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communitydoc13 said:
IMO both men and women should get designated maternity/paternity leave. If you don't have kids you don't get it. If you have to add time at the end, fine. The progressive leave policy above is helpful.

FWIW, all the women that I knew in residency who got pregnant worked very hard, were cognizant of the hard work others were doing on their behalf and tried hard to pay it back.
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I agree with that, but I think the progressive leave policy says you don't have to add time (I know when I was in residency they allowed maternity leave, you just had to complete X amount of time). Not sure, but does all FMLA get covered for all indications or only pregnancy?

Unfortunately, this is very difficult and only an honest discussion has any hope to solve this very difficult issue, as we all know and it has been said above, somebody has to take on the negative consequences 12 weeks of someone being absent from work - The mother being away from the baby, the baby being away from the mother, co-workers, the business, etc.

I will say, the sacrifice for the kids is worth it. What are you trying to really gain? Academic spot in rad onc? Don't sacrifice for this field...
 
I deferred having kids during residency, and needed to go through significant struggles with IVF to have a child. It is disturbing to me that some of my colleagues view maternity leave as a vacation or catching a break or having it easy. I'm not into the whole WWC movement but I am sad to see this is a real mentality.
 
OTN said:
“There are consequences and parents are in general punished professionally in our field, everyone knows this.”

This has honestly not been my experience, either in training or after.
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Fair enough. I didn't mean that people were targeting parents (never experienced this). I do believe that it is impossible to be as committed to your career if you are a committed parent and that this is noticed. Maybe just my limitation/insecurity here.
 
communitydoc13 said:
IMO both men and women should get designated maternity/paternity leave. If you don't have kids you don't get it. If you have to add time at the end, fine. The progressive leave policy above is helpful.

Providing maternal/paternal leave is a societal benefit. We should be encouraging young professional couples to have children in my opinion. It is interesting to me that people resent others parental leave so much. I didn't take any despite having multiple children in residency. I wish I had.

There are consequences and parents are in general punished professionally in our field, everyone knows this. This is endemic to our culture. You can't have it all. Among your colleagues (both male and female), were the ones who had children young and shared parental responsibility equally with their spouse viewed as favorably as those whose spouse took on the bulk of parental demands while they put in extra time at work for career development?

Among the women I trained with, the ones who were ascendant in their academic career trajectory (at least early on) all deferred having children. Among the men, the ascendant ones either had a partner who provided the bulk of parental care or again deferred parenting. The response to parenting is a big reason why MD/PhDs are less productive ultimately in terms of academic career. A commitment to parenting will by definition diminish your commitment to work.

FWIW, all the women that I knew in residency who got pregnant worked very hard, were cognizant of the hard work others were doing on their behalf and tried hard to pay it back.
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My issue was the twitter comment I posted with the large group arguing they should get maternity leave WITHOUT extending training. My experience was not same as yours with people verbally upset the maternity leave months were not just written off and ignored.

I have zero problems with maternal or paternal leave if the training hours are made up and people don't game the system to end up graduate with virtually no head and neck rotations but 15 months of breast or something. I would love to hear an honest argument from these people of why they think they should have to do less training than others other than "because sexism" But the second you allow people to shave hours off their training then you have to extend that option to anybody who wants it for whatever reason is important to them. If you want to be intellectually consistent anyway.

You make a good point about having it all. There are truth to being pregnant and raising young children that are inconvenient, but they are still truths. You can't redefine the world to suit your alternate reality where you can have babies and raise them while working 70 hours a week at the same time and also getting the same vacation as everyone else who didn't have kids.

This is all an unfortunate byproduct of the lie that the second wave feminist told that you should be able to expect to have equality with the situations of men despite having babies. Guess what, men can't have babies by definition. Men and women are different by the nature of the universe. If you take 5-10 years out of someone's professional life to some degree for having and raising children to school age you expect equivalent outcomes? Huh? One is not better than the other we are just different and only one sex can give birth which necessarily takes time and resource. If you choose to have babies you will be trading time spent in your career. Not to say that raising families is less valuable than pursuing demanding careers. Raising families properly is likely much harder both in terms of effort and time and certainly the father has a role, but the fact still remains that during pregnancy and the early years that role is much more limited. Don't shoot the messenger! If you want to make the marxist argument that men's salaries should be cut by the government and leadership positions restricted and we should have communal family raising or something to try and make the outcomes equivalent, then go ahead and make that argument, but don't argue that you are entitled to less training because that undermines the legitimacy of positions in the public's eye and puts patients at risk if you believe the training hours matter at all.
 
