'm just sayin'!

She is the dumbest mother ever! I mean really, you name your kid abcde and then are surprised that people laugh at your kid’s name?!

 

[Apollyon]

She is the dumbest mother ever! I mean really, you name your kid abcde and then are surprised that people laugh at your kid’s name?!

Exactly. Stupid games, stupid prizes, etc.

 

[BoardingDoc]

She is the dumbest mother ever! I mean really, you name your kid abcde and then are surprised that people laugh at your kid’s name?!

My personal favorite is still from when I was a resident training at a local peds ED. Grabbed the next patient in the rack and saw the name T-ian. I walk in and ask how "tee-ahn" is doing.

The mother looks at me like I'm an idiot and says "it's not tee-ahn, it's Ta dash ian."

Felt so bad for that kid.

I have also met a few "Male" and "Female" named children, as well as "Da King" and a solid runner up to my favorite listed above: "JesusTheChrist". All of these are first names.

 

[raiderette]

My personal favorite is still from when I was a resident training at a local peds ED. Grabbed the next patient in the rack and saw the name T-ian. I walk in and ask how "tee-ahn" is doing.

The mother looks at me like I'm an idiot and says "it's not tee-ahn, it's Ta dash ian."

Felt so bad for that kid.

I have also met a few "Male" and "Female" named children, as well as "Da King" and a solid runner up to my favorite listed above: "JesusTheChrist". All of these are first names.

I also knew a T-A Ta dash A. The mother would get so angry when people couldn't figure it out. She also spelled her daughter's name Zhanvee'ave (as in Genevieve) and told everyone it was French.

 

[Piebaldi]

I also knew a T-A Ta dash A. The mother would get so angry when people couldn't figure it out. She also spelled her daughter's name Zhanvee'ave (as in Genevieve) and told everyone it was French.

Lol I think this one takes the cake.

How do you pronounce T-A Ta dash A: tadashatadasha?

 

[BoardingDoc]

Lol I think this one takes the cake.

How do you pronounce T-A Ta dash A: tadashatadasha?

I think @raiderette was saying that they had seen a T-A and that it was pronounced "Ta Dash A." Not that they had seen someone named "T-A Ta dash A".

That said, with the degree of stupidity involved in these cases, I wouldn't be surprised if either are correct.

 

[mvenus929]

Ice Tea Baby Jesus is still my favorite name.

 

[Piebaldi]

I think @raiderette was saying that they had seen a T-A and that it was pronounced "Ta Dash A." Not that they had seen someone named "T-A Ta dash A".

That said, with the degree of stupidity involved in these cases, I wouldn't be surprised if either are correct.

Haha too funny. You guys are cracking me up.

 

[raiderette]

Lol I think this one takes the cake.

How do you pronounce T-A Ta dash A: tadashatadasha?

Yes, I somehow lost my parentheses. It was just tadasha. My mom works in a high school and she says she also has 'ion. Can you guess how that is pronounced?

 

[Piebaldi]

Yes, I somehow lost my parentheses. It was just tadasha. My mom works in a high school and she says she also has 'ion. Can you guess how that is pronounced?

I don't think I can even imagine how that is pronounced. These days I frequently say how do you pronounce your name/last name?

 

[Naruhodo]

Somewhat off topic (then again we're already off topic), but at least some IM programs allow residents to work part-time (and spread residency out over additional years). Generally this is for family reasons, though at least one resident used it to pursue a professional musical career: The rock star hospitalist