pregnant

[candycane]

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How many weeks of internship are required for a "complete" interniship? I am pregnant and trying to determine how long I can take for maternity leave. Keep in mind that I do not want to repeat a rotation for any reason. Thanks for the help

 

[toofache32]

Check with your departmental secretary. That's what I did when I asked about paternity leave. She said at our institution you can get up to 8 weeks of maternity leave as an employee, but most residents don't take that much. Then she tried to give me some grief about "consider the toll it may take on your fellow residents/interns in your abscence." Whatever.

Don't let anyone bully you or make you feel bad about it... they will. At my university, the general surgeons are the worst about yelling "weak!" and making people feel bad for using their uterus.

 

[BKN]

How many weeks of internship are required for a "complete" interniship? I am pregnant and trying to determine how long I can take for maternity leave. Keep in mind that I do not want to repeat a rotation for any reason. Thanks for the help

By law, you must be offered up to 12 weeks unpaid leave. The real issue is completing your educational requirements which are not related to how many weeks you may miss. Your PD determines when you meet these and whether you will have to add time on to the program. Talk to him/her.

 

[ramonaquimby]

Your PD determines when you meet these and whether you will have to add time on to the program. Talk to him/her.

great question! i thought it wasn't the PD per se, but the regulations of your field. i know that internal medicine and family medicine say that you can miss no more than 6 weeks (ridiuclous!) for you to not have to extend your residency. i guess if the PD were on your side, s/he could give you a month of 'research' rotation as an additional 4 weeks, but i think this is rare. if you have a note from your obgyn saying you have 'complications', you can get up to 12 i believe, but you'll also finsih residency 2.5 months late. i also think it's crap that you can't push all your vacation time into maternity leave, but oh well...

 

[robotsonic]

I know I will get flamed for this, but does anyone else think that it is somewhat unfair to the other interns to take off 3 months during intern year? Intern year is hard enough as it is, think how difficult it would be if the interns also had to pick up the slack of someone who chose to have a baby. Most of the programs at which I am interviewing have 5 to 7 categorical residents per year. If there are a bunch of prelim residents I guess you are ok, but if not, then the other interns are stuck with extra work. Those interns want to spend time with their families, too.

Sorry, but I think it might be a little selfish to have a baby during your intern year and then expect your fellow interns to accomodate you. But I'm going into general surgery 😉

I might be wrong. Maybe it isn't such a burden on the other residents. Please feel free to argue with me 🙂

 

[candycane]

Robotsonic... yeah what you are saying is kinda insensitive. If you read my OP you will see that I am not looking to screw anyone... in fact I am saving all my vacation for maternity leave... that means that when other interns leave for vacation, I am screwed covering for THEM. What I was wondering was what the standard amt of time required to complete an internship is within one year without having to do extra months etc.

 

[toofache32]

I know I will get flamed for this, but does anyone else think that it is somewhat unfair to the other interns to take off 3 months during intern year?...

...Sorry, but I think it might be a little selfish to have a baby during your intern year and then expect your fellow interns to accomodate you. But I'm going into general surgery 😉

This is funny, because I thought I was the one who would get flamed for taking paternity leave.

As far as being "selfish", I'm not sure how to view this other than short-sighted, probably from someone without a family. I hope you don't take this the wrong way, because I'm not trying to be a jerk. When is a good time during residency to have a baby? There is no good time. That's my big gripe about general surgery....they still have the old-school mentality (more than other specialties) that work comes before family. Come'on....it's just a job, and I think those particular surgeons should get over themselves. I pity the family of the resident that puts work first.

As someone who only recently had his first child in the 3rd year of residency, I've seen both sides. Single people without children have no idea about the commitment involved in being a parent. I know I didn't. Yes, there is a commitment to being a resident also, but again...it's just a job. Some of the general surgery residents have blatently given me a hard time about it, but I respond to them with a blatent "Fu@& You" while looking them in the eye which usually backs them down when they see how passionate I am about putting my children first. But then again, I'm somewhat confrontational. And they can't really argue with it because I am a hard worker at the hospital, take orders and criticism well, and get my $hit done without problems when I am there.

 

[Apollyon]

How many weeks of internship are required for a "complete" interniship? Keep in mind that I do not want to repeat a rotation for any reason.

Your "for any reason" is being pregnant. You may be in an untenable position if you don't want to put your child into day care or have a child care provider at a month old.

 

[toofache32]

Your "for any reason" is being pregnant. You may be in an untenable position if you don't want to put your child into day care or have a child care provider at a month old.

And "repeating" a rotation isn't really repeating in this situation...it's just making it up later. If at all.

 

[Poety]

This is funny, because I thought I was the one who would get flamed for taking paternity leave.

As far as being "selfish", I'm not sure how to view this other than short-sighted, probably from someone without a family. I hope you don't take this the wrong way, because I'm not trying to be a jerk. When is a good time during residency to have a baby? There is no good time. That's my big gripe about general surgery....they still have the old-school mentality (more than other specialties) that work comes before family. Come'on....it's just a job, and I think those particular surgeons should get over themselves. I pity the family of the resident that puts work first.