I don’t get it. Simul is rightly hero worshipped on this forum. Part of his platform was to grant parents appropriate leave for child bearing and rearing. The powers that be comply. Bitching ensues
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We should support good leaders, women and men alike. Lisa K let the field down and gaslight residents calling them dumb. Then you have breast feeding hating jewels like PW. The very best people!
 
Gfunk6 said:
I don’t get it.
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What don't you get? There are 4 possible situations;

1. Residents get X number of weeks of maternal and paternal leave but have to make it up at the end of their training if PTO doesn't cover it.
2. Residents get X number of weeks of maternal and paternal leave but still graduate on June 30 with everyone else and get the same amount of PTO as everyone else.
3. Residents get X number of weeks of paid elective/personal/enrichment/family/whatever time beyond PTO to use for whatever they want. Everyone graduates same time.
4. Residents do not get maternity or paternity leave and must take the time off with PTO. If they do not have enough PTO, they are fired for breach of contract.

Ignoring competency issues, 3 of the above are objectively fair (with one being excessively harsh that I doubt few would support). One is not. Do you see which one it is?
 
thecarbonionangle said:
We should support good leaders, women and men alike. Lisa K let the field down and gaslight residents calling them dumb. Then you have breast feeding hating jewels like PW. The very best people!
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Hey now. Who said I hate breast feeding. I own a motorboat!
 
Chartreuse Wombat said:
I was a PD for nearly 20 years and was on the ACGME RRC. I have experienced first-hand residents timing their pregnancies to coincide with more difficult rotations and also using the research time for childbearing. There are downstream effects of these choices. In the first instance clinical coverage is made more difficult and in the second case research productivity is likely to be reduced. Actions have consequences.

I expect that many on this board will criticize me for pointing this out; e.g. programs shouldn't rely on resident labor. The reality is that graded responsibilities with appropriate supervision leads to the best residents. My expectation of residents is that they should prioritize their training while in residency. This is not to say that they should not have children only that there are consequences of choosing to do so. Of course I am old and many will label me as a dinosaur or worse.
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I'll take the bait. Need a program depend on resident labor for residents to have (and benefit from) "graded responsibilities"? I would argue that there is little intrinsic value in resident coverage of attendings being a 'zero sum game' -at least not for the residents. Shouldn't the one who bills for the encounter be the one who picks up the slack?
 
Lamount said:
I'll take the bait. Need a program depend on resident labor for residents to have (and benefit from) "graded responsibilities"? I would argue that there is little intrinsic value in resident coverage of attendings being a 'zero sum game' -at least not for the residents. Shouldn't the one who bills for the encounter be the one who picks up the slack?
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Residents are paid to care for patients and learn on the job. As far as I can tell residents are voluntarily employed. If you extend your logic residents could just read books and pay for ASTRO contouring courses and they can pass their boards. Why should they be paid?

The last 12 months of the resident experience residents should be operating with minimal oversight. The very best in my thirty years of experience seek out this autonomy. It is the very best way to learn.

There are bad programs out there to be sure but when I trained thirty years ago I wanted to see and do everything so i would be prepared for a busy clinical practice. I have operated a busy service without a resident for the last 5 years (10-12K wRVUs in clinic 4-5 days a week)
 
Chartreuse Wombat said:
Residents are paid to care for patients and learn on the job. As far as I can tell residents are voluntarily employed. If you extend your logic residents could just read books and pay for ASTRO contouring courses and they can pass their boards. Why should they be paid?

The last 12 months of the resident experience residents should be operating with minimal oversight. The very best in my thirty years of experience seek out this autonomy. It is the very best way to learn.

There are bad programs out there to be sure but when I trained thirty years ago I wanted to see and do everything so i would be prepared for a busy clinical practice. I have operated a busy service without a resident for the last 5 years (10-12K wRVUs in clinic 4-5 days a week)
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its easy to seek out autonomy

problem is it’s not truly autonomy unless you’re calling the final shot

are most academic attendings giving up the steering wheel?

Back in my day, we would do all the work and present the modern correct plan and our oldie attendings would do whatever they wanted anyways bc “that’s how I trained”

Then I’d watch them overcontour to make final volume look like 2D fields while billing IMRT
 
Chartreuse Wombat said:
Residents are paid to care for patients and learn on the job. As far as I can tell residents are voluntarily employed. If you extend your logic residents could just read books and pay for ASTRO contouring courses and they can pass their boards. Why should they be paid?

The last 12 months of the resident experience residents should be operating with minimal oversight. The very best in my thirty years of experience seek out this autonomy. It is the very best way to learn.

There are bad programs out there to be sure but when I trained thirty years ago I wanted to see and do everything so i would be prepared for a busy clinical practice. I have operated a busy service without a resident for the last 5 years (10-12K wRVUs in clinic 4-5 days a week)
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Agree that senior residents should be operating with minimal oversight. I also agree that it is much better to learn how to be a busy resident than to only start to learn this as an attending. I had >20 OTVs and 5 consults today and thank my lucky stars that I trained in a busy program (though I suspect that, for some, this doesn't seem like all that much). I am not disputing any of those assertions. What I am asking is... how does residents picking up the slack for each other benefit resident training? In what way would training be worse if attendings saw their patients alone when their resident was out? I work with a resident some days, an NP other days, and by myself on occasion as well. I don't think my residents would be better trained if I demanded full coverage... and I have a hard time seeing the rationale for this argument.
 
RickyScott said:
www.google.com

Biden to issue executive order to curtail noncompete clauses

President Biden plans to sign an executive order to crack down on noncompete agreements used by employers to prevent their employees from moving to rival firms, the White House announced Wednesday.…
www.google.com www.google.com
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Won't affect state laws on this and likely won't extend to professionals like doctors I'm guessing.

Non-competes are decided at a state level, like many things (abortion pre RvW, asset protection, employment law etc). Enforceable in some states, banned in others. EO won't change any of that
 
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Lamount said:
Agree that senior residents should be operating with minimal oversight. I also agree that it is much better to learn how to be a busy resident than to only start to learn this as an attending. I had >20 OTVs and 5 consults today and thank my lucky stars that I trained in a busy program (though I suspect that, for some, this doesn't seem like all that much). I am not disputing any of those assertions. What I am asking is... how does residents picking up the slack for each other benefit resident training? In what way would training be worse if attendings saw their patients alone when their resident was out? I work with a resident some days, an NP other days, and by myself on occasion as well. I don't think my residents would be better trained if I demanded full coverage... and I have a hard time seeing the rationale for this argument.
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how does residents picking up the slack for each other benefit resident training?...

My answer is that it teaches them to cross-cover for their colleagues something that they will be expected to do for the 30-40 years of practice after residency. They learn how to make decisions in the absence of complete information

Of course this can be abused; how many breast or prostate follow-ups does one need to do in their training? Attendings should of course pick up some of the slack but this example was in the context of a "challenging service" e.g. head and neck. In many programs the resident contribution is an important element of ensuring high quality, patient centric care.

I am not in any way supporting incompetent attendings who rely on resident work. I know that some of you have had that experience and that is disappointing. I assume competent, busy attending clinicians. Given the nature of practice in 2021 (increased wRVU expectations for attendings) there are many practices that would be "less safe" were it not for a resident who can allow for MDs to be two places at once. Again I am not using this to facilitate incompetent attendings. That is another issue and should be dealt with by the Chair
 
medgator said:
Won't affect state laws on this and likely won't extend to professionals like doctors I'm guessing.