As someone who only recently had his first child in the 3rd year of residency, I've seen both sides. Single people without children have no idea about the commitment involved in being a parent. I know I didn't. Yes, there is a commitment to being a resident also, but again...it's just a job. Some of the general surgery residents have blatently given me a hard time about it, but I respond to them with a blatent "Fu@& You" while looking them in the eye which usually backs them down when they see how passionate I am about putting my children first. But then again, I'm somewhat confrontational. And they can't really argue with it because I am a hard worker at the hospital, take orders and criticism well, and get my $hit done without problems when I am there.

👍 👍

I think you're commendable for putting your children first. And you are right, being a new mom myself, even I, had NO IDEA how much they change your life (ofcourse, I thought I did like everyone else 🙄 )- its just the way it is - but don't the "F*&^ you's" come easier now that the baby is here? I find they do 😛 It's some weird parental protective instinct I think 🙂

 

[robotsonic]

As far as being "selfish", I'm not sure how to view this other than short-sighted, probably from someone without a family. I hope you don't take this the wrong way, because I'm not trying to be a jerk. When is a good time during residency to have a baby?

Single people without children have no idea about the commitment involved in being a parent. I know I didn't.

You are right; I do not have children. This is mostly because I do (at least somewhat) understand the commitment involved, and know that it is better to wait (better for me, my baby, and my fellow interns). Yes, babies ARE a big commitment, and maybe intern year isn't the right time to take that commitment on.

And to clarify something: I am not opposed to residents having children. I just don't like it when someone wants to know how many months of internship they can miss - because I don't think this is fair to the other interns.

 

[ramonaquimby]

I am saving all my vacation for maternity leave...

are you sure you're allowed to do this? i aksed numerous times and have read the guidelines and it specifically says one cannot. is this an 'udnerthetable' thing? in whcih case, AWESOME! 👍

 

[robotsonic]

are you sure you're allowed to do this? i aksed numerous times and have read the guidelines and it specifically says one cannot. is this an 'udnerthetable' thing? in whcih case, AWESOME! 👍

Hey, I didn't say that! 😕

 

[GoofyDoc]

I know I will get flamed for this, but does anyone else think that it is somewhat unfair to the other interns to take off 3 months during intern year? Intern year is hard enough as it is, think how difficult it would be if the interns also had to pick up the slack of someone who chose to have a baby. Most of the programs at which I am interviewing have 5 to 7 categorical residents per year. If there are a bunch of prelim residents I guess you are ok, but if not, then the other interns are stuck with extra work. Those interns want to spend time with their families, too.

Sorry, but I think it might be a little selfish to have a baby during your intern year and then expect your fellow interns to accomodate you. But I'm going into general surgery 😉

I might be wrong. Maybe it isn't such a burden on the other residents. Please feel free to argue with me 🙂

Robotsonic, like others have said, if you don't have children yourself, you will just not be able to imagine what it's like to be a parent. While other residents are "picking up the slack" of their comrade on maternity leave, you might be thinking that the new mom is relaxing at home and enjoying her "time off." In reality, she is probably slaving at home and totally sleep-deprived due to the demands of the new baby. You might think, well why put herself thru this pressure during residency? Life doesn't neccesarily get easier after residency. Add to that the fact that our biological clocks are ticking away and it really does get more difficult to conceive the longer one delays. HTH. BTW, I didn't feel your post was offensive.

 

[toofache32]

... While other residents are "picking up the slack" of their comrade on maternity leave, you might be thinking that the new mom is relaxing at home and enjoying her "time off." In reality, she is probably slaving at home and totally sleep-deprived due to the demands of the new baby...

Good point. My wife works at home much harder & longer hours than I do. At least I get 24 hours off every week. We didn't want to get into the rent-a-mommy nanny thing....why have kids if you don't want to raise them.

I try to keep our 2-year-old when I have a day off so she can go out and have some sanity time. It takes a toll on her to only have conversation with a 2-year-old all day. I'm more worn out after 4 hours of baby-duty than after a full call shift at the hospital.

 

[onceinawhile]

How many weeks of internship are required for a "complete" interniship? I am pregnant and trying to determine how long I can take for maternity leave. Keep in mind that I do not want to repeat a rotation for any reason. Thanks for the help

Might depend on your specialty. I am in IM and I was told by our PD that it is mandatory (by ACGME?) to work at least 48 weeks per year in order to graduate on time. Leaves only 4 weeks total per year for vacation, sick leave, maternity/ paternity leave. If you miss more than 4 weeks, you have to make it up at the end and post-pone your graduation.

 

[onceinawhile]

You are right; I do not have children. This is mostly because I do (at least somewhat) understand the commitment involved, and know that it is better to wait (better for me, my baby, and my fellow interns). Yes, babies ARE a big commitment, and maybe intern year isn't the right time to take that commitment on.