Non-competes are decided at a state level, like many things (abortion pre RvW, asset protection, employment law etc). Enforceable in some states, banned in others. EO won't change any of that
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That’s is also what I thought, but looks like there is going to be a conflict between state and federal jurisdiction here.

www.google.com

Biden Proposes Nationwide Non-Compete Ban

President-Elect Biden recently released his “Plan for Strengthening Worker Organizing, Collective Bargaining, and Unions.” His Plan states that “Biden will work with Congress to elim
www.google.com www.google.com
 
RickyScott said:
That’s is also what I thought, but looks like there is going to be a conflict between state and federal jurisdiction here.

www.google.com

Biden Proposes Nationwide Non-Compete Ban

President-Elect Biden recently released his “Plan for Strengthening Worker Organizing, Collective Bargaining, and Unions.” His Plan states that “Biden will work with Congress to elim
www.google.com www.google.com
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"National non-compete bans have been proposed and have failed in the past, and it is unclear how likely a nationwide ban like the one described in the Biden Plan is to be enacted into law. "

Like i said, not holding my breath. Even mentions Biden carving out an exemption for certain " trade secrets"
 
After careful consideration, volunteers have determined that the level of unhelpful vitriol in recent posts merits comment.
This level of insensitivity is not consistent with collegiality and does not promote any positive change. It set off a series of destructive and hurtful exchanges that are not consistent with our goals or values.
Please remember to disagree without animus and in a spirit of collegiality.
 
ROforbetterorworse said:
its easy to seek out autonomy

problem is it’s not truly autonomy unless you’re calling the final shot

are most academic attendings giving up the steering wheel?

Back in my day, we would do all the work and present the modern correct plan and our oldie attendings would do whatever they wanted anyways bc “that’s how I trained”

Then I’d watch them overcontour to make final volume look like 2D fields while billing IMRT
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This is a huge challenge as an attending. I try to make the residents make as many decisions as possible, but final contours and plans are mine. I can’t approve something that I don’t believe is good enough. Walking this like is super hard.
 
Chartreuse Wombat said:
how does residents picking up the slack for each other benefit resident training?...

My answer is that it teaches them to cross-cover for their colleagues something that they will be expected to do for the 30-40 years of practice after residency. They learn how to make decisions in the absence of complete information

Of course this can be abused; how many breast or prostate follow-ups does one need to do in their training? Attendings should of course pick up some of the slack but this example was in the context of a "challenging service" e.g. head and neck. In many programs the resident contribution is an important element of ensuring high quality, patient centric care.

I am not in any way supporting incompetent attendings who rely on resident work. I know that some of you have had that experience and that is disappointing. I assume competent, busy attending clinicians. Given the nature of practice in 2021 (increased wRVU expectations for attendings) there are many practices that would be "less safe" were it not for a resident who can allow for MDs to be two places at once. Again I am not using this to facilitate incompetent attendings. That is another issue and should be dealt with by the Chair
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Agree with above. Learning to make complicated decisions only happens when you experience complexity. If residents are fully shielded from cross coverage they will never know how to handle bad setups, severe acute toxicity, late toxicity, complex treatment planning, etc.
 
ROforbetterorworse said:
its easy to seek out autonomy

problem is it’s not truly autonomy unless you’re calling the final shot

are most academic attendings giving up the steering wheel?

Back in my day, we would do all the work and present the modern correct plan and our oldie attendings would do whatever they wanted anyways bc “that’s how I trained”

Then I’d watch them overcontour to make final volume look like 2D fields while billing IMRT
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I do my own volumes without looking at theirs. Then we compare and I talk about which differences reflect them missing something important vs which are due to my personal preferences and/or reflect my unconventional approaches to certain situations.
 
gmsquid said:
This is a huge challenge as an attending. I try to make the residents make as many decisions as possible, but final contours and plans are mine. I can’t approve something that I don’t believe is good enough. Walking this like is super hard.
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I agree completely. The current supervision requirements make autonomy very difficult to create. One answer ironically is the VA system. Residents have much more autonomy
 
Lamount said:
I do my own volumes without looking at theirs. Then we compare and I talk about which differences reflect them missing something important vs which are due to my personal preferences and/or reflect my unconventional approaches to certain situations.
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In the old days I did the same. Contour independently and then discuss. I learned from the resident as they learned from me.
 
Turaco said:
And for those of who do not want or cannot have children? Do we get the same time to pursue whatever is important to us outside of work? Why is it so much to ask that the same rules apply to everybody?

I think it is absurd to treat the choice to have children at a specific time as some sacrosanct right that supersedes everything else.

If it were an unplanned pregnancy, I would absolutely have compassion, and I think we should create an environment where people who are in these situations are absolutely supported and can feel free to come forward, but the idea that it is a deliberate lifestyle choice (it certainly is for me!) has been hammered in our heads our whole lives, and well, you can't have it both ways. I have seen people try to strategically game the whole thing many times. Children are not these things you just choose to have when it's convenient for you then just dump them in daycare so you can have your career too. I think they are actually a pretty big thing and hence why I forego all of that.

I love the idea of having 12 months of elective for everyone (actually lets make it 6 months - time is precious). You want to use that for having children? Great. You want to use that for research? Great. You want to use that to surf in Australia? Great. You want to use that to stay in clinic and write notes? Great. The problem is that many who choose to have kids look would look at those who do something else and say, wait I ALSO want to take a long vacation and do research out of clinic. I have again personally seen this where someone was miffed they had to burn vacation for maternity leave.


See above regarding the methodical planning of child-bearing. You are talking about something else.


I did not call out an individual user, I referenced #WWC and I wasn't aware that using the a-word was censure-worthy. I highly doubt that it was my use of the slang for a donkey that offended somebody rather than my criticism of #WWC. Is it permitted to criticize #WWC here? It seems like not, which was my original point I was trying to make that got subsequently deleted. I personally feel that the whole #WWC thing promulgates a false narrative. But that's just my opinion. It is curious if one cannot state that here.

Again, this topic has nothing to do with the person who died. It just transitioned to it from in an an unfortunate way.
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People who cannot biologically have children can adopt and maternity leave as a benefit is available to those people also.

Not only maternity leave but also paternity leave should be benefits available to all people.

Agreed that more sabbatical time should be available to people. Countries where this is the case have shown that it improves productivity and overall sense of well-being.

A factor you seem to be ignoring in this discussion is it maternity/paternity leave is not simply for the parents but also a benefit for the child. Data shows that it improves mental health, reduces infant hospitalizations and increases rates of breastfeeding. This is not a consideration in other instances of leave.
 
lyltothend said:
People who cannot biologically have children can adopt and maternity leave as a benefit is available to those people also.

Not only maternity leave but also paternity leave should be benefits available to all people.

Agreed that more sabbatical time should be available to people. Countries where this is the case have shown that it improves productivity and overall sense of well-being.

A factor you seem to be ignoring in this discussion is it maternity/paternity leave is not simply for the parents but also a benefit for the child. Data shows that it improves mental health, reduces infant hospitalizations and increases rates of breastfeeding. This is not a consideration in other instances of leave.
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Societally, having children should be encouraged. Huge demographic issue in most developed countries including this one, although places like Japan and Italy are getting it worse
 
lyltothend said:
People who cannot biologically have children can adopt and maternity leave as a benefit is available to those people also.

Not only maternity leave but also paternity leave should be benefits available to all people.

Agreed that more sabbatical time should be available to people. Countries where this is the case have shown that it improves productivity and overall sense of well-being.

A factor you seem to be ignoring in this discussion is it maternity/paternity leave is not simply for the parents but also a benefit for the child. Data shows that it improves mental health, reduces infant hospitalizations and increases rates of breastfeeding. This is not a consideration in other instances of leave.
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Again, I do not have a problem with maternity and paternity leave. My problem is with those who want it without extending their training. Children should be raised by their parents, not low wage caregivers. Maternity and paternity leave is a good thing and I actually don't think we give enough of it. I would be totally fine with someone taking 6 months or even a year if they wanted as long as that option goes to everybody. Agree that sabbatical time is important and America kind of has it wrong in this regard. Iceland just did an experiment with a 4 day work week and the results are what you would expect.
 
gmsquid said:
Agree with above. Learning to make complicated decisions only happens when you experience complexity. If residents are fully shielded from cross coverage they will never know how to handle bad setups, severe acute toxicity, late toxicity, complex treatment planning, etc.
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Cross coverage is good if it's as you've defined. In reality, it's prepping notes with generally no real involvement in the day to day of a service excepting occasional acute tox pages, all while taking a resident away from an academic day, which generally coincides with a non-clinical day for the attending with which the resident is working, hence interfering with the chance to discuss planning in person.
 