And to clarify something: I am not opposed to residents having children. I just don't like it when someone wants to know how many months of internship they can miss - because I don't think this is fair to the other interns.

Robotsonic: I don't think it is fair to judge people for becoming pregnant in their intern year. You have no idea what is their personal situation. They might have been struggling with infertility for years, their biological clock might be ticking etc. Believe me, it is going to be much more difficult for the new mom anyway than for any of her classmates "picking up her slack".

 

[robotsonic]

Robotsonic, like others have said, if you don't have children yourself, you will just not be able to imagine what it's like to be a parent. While other residents are "picking up the slack" of their comrade on maternity leave, you might be thinking that the new mom is relaxing at home and enjoying her "time off." In reality, she is probably slaving at home and totally sleep-deprived due to the demands of the new baby. You might think, well why put herself thru this pressure during residency? Life doesn't neccesarily get easier after residency. Add to that the fact that our biological clocks are ticking away and it really does get more difficult to conceive the longer one delays. HTH. BTW, I didn't feel your post was offensive.

The thing is, I think that I do understand how much work a new baby is. Children are a big responsibility, and they deserve your time! But that's not the issue here. The issue is that during intern year, all of the interns have a ton of new responsibilities and they all have to work together to make sure that everything gets done. When one person isn't pulling his or her weight, the others suffer. I don't care if that other person is "slaving at home," she is still making the others do extra work because she couldn't fulfill the commitment that she made to her residency and to her fellow interns. It's true that it gets more difficult to conceive later in life, but for the majority of interns this is not an issue, as 2 or 3 more years of waiting is not going to make a significant difference in fertility.

While it is also true that life doesn't necessarily get easier after residency, I think you are more likely to have control over your schedule after residency than during it. Because you don't have your fellow interns depending on you, you can choose to take off for maternity leave and not be letting anyone down. It is your own career then, not that of your peers.

I still believe that it is unfair to the other interns to take off 3 months during intern year, even if the person is working just as hard at home during that time.

And thanks for not flaming 🙂

 

[3dtp]

While other residents are "picking up the slack" of their comrade on maternity leave, you might be thinking that the new mom is relaxing at home and enjoying her "time off."

I think that this picks at the cruxx of the matter. Hospitals regard residents (and interns, especially) as free labor. Since they are free labor, attendings can leverage themselves, and hospitals can function more economically. The same arguement was made against the widely violated 80 hour rule. The hospitals said they can't afford it, or worse, said, who will take care of the poor if we lose the extra 40 hours/resident by complying? Some hospitals even suggested that they start "PA residencies" to replace MD resident hours lost. Why? because they could get a PA "resident" for half price of a full PA, work them as long as they wanted without the meddlesome 80 hour rule, and meet their labor needs cheaply. Fortunately, the PAs figured out that game and it hasn't caught on....yet.

Remember, the REAL (supposed) purpose of residency is to train to become a better doc. All else should be secondary to that purpose, but sadly is not, and will not as long as hospitals hold all the cards.

So, if you're not there, instead of hiring a "temp" ie locums, PA or whatever, you simply shunt more work on your "covering" interns. In the old days GPs did their internship, went into practice and covered their own patients, but now, the specialty boards, seeking ever more free labor have lobbied hospitals, insurance companies and medicare to accept only board certified doctors as "real" doctors, assuring that the pipelines will remain full.

 

[surg]

whether you need to make up time is often defined by the board you plan to get certified through (assuming that you want to be board certified).

For instance in general surgery (http://home.absurgery.org/default.jsp?certgsqe) the American Board of Surgery requires that:
"General Requirements

Applicants must:
Within six months after completion of residency, have a full and unrestricted (permanent) license to practice medicine in the U.S. or Canada.
Have satisfactorily completed a minimum of five years of progressive residency education in a program in surgery (general surgery) accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada.
Have obtained, over the five years in the accredited surgery program, at least 54 months of clinical surgical experience, with no fewer than 36 months devoted to the essential content areas of surgery (general surgery) as defined.
Have acted in the capacity of chief resident/senior resident in general surgery for a 12-month period, with the majority of the 12 months served in the final year. The entire chief resident experience must be devoted to the essential content areas of surgery, with no more than four months devoted to any one area.
Have spent no fewer than 48 weeks of full-time surgical experience in each residency year.
Have spent the final two residency years in the same program, unless prior approval for a different arrangement has been granted by the ABS. For residents who will complete their residency training in June 2008 or thereafter, the required 60 months of residency training may be accomplished at no more than three residency programs overall.
Have been the operating surgeon for a minimum of 500 operative procedures in five years and for a minimum of 150 operative procedures in the chief resident year. The ABS does not require a certain minimum number of procedures within a content area."

These items are similar but not identical to the ACGME program requirements(http://www.acgme.org/acWebsite/downloads/RRC_progReq/440pr703_u704.pdf) which I can't find the minimum weeks required and only says:

"Duration and Scope of Education:
Five years of graduate training in surgery following graduation from a medical school accredited by the Liaison Committee for Medical Education (LCME) is required for the acquisition of the necessary knowledge, technical skill, and judgment. Each resident must be notified in writing of the length of the program prior to admission to the program. All years must be in an accredited program under the guidance of the program director in surgery, regardless of assignments to other disciplines."

I think it is important to remember that while most of us are sympathetic to the need for maternity/paternity leave, the concerns of the board and the RRC are also important to balance, namely that the education of someone finishing a residency can not be given short shrift either. It is essential that you have sufficient exposure and experience in residency to handle things on your own when you are done. Unfortunately, this puts people wishing to take time off to pursue worthwhile things (such as pregnancy), in a bad situation. I have now had a 2 friends that had to extend their residencies for pregnancy related reasons (1 time for pregnacy related complications, 1 time for extended maternity leave). Only you can determine what is best for you and your child. Take what time you need to do what you need to, but realize that there may be consequences and difficult choices ahead.

 

[MD'05]

Any time off in internship year will screw your fellow interns. That is why our program will not allow time off during critical rotations.

You should really wait until second year to have a baby.

 

[gwen]

its hard to judge people regarding when they to decide to have children. whoever said it was right, you don't know the background (infertility, age, etc) everyone is running on a different time clock. so who are we to say, get pregnant on so and so day.

and at the same time, yes, it totally sucks to have an intern gone which is why second year is considered the best for pregnancy as long as you don't have the aforementioned problems (similarly, third year of ob-gyn is considered the best amongst ob residents)...its not as bad as intern year and you still have the comforts of a third year helping you. we have a second year who just had twins and her class is scrambling for all the time she was/is gone. she was on strict bed rest for two months prior to her delivery and is now on maternity leave. this means that she will graduate a bit later...which is fine, she chose her kids over work (thank goodness). all of the residents and our PD and other attendings gave her one vacation day (PT) each so she could get more time off.

i just think that people who choose to get pregnant as interns should not whine about the extra time they may have to work later to make up for the work. life sucks. sometimes being a woman sucks (btw, i am a woman)...but that's life. so make decisions wisely. sometimes you have to choose between your career and your family...so just suck it up (this is not to anyone in particular...so pls don't harass me later)

 

[toofache32]

its hard to judge people regarding when they to decide to have children. whoever said it was right, you don't know the background (infertility, age, etc) everyone is running on a different time clock. so who are we to say, get pregnant on so and so day.

Exactly. Anyone who says different needs to get a freakin' life outside of where they work. I love my job, but it's still just a job. I got over myself and the whole "doctor" BS a long time ago. This isn't the 1950s.

The problem isn't the "extra work" and "slack" the other interns have to pick up. The problem is the mentality of "strong intern" vs. "weak intern" that gets passed down from upper-levels....and a "strong" intern to your R3 is one who will forget about everyone else (including family) to please the R3. The interns who fall prey to this are suckers. They forget that it's just a job.

 

[toofache32]

Any time off in internship year will screw your fellow interns. That is why our program will not allow time off during critical rotations.

You should really wait until second year to have a baby.

As if people really have a choice (like you make it sound). My wife and I tried for 2 years to have a baby before finally getting pregnant...if it lands during intern year then what do you recommend? You can't schedule babies like you schedule your hair appointment.

 

[jamie]

Any time off in internship year will screw your fellow interns. That is why our program will not allow time off during critical rotations.

You should really wait until second year to have a baby.

sounds like it's a little too late for that! 😉

regardless of your field of work (medicine, law, education, business, etc), you will generally screw over your coworkers when you take an extended leave, whether it be for maternity leave or other reasons. personally, i think one could always come up with a reason to postpone having a baby (especially as a resident), and sometimes you just have to bite the bullet and get on with your life. congratulations.

 

[earwig]

Quote: Originally posted by toofache32
I love my job, but it's still just a job. I got over myself and the whole "doctor" BS a long time ago. This isn't the 1950s.

Medicine, unlike other occupations, is not "just a job". If all doctors had your attitude, we would not have excellent and dedicated physicians. Not investing enough time, energy and devotion in your training will bite you back when the time comes to practice in real life.
I agree with ROBOTSONIC who implied that decision to postpone childbirth stems from a greater sense of responsibility for your child and for wellbeing of your peers. If I was planning to get pregnant, I would not apply for a residency on that year. You may argue that accidents happen and bioclock is ticking but who should be better at contraception than the doctors?

 

[Poety]

I can probably speak on this since I actually have a new baby. I got pregnant (surprise!) at the end of my 4th year. And for the reasons stated above, I postponed my graduation until this year to spend time with my child, and to not put additional stress on me, my family or fellow interns while she was an infant.

I have had no problems at all interviewing, and I feel like (although bored sometimes!) I'm spending the quality time my daughter needs, as well as saving myself up for when a lot of outside demands will be put on me. I didn't choose to take years off since personally, I think she will need me more when shes a bit older, so I chose to complete a residency while she's still very young.