Turaco said:
Children should be raised by their parents, not low wage caregivers
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This is a very uninformed and insensitive comment

How do you expect this arrangement to work for physicians?

Quit your job? Expect one parent to never work?

your statement is one step away from saying 1 Parent working is bad for child too
 
Turaco said:
Again, I do not have a problem with maternity and paternity leave. My problem is with those who want it without extending their training. Children should be raised by their parents, not low wage caregivers. Maternity and paternity leave is a good thing and I actually don't think we give enough of it. I would be totally fine with someone taking 6 months or even a year if they wanted as long as that option goes to everybody. Agree that sabbatical time is important and America kind of has it wrong in this regard. Iceland just did an experiment with a 4 day work week and the results are what you would expect.
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Radoncs don’t need 4 years of training to begin with, so missing a year for kids/rehab etc is no big deal. Training was only extended to 4 years because of the bad job market in the 1990s. Take away garbage research, and focus only on practice changing literature and clinic and 2.5 years is probably fine. Would assume that’s about how much a clinical oncologist receives in England,probably less.
 
RickyScott said:
Radoncs don’t need 4 years of training to begin with, so missing a year for kids/rehab etc is no big deal. Training was only extended to 4 years because of the bad job market in the 1990s. Take away garbage research, and focus only on practice changing literature and clinic and 2.5 years is probably fine. Would assume that’s about how much a clinical oncologist receives in England,probably less.
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That leaves plenty of room to add training in systemic therapy while taking out unnecessary unhelpful fluff
 
ROforbetterorworse said:
This is a very uninformed and insensitive comment

How do you expect this arrangement to work for physicians?

Quit your job? Expect one parent to never work?

your statement is one step away from saying 1 Parent working is bad for child too
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how do I expect it to work for physicians? You mean a family where both parents are well within the top 1% of income earners in the country? Oh cry me a river!

One parent stays at home with children at least until they are old enough for preschool and you can work part time. It’s not hard. If you are actual 2 physician household you can certainly afford to live off even a measles 350k rad onc income. My mom staid at home to raise us until school age off my dads 80k income and we did just fine.

or by all means make a combined 1.2 million and put your kid in daycare with who knows who raising them. I don’t care. I know the data shows that kids raised in two parent households by their own parents do better.

putting kids in daycare should be a last resort not the expectation. Trying to have two parents both be careerists and raise kids at the same time seems like a bad idea. Something has to give and you can’t have at all. But what the heck do I know!
 
Turaco said:
how do I expect it to work for physicians? You mean a family where both parents are well within the top 1% of income earners in the country? Oh cry me a river!

One parent stays at home with children at least until they are old enough for preschool and you can work part time. It’s not hard. If you are actual 2 physician household you can certainly afford to live off even a measles 350k rad onc income. My mom staid at home to raise us until school age off my dads 80k income and we did just fine.

or by all means make a combined 1.2 million and put your kid in daycare with who knows who raising them. I don’t care. I know the data shows that kids raised in two parent households by their own parents do better.

putting kids in daycare should be a last resort not the expectation. Trying to have two parents both be careerists and raise kids at the same time seems like a bad idea. Something has to give and you can’t have at all. But what the heck do I know!
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yeah you really don’t know anything based on comments

Good luck to you

EDIT: don’t feel like getting personal
 
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ROforbetterorworse said:
This is a very uninformed and insensitive comment

How do you expect this arrangement to work for physicians?