I should also add that I happened to be one of the lucky ones who got my surprise before residency started - but I would be 100% understanding to a colleague if they got pregnant during internship as well. Personally, I think that life is hard enough - and I've learned (after having mine) that it DOES TAKE A VILLAGE!!! (this is not to say that I would happy about the extra call - but such is life)

I'm sure anyone who gets pregnant is going to feel guilty enough about having to leave their colleagues for some period - perhaps it would be better to be supportive rather than cynical about it since here again, you never know if it could happen to you! (unless ofcourse you've had a tubal ligation, are asexual, or had a vasectomy) 😛

 

[MBK2003]

I've had 2 kids during residency. The first was born the day after internship started. I was on a 3 month elective rotation to start internship and provided with 6 wks maternity leave and 2 weeks vacation. My fellow interns were not responsible for any additional coverage because of my absence, the elective rotation was simply elective with no call. The second child was born just as 3rd year was starting. My pregnancy coincided with that of another resident in my class. Yeah, my classmates had to pick up 2-3 extra cases and each of them spent one day in the ER during my 6 week absence. Was this fair to them? No, probably not since some of them are not likely to take maternity leave during the residency for personal reasons. Are there other residents who are going to have kids this year? Yes actually 3 other residents are taking maternity/paternity leaves at the end of this year. Do I begrudge them when I have to cover their patients or spend an extra day every 2-3 weeks in the ER? No, I honestly don't. Perhaps my perspective is unique, but birth, death, and illness are things that sometimes happen and can't always be planned for (despite OCPs). As an intern a classmate's parent became acutely ill and eventually passed away. He was out for 4 weeks during his parent's hospitalization and then for a little time after the funeral. Co-interns were very unhappy to be taken off elective rotations to cover his inpatient medicine rotation, but they weren't pissed at him, they were unhappy that the residency leaves the burden of coverage to the residents because they are essentially free and are also the path of least resistance. As someone above pointed out, there is a level of masochism that many of us have that keeps us pursuing this training, but ultimately the system is what lets us down and rarely is it our co-residents.

 

[Poety]

very well said MBK 👍 👍

 

[usnavdoc]

Robotsonic: I don't think it is fair to judge people for becoming pregnant in their intern year. You have no idea what is their personal situation. They might have been struggling with infertility for years, their biological clock might be ticking etc. Believe me, it is going to be much more difficult for the new mom anyway than for any of her classmates "picking up her slack".

It may be more difficult for the new mom than the interns picking up her slack. But that was the choice she made for everyone. The other interns had no say in the matter but yet they get to spend that much more time away from their loved ones as well.

If she wants to get pregnant and have a baby(regardless of intent or biological clock or whatever) then fine. But no one is forcing her to start internship this year. I find that selfish.

You may not care but your fellow interns are not gonna be happy about the situation.

 

[djipopo]

Perhaps my perspective is unique, but birth, death, and illness are things that sometimes happen and can't always be planned for (despite OCPs).

As someone above pointed out, there is a level of masochism that many of us have that keeps us pursuing this training, but ultimately the system is what lets us down and rarely is it our co-residents.

Bravo! sometimes you just can't wait 8 years (thru med school and most residencies) to wait to have kids. plus, sometimes $hit happens. if your fellow residents have to pick up the slack, it's not your colleague's fault, it's a fault in the system.

 

[DaBigDawg]

Exactly. Anyone who says different needs to get a freakin' life outside of where they work. I love my job, but it's still just a job. I got over myself and the whole "doctor" BS a long time ago. This isn't the 1950s.

The problem isn't the "extra work" and "slack" the other interns have to pick up. The problem is the mentality of "strong intern" vs. "weak intern" that gets passed down from upper-levels....and a "strong" intern to your R3 is one who will forget about everyone else (including family) to please the R3. The interns who fall prey to this are suckers. They forget that it's just a job.

...and that attitude is exactly why our field is no longer what it used to be. Its now filled with a large number of shift workers who just want to get paid and then get on with the rest of their lives.

The strong intern vs. weak intern thing has nothing to do with pleasing the R3... at least not for me. It has to do with patient care. You treat everyone of your patients as if THEY were family and you put forth the effort to make sure they get the best care you can provide. If that means not having a "life" outside work... well I'm sure the patient's family will be thankful you placed their loved one's care first. I know that if I had to pick a doctor for a loved one, it wouldn't be some guy who graduated from the best medical school or went to the biggest "name" residency. It would be the doctor who works as hard as he can and puts my loved one's care first and foremost.

Maybe my view is the wrong one and maybe I'll realize it when I'm older and with no family... hopefully that won't be the case.

As far as the work hour requirements, I fully understand the importance of the limits... mainly because of the impairment of patient care that occurs as one nears the 24-30 hour limit.

My view: Having children is great but you have to make up any educational requirements that you miss. If that means extending your residency, I'm sorry but thats the choice you made.

 

[freshity]

i agree that it's not the resident's fault that the hospital doesn't fully support maternity and paternity leave. they have designed a program that allows for someone to not be there and to be guaranteed their job on returning, but do nothing to fill the shoes left by that person while away. that's their problem, not the missing resident's.

the problem is the system that only arranges to take care of half of the problem. why do they leave their other residents hanging like that? believe me, if and when i find myself in that position, i will certainly complain to the program director and chiefs if i feel they have made inadequate arrangements for someone's absence. what will they do, fire me? it would never occur to me to be mad at my fellow resident. that's the employer's problem. again, people need to be looking at residency as more of a job than we currently do, and residency directors (and the rest of the crew) need to be treating residents more like employees, just like everyone else that is there.

we have a right to take advantage of our work benefits. i don't get mad at the other diners in the cafeteria if they run out of food, napkins, silverware, etc.

 

[Poety]

My view: Having children is great but you have to make up any educational requirements that you miss. If that means extending your residency, I'm sorry but thats the choice you made.

I agree with this, but I wouldn't agree with patient care coming before my family - and the reason is this, the most functional and effective physicians are those that are well rested, and satisfied with their lives outside of work. This means, in order to be those things - you must maintain a balance (which seems to be a huge problem for a lot of people, why would you NOT want balance in your life I'll never know)

The point I'm trying to make is this - I don't think people should be running out of the door once their time is done, and I don't think most do, as they are quite committed to their patients. However, there should also be committment to family which means having seperate "me time, family time, friend time, whatever" so that you maintain your whole sense of self throughout this thing.

Once you start losing your sense of self, you start making improper decisions for people and you get too wrapped up in being this God like figure which you are NOT.

I don't want my family member treating me as they are working from the heart not from their head - I want to be treated as a patient, by a physician that understands the physician - patient relationship and doesn't cloud it with their obsession with medicine. I want the physician that got nooky the night before and is in a GOOD mood - I even want the physician that has the weekends off so that when I schedule my surgery on Monday - I know he wasn't slaving away in the hospital all weekend and is in NO MOOD to see me.

The best attendings I've worked with (and the SMARTEST) had balanced family lives, they were able to give even more to their patients because they were able TO GET BACK FROM THEIR FAMILY - we all need to replenish ourselves in someway, and if you think a patient is going to fill that cup you're sorely mistaken.

I have worked with residents and attendings for 13+ years, and you can trust me when I say- having the hospital staff and patients as your be all end all will only screw you in the end because they all eventually go home or go away - your family doesn't.

 

[CNphair]

You may argue that accidents happen and bioclock is ticking but who should be better at contraception than the doctors?

This made me laugh. My best friend got pregnant in her 4th year of med school...most unexpectedly. She is going into OB/Gyn and she used Depo-provera PLUS condoms. She did NOT want to get pregnant. Despite being on Depo for 3 years, she still got pregnant. What are the chances? Pretty slim. She took it as a sign that the pregnancy was meant to be.

 

[orientedtoself]

I don't have kids. But it seems to me that the majority of the time commitment in having a family is not the six weeks of maternity leave, but the eighteen years of raising the kid, which should be done by both parents. The majority of child-rearing is done by women in this country. I think this a major problem in our society. If women are taking on more "men's work", men need to be more flexible with gender roles and take on more "women's work." And to those of you who don't want to take extra call to fill in for a co-intern or resident, I hope that I won't work with you in the future. I want to work in a supportive environment, where residents help each other out through difficult times.

 

[DaBigDawg]

I agree with this, but I wouldn't agree with patient care coming before my family - and the reason is this, the most functional and effective physicians are those that are well rested, and satisfied with their lives outside of work. This means, in order to be those things - you must maintain a balance (which seems to be a huge problem for a lot of people, why would you NOT want balance in your life I'll never know)

The point I'm trying to make is this - I don't think people should be running out of the door once their time is done, and I don't think most do, as they are quite committed to their patients. However, there should also be committment to family which means having seperate "me time, family time, friend time, whatever" so that you maintain your whole sense of self throughout this thing.

Once you start losing your sense of self, you start making improper decisions for people and you get too wrapped up in being this God like figure which you are NOT.

I don't want my family member treating me as they are working from the heart not from their head - I want to be treated as a patient, by a physician that understands the physician - patient relationship and doesn't cloud it with their obsession with medicine. I want the physician that got nooky the night before and is in a GOOD mood - I even want the physician that has the weekends off so that when I schedule my surgery on Monday - I know he wasn't slaving away in the hospital all weekend and is in NO MOOD to see me.

The best attendings I've worked with (and the SMARTEST) had balanced family lives, they were able to give even more to their patients because they were able TO GET BACK FROM THEIR FAMILY - we all need to replenish ourselves in someway, and if you think a patient is going to fill that cup you're sorely mistaken.

I have worked with residents and attendings for 13+ years, and you can trust me when I say- having the hospital staff and patients as your be all end all will only screw you in the end because they all eventually go home or go away - your family doesn't.

I think we all agree that balance is what we should stive for... but until you can find a way to go to all your kid's games, get some "nooky", keep up with all your friends, continue to follow you favorite football team by making road trips to all their away games and of course showing up to all their home games with full body paint AND take care of all your patients to the best of your ability, you'll have to start deciding what you can give up.