Quit your job? Expect one parent to never work?

your statement is one step away from saying 1 Parent working is bad for child too
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Party of family values happening over there with turaco/khe88
 
ROforbetterorworse said:
yeah you really don’t know anything based on comments

Good luck to you

EDIT: don’t feel like getting personal
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Please tell me more about the rough life of two physician households!

i will say that I greatly admire the multiple women I have met in my career that have managed to make it work with a lower-earning father and/or grandparent that stays at home to make it work. It would certainly be easier to just dump them in daycare. Bravo to those who take the more difficult path for the benefit of their family!

i typically see that this is the way it is. I’ve only seen a few times the rich former DINKs have a baby and dump it in daycare immediately then continue their previous career lifestyle. That seems pretty rare in my experience and perhaps explains my disdain for it. I think most fundamentally understand that it is better for a family member to be with the child.
 
Turaco said:
Please tell me more about the rough life of two physician households!

i will say that I greatly admire the multiple women I have met in my career that have managed to make it work with a lower-earning father and/or grandparent that stays at home to make it work. It would certainly be easier to just dump them in daycare. Bravo to those who take the more difficult path for the benefit of their family!
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I don’t have personal experience on 2 physician household so I’ll withhold comments, but I can empathize with ANY 2 working household

But given you don’t have children, I find you to be extraordinarily judgmental and small minded

Life is gray. It’s not black and white between if you want Kids then parents must quit job or else they are bad parents and kids are screwed

and you contradict yourself bc you said earlier “children should be raised by their parents”

that’s plural.

Later you say only 1 parent staying at home is fine like your situation

So why don’t you ask ppl to save enough money to afford Both parents staying at Home for 5 years until preschool

Bc that’s nonsense that’s why

okay I’m done talking to you now…..bbbbyyyeeeee
 
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ROforbetterorworse said:
But given you don’t have children, I find you to be extraordinarily judgmental and small minded
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and there it is. The “if you don’t have kids STFU” argument.

The blowback I’ve gotten from ex gfs on criticizing even the tiniest little thing pales in comparison to open my mouth about child rearing as a single man!

Wikipedia really needs another section for their logical fallacies page. Cause wow.

Edit: to clarify since you seem kinda dense. I certainly did not mean BOTH parents needs to stay at home AT THE SAME TIME to raise the kids. I’m not an idiot. By that I mean shared parenting.

as long as SOME family member is with the child is what matters. Mother father grandparent aunt, older sibling, whatever. Somebody who has a vested interest whom the child will see for rest of its life. Not some rando making $12/hour. Amazing I had to clarify that.
 
Turaco said:
Please tell me more about the rough life of two physician households!

i will say that I greatly admire the multiple women I have met in my career that have managed to make it work with a lower-earning father and/or grandparent that stays at home to make it work. It would certainly be easier to just dump them in daycare. Bravo to those who take the more difficult path for the benefit of their family!

i typically see that this is the way it is. I’ve only seen a few times the rich former DINKs have a baby and dump it in daycare immediately then continue their previous career lifestyle. That seems pretty rare in my experience and perhaps explains my disdain for it. I think most fundamentally understand that it is better for a family member to be with the child.
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I feel bad for the children whose parents keep them at home and don't allow them the opportunity to socialize with their peers, develop social and play skills, enjoy a structured educational curriculum, and be cared for by childcare professionals rather then first time amateurs. It is probably this anti-social home rearing tendancy leading to the risk of autistic spectrum disorders.

See? I can make broad proclamations and judgement with no data too! You cite "studies," but should know that on here that doesn't fly. by all means cite them. Everyone I have seen has shown either no difference, or a difference stratified by SES (children in lower income familes doing better at home, higher with childcare). The signal seems to be that it is quality of time, rather then quantity of time that matters. I know I can give a lot more of myself to my children int he 3 hours i am home between work and bed then if I am watching them for 15 hours on the weekend. Most of the studies are of garbage quality and likely showing correlations in any case.

You don't need to STFU because you are childless. You need to STFU because you are making broad sweeping proclamations based on your preconceptions with no supporting data and failing to take into account the context of each individual family.
 
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DoctwoB said:
I feel bad for the children whose parents keep them at home and don't allow them the opportunity to socialize with their peers, develop social and play skills, enjoy a structured educational curriculum, and be cared for by childcare professionals rather then first time amateurs. It is probably this anti-social home rearing tendancy leading to the risk of autistic spectrum disorders.