I think medicine is one of the fields in which the balance should lean (slightly but lean nonetheless) towards work. That doesn't mean you won't have a great family, get a lot of "nooky", and hopefully even get to watch your favorite team win the super bowl. What is does mean is that occasionally you will have to sacrifice some or all of those things when called on to do so. How often you'll be called on to make these sacrifices will depend on a large part on what field you go into. You won't be missing too much nooky if you're a radiologist or a dermatologist.

Every decision we make has an opportunity cost and the decision we made to embark on the road towards becoming competent doctors has a HUGE opportunity cost. We can lessen these by trying to be more efficient, choosing less "demanding" specialites, cutting out all the extra scut work that can be done by ancillary staff, and helping each other out when needed. But we will all have to sacrifice and I HATE IT when students, residents, and attendings act like they are being asked to kill their families when they are required to put in extra effort. You son might be sad that you missed his baseball game once in awhile but I think the positive example you display by working hard will serve him well later in his life. Who knows.

Just my two cents. I'm sure there are great doctors who believe the exact opposite... that family and personal interests should override work. I however believe that your work should take precedence... unless you are going to get "nooky"... if thats the case then all bets are off.

 

[Poety]

Well said DaBig, I think we're pretty much on the same page here - as I'm sure most are -but just love to argue extremes 😉

Its funny, being on SDN, you'd wonder why half of us didn't go into law eh? 😛

 

[robotsonic]

DaBigDawg, well said. Medicine, more so than many other fields, requires some sacrifices, and requires you to (only at times, and hopefully rarely) put your patients above your family.

But I want to respond to this, if it is indeed directed to me:

And to those of you who don't want to take extra call to fill in for a co-intern or resident, I hope that I won't work with you in the future. I want to work in a supportive environment, where residents help each other out through difficult times.

I never said that I would refuse extra call to fill in for a co-intern. We all want to be in supportive environments and we all want others to be there for us just in case there is an emergency and we need to miss work. But when the emergency is planned (as is the case for most pregnancies), I have a lot less sympathy. It is your choice to have a baby and to take on the extra work of a child during internship; it is not my choice. I don't want to have to spend less time with my family because you CHOSE to have a baby at an inappropriate time. Why is your time with family more important than my time with family? Please remember that we all want to see our families, get nooky, go to our kids' basketball games, etc. My point is just that intern year is not the right time to burden yourself or others with new responsibilities that you may not be able to handle. I think Poety's decision to delay internship for a year was the right one.

 

[orientedtoself]

.

 

[orientedtoself]

I never said that I would refuse extra call to fill in for a co-intern. We all want to be in supportive environments and we all want others to be there for us just in case there is an emergency and we need to miss work. But when the emergency is planned (as is the case for most pregnancies), I have a lot less sympathy. It is your choice to have a baby and to take on the extra work of a child during internship; it is not my choice. I don't want to have to spend less time with my family because you CHOSE to have a baby at an inappropriate time.

The issue here is reciprocity. If you expect to take some time off during residency for family leave, then you would be willing to work extra while someone else takes time off. This is where the disparity between maternity and paternity leave factors in. Very few guys take more than a couple of days, so they never expect to recuperate those lost days. In contrast, several OB/GYN residents have had children residency over the last few years at my school. I think part of why the people and program are more family-friendly is because the majority of OB residents are women. Well, that and they are obsessed with reproduction.

 

[maxheadroom]

This has been a real issue in my program. There are four of us to cover call, hence we're Q4. When someone has a child and takes 6 weeks of maternity leave, we all move to Q3. Our call is technically home call, so there's no going home early. Believe me, the difference between busy Q4 and busy Q3 can be significant, especially over 6 weeks. We're all pretty good about the leave, but in a small resident group any sort of extended leave can have a profound impact on the entire group.

 

[GoofyDoc]

For those people who say women shouldn't have kids during residency because medicine comes before family, that argument is weak to say the least. I doubt that is your real meaning because if it were so, then women shouldn't have children after residency either because they would have to take maternity leave from their jobs. The bottom line is you don't want your female colleagues having children so that you don't have to take on any extra work. Personally, I would feel bad that other interns/residents would have to do extra work on my behalf if I had to go on maternity leave, but it wouldn't change a thing. It's not selfish of a woman to have a child during residency. However, it's selfish for others to make her feel bad about it. If you really are such altruistic individuals, you obviously wouldn't mind taking on the extra work because you've already given up your life to the service of the sick and needy!

I'm not trying to fan flames here, just venting. I think any parent would be nuts to suggest that the pursuit of medicine is more important than one's own child.

 

[jamie]

This has been a real issue in my program. There are four of us to cover call, hence we're Q4. When someone has a child and takes 6 weeks of maternity leave, we all move to Q3. Our call is technically home call, so there's no going home early. Believe me, the difference between busy Q4 and busy Q3 can be significant, especially over 6 weeks. We're all pretty good about the leave, but in a small resident group any sort of extended leave can have a profound impact on the entire group.

And that's why I chose a program with 30 residents in each class.

 

[Poety]

Q30 is good!

I for one, would never put my career before that cute little button in my avatar - thats for sure 😛

 

[BKN]

the problem is the system that only arranges to take care of half of the problem. why do they leave their other residents hanging like that? believe me, if and when i find myself in that position, i will certainly complain to the program director and chiefs if i feel they have made inadequate arrangements for someone's absence.

I wonder how you expect me to do that. Do you think that I can find a resident or PA to drop into the slot ad lib for the period of time that someone is out? I don't think this would happen often enough to justify an extra resident FTE at each level unless the residency was bigger than any in existence.

Also, I'd like to take the sexual politics out ot this thread. i believe I've read that men take as much sick time as women do (incuding maternity leave). For male residents I believe it's accidents and time in substance abuse programs.

 

[Poety]

Hey BKN, would it be possible to get per diem work to cover people's shifts when they are out? Like moonlighters or something? Or is that not cost efficient either. And, if they are out - and it ends up being where with their loss the other residents will run over the 80 hours - how do you make up for that absence and stay within the work hours limit?

 

[3dtp]

This has been a real issue in my program. There are four of us to cover call, hence we're Q4. When someone has a child and takes 6 weeks of maternity leave, we all move to Q3. Our call is technically home call, so there's no going home early. Believe me, the difference between busy Q4 and busy Q3 can be significant, especially over 6 weeks. We're all pretty good about the leave, but in a small resident group any sort of extended leave can have a profound impact on the entire group.

I agree with all that you have said. The question is a little broader than just maternity leave, I think.

Two things to think about:
1. Missing time for leave (of any kind) does mean you miss out on the educational opportunities.

2. Residency's primary purpose is not about being on call Q3 or Q4 or macho marathon shifts (and it's all shiftwork, only the length and frequency of the shifts are at issue). It is about education.

Hospitals have, over the years decided that residents are front line workers to take care of patients, frequently at the expense of the very educational purpose of the residency. They whine to get the government (you and I) to pay for their minimal costs, then when one is absent foist the load on the remaining residents not considering the negative impact on them, nor on their education.

Does anyone else think this is nuts?

We are there to learn the best medicine we can. And the specialty boards are sitting in judgement at the end of the residency to make sure we do.

In business (and medicine is a business that costs 15% of the GDP), provisions are made for key employee absence, vacations and illness. Why are teaching hospitals exempt? When an attending at a non-teaching hospital needs a break or a vacation and he is in a small group or solo practitioner, he pays CompHealth to get him a locums to cover for his time away.

Why don't the hospitals plan and budget for a PA or an RNP during those inevitable times when someone is out for whatever reason? It's all about the Benjamins.

At my hospital, a resident was stricken with acute appendicitis requiring an emergency appy. On POD1, the chiefs came by to encourage him to get back to work the day post discharge. Another had an urgent scope for bleeding, and was asked to return to work following a procedure for which he was given Versed. The pressure was real.

Do you want someone on your team under those circumstances? Would you put your license on the line because the hospital wouldn't/couldn't make provisions for coverage?

This is not about being macho/suck it up/your a doc. It is about what's best for the patients and ourselves. Let's not lose sight of this. I was given a book when I graduated from med school. One of the first chapters was titled, "If you think you're indispensible, check your appointment book a week after you die."

 

[BKN]

Hey BKN, would it be possible to get per diem work to cover people's shifts when they are out? Like moonlighters or something? Or is that not cost efficient either. And, if they are out - and it ends up being where with their loss the other residents will run over the 80 hours - how do you make up for that absence and stay within the work hours limit?

Well. EM has a 60 hour limit and I work my residents about 50, the other 10 hours are in assigned study and didactics. So if i run out of residents it comes out of study, which really disturbs me. I don't know how other residencies do it. The moonlighting thing would only work if you weren't up against your limits. The payment would make the abused residents feel better, but internal moonlighting is included in the limits.

 

[robotsonic]

For those people who say women shouldn't have kids during residency because medicine comes before family, that argument is weak to say the least. I doubt that is your real meaning because if it were so, then women shouldn't have children after residency either because they would have to take maternity leave from their jobs.

That's right, women shouldn't go into medicine if they want to have children. If they want to be good mothers and wives, they should remain barefoot in the kitchen where they belong. Kidding, kidding!

Now to be serious: I am a woman, and I plan on having children. (I think some people might be confused by my avatar. Indeed, I am not really an old Punjabi guy.) And no, I never said that "women shouldn't have kids during residency because medicine comes before family" and I never would. That is not the point I've been trying to make.

I can't write more because I really need to study for step 2 and go to bed, but I'll just add that DaBigDawg, maxheadroom, and 3dtp have all made great points, and I appreciate the PD perspective from BKN. I really like hearing all of the opinions on this. Also, I agree with BKN that we should take the gender politics out of this issue, because I think people are reacting more to that than to the real issues being brought up.