See? I can make broad proclamations and judgement with no data too! You cite "studies," but should know that on here that doesn't fly. by all means cite them. Everyone I have seen has shown either no difference, or a difference stratified by SES (children in lower income familes doing better at home, higher with childcare). The signal seems to be that it is quality of time, rather then quantity of time that matters. I know I can give a lot more of myself to my children int he 3 hours i am home between work and bed then if I am watching them for 15 hours on the weekend. Most of the studies are of garbage quality and likely showing correlations in any case.

You don't need to STFU because you are childless. You need to STFU because you are making broad sweeping proclamations based on your preconceptions with no supporting data and failing to take into account the context of each individual family.
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I’m talking about raising children to school age. I if course agree with socializing kids in the normal sense of going to school and making friends. So that strawman is DOA, sorry. I am talking about the situation when they are 0-5 years of age when their needs from parents are much higher.

you all can call me incel, loser, etc. fine. I literally don’t care. I think it’s funny how people get so triggered by obvious truths.
 
Turaco said:
and there it is. The “if you don’t have kids STFU” argument.

The blowback I’ve gotten from ex gfs on criticizing even the tiniest little thing pales in comparison to open my mouth about child rearing as a single man!

Wikipedia really needs another section for their logical fallacies page. Cause wow.

Edit: to clarify since you seem kinda dense. I certainly did not mean BOTH parents needs to stay at home AT THE SAME TIME to raise the kids. I’m not an idiot. By that I mean shared parenting.

as long as SOME family member is with the child is what matters. Mother father grandparent aunt, older sibling, whatever. Somebody who has a vested interest whom the child will see for rest of its life. Not some rando making $12/hour. Amazing I had to clarify that.
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Multiple non-randomized trials have shown a detriment to child rearing by non parents done in the 1930s and 1940s mainly out of north-western Europe. You make a great point!
 
RadOncMegatron said:
But what will happen to us "normies" who only know how to use the healing beam? LOL
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I know right? I'm convinced that a solid tumor pathway for "clinical oncologist" is the way to go but it would hose me and even worse the nearly 2000 grads after me.

I would argue that the confluence of tech, personalized medicine, evidence based algorithmic medicine and protocolized systemic therapy makes the integrated oncologist the way to go. Heme and transplant can of course stay a different animal with a different training pathway.

Maybe the most rational (and most damaging to us) pathway would be option for 2 year radonc fellowship after medonc instead of heme for those who want to do this? One could be boarded in onc and rads or onc and heme?

I suspect outcomes would improve. For you academic GU docs out there, do you really think you couldn't handle the entire therapeutic pathway from local XRT/salvage XRT through next gen endocrine therapy, single agent chemo and radionuclides? If this was your clinical practice I bet your next clinical research initiative would be your best.

The shear numbers of stellar trainees radonc has produced in the last 10-15 years should really put an onus on leaders for some sort of real time certification for practicing radoncs to expand their scope of care.

Of course, never happening.
 
Turaco said:
as long as SOME family member is with the child is what matters. Mother father grandparent aunt, older sibling, whatever. Somebody who has a vested interest whom the child will see for rest of its life. Not some rando making $12/hour. Amazing I had to clarify that.
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Speaking as someone who had two full-time working parents and spent some time in daycare, I found your assertions interesting... so I checked the literature. The few studies and reviews I have encountered show that there is really no difference in psychological or academic development in children who are raised at home vs. who attend daycare (lo and behold). Do you have data to support your claims... or just some strong feelings that you describe as objective facts?
 
Lamount said:
Do you have data to support your claims
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I say forget the data here. This is parenting. We are uniformly non-experts when we start and marginally better when we finish. There are multiple radically different models of child raising that seem to work. I'd have a hard time being confident in data anyway, particularly considering the reproducibility of social science studies (even worse than our own studies).

Turaco acknowledges that he is not a parent. His opinion is valid but I'm not taking it seriously. I might take his opinion on maneuvering a small hospital environment seriously but not this. I suspect that if he settles down with a professionally ambitious woman and has kids, his opinion might change.
 
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