Residency and babies

[rubisco88]

Just started my 2nd year of medical school in Texas and I'm going to be 26 a few months from now. I'll finish my MD when I'm 28 and probably finish residency at the youngest when I'm 32 ( 4 yrs). I'm currently engaged, but the wedding has taken a backseat for now. Currently, I'm feeling a lot of anxiety over the uncertainty of whether I'll be able to accomplish all the things I want family/personal-wise due to the demands of medicine. I would like have at least 2-3 kids (leaning more towards 3) by the age of 35.

Making it even more difficult is that my fiancé is in California working on an Econ Phd. He has 2-3 years left of his program and he plans to try to finish when I finish so that he can get a job wherever I do my residency. He considering a job in the private sector since landing a professorship in a specific location will probably be difficult. Planning a wedding is stressful and we don't really have the money since both of us our grad students. I am now considering destination wedding in Hawaii with just our immediate families as a cheaper and less stressful option. MS1 summer would have been ideal but we missed that opportunity so it seems like the only option for marriage might be around 4th year...however I'm going to be 28 then and it also seems like a good time to have our first child. Is taking a year off a viable option before heading into an internship?

Will I be able to have kids in residency and when exactly? Are you allowed to have more than one pregnancy in residency (at least 2)? How much longer will it take to finish if you do have kids? I am considering PM&R, pediatrics, and psychiatry right now since they are of interest to me, less competitive (I'm an average student), and shorter relative to other residencies. Is it possible to take any time off after residency before practicing? I would like to do residency in Southern California as both our families will be in that area so they could help with child care, but it's very possible that we end up in Texas and have to hire help on a residency salary and he'll probably be making 90-120k.

Any advice would be great. Please help a stressed med student out 🙁.

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[mvenus929]

Pediatrics in general is a very baby friendly residency... but if you have two, your finish date might be delayed by a couple months, depending on how your program works the maternity leave (some programs have a 'baby friendly' rotation you can do with relatively few hours). The chiefs at my program recommend not having a kid during intern year, but otherwise, there are many kids at our program.

I can't really answer your time off questions--you can take time between fourth year and intern year, but it makes it more difficult to land a residency if you aren't doing a dual-degree program.

 

[drcrispmd]

The females who have had a baby in residency finished 1 month behind. One of my med school friends had 3 babies during her family medicine residency (1 every year, all boys). I can't remember if and how many months behind she was. They cannot prevent you from having more than 1 baby. do try to plan and let you PD and fellow residents know because schedules may need to be changed.

 

[rokshana]

you may want to consider taking time off between 2nd and 3rd year or 3rd and 4th year….maybe a research year and get married, get pregnant …it will be easier than taking time off after graduating…easier to explain a research year to graduate a year later rather than having a gap between med school and residency…plus you will have to explain the gap year forevermore on licensing and credentialing paperwork…


and when it comes time for residency, you may want to look at larger programs since having a resident out on maternity leave in a smaller program is harder to deal with in terms of scheduling and workload the other residents have to take on with a person out.

 

[Law2Doc]

1. Doubtful a destination wedding in Hawaii is ever "cheaper"even if the guest list is short.
2. Residencies don't prohibit you from getting pregnant but if you end up needing eg more weeks in the ICU etc because of multiple maternity leaves you could potentially extend your residency.
3. The big issue is going to be who takes care of these kids while you are slogging through 80 hour work weeks and weekend and overnight call. If he's earning 100 and you are earning 45 it's certainly possible to hire someone, but that has it's own set of headaches.
4. The fact that you aren't even married yet and seem focused on age 28 being time to have the first child is a bit horse before the cart, no? You may not have as much control over the timing as you'd like to think --plenty of people have to try for a while these days. Also it seems you could simply try to crank out a few kids starting at age 32 and not disrupt your training. What's the rush?

 

[rubisco88]

1. Doubtful a destination wedding in Hawaii is ever "cheaper"even if the guest list is short.
2. Residencies don't prohibit you from getting pregnant but if you end up needing eg more weeks in the ICU etc because of multiple maternity leaves you could potentially extend your residency.
3. The big issue is going to be who takes care of these kids while you are slogging through 80 hour work weeks and weekend and overnight call. If he's earning 100 and you are earning 45 it's certainly possible to hire someone, but that has it's own set of headaches.
4. The fact that you aren't even married yet and seem focused on age 28 being time to have the first child is a bit horse before the cart, no? You may not have as much control over the timing as you'd like to think --plenty of people have to try for a while these days. Also it seems you could simply try to crank out a few kids starting at age 32 and not disrupt your training. What's the rush?

I've been looking at figures and the average wedding in the states is 29k while a destination wedding seems to be 10-20k. 20k if the guest list is about 50 people, but I'm thinking just like 10 people (parents, sibling, immediate family).

I think it's risky to start having babies at 32, since fertility declines at 35 especially if I want to have more than 1. I'm not sure how quickly I'll be able to get pregnant and if there are issues, I'm probably screwed with little time to consider other possible options in fertility technology. Is it even really wise to to take a year off between residency and my real job. I keep hearing there are issues with health coverage and other things (will I forget what I learned??). I don't really hear of people taking a year off after residency to have a baby. Is it maybe more feasible to take a year off between residency and a fellowship if I choose to pursue one?

 

[Law2Doc]

I've been looking at figures and the average wedding in the states is 29k while a destination wedding seems to be 10-20k. 20k if the guest list is about 50 people, but I'm thinking just like 10 people (parents, sibling, immediate family).

I think it's risky to start having babies at 32, since fertility declines at 35 especially if I want to have more than 1. I'm not sure how quickly I'll be able to get pregnant and if there are issues, I'm probably screwed with little time to consider other possible options in fertility technology. Is it even really wise to to take a year off between residency and my real job. I keep hearing there are issues with health coverage and other things (will I forget what I learned??). I don't really hear of people taking a year off after residency to have a baby. Is it maybe more feasible to take a year off between residency and a fellowship if I choose to pursue one?

First, I think your definition of "cheaper" is different because the per person cost for anyone to take a multiple day trip to Hawaii is quite high even if your cost of a small reception once there is reasonable. By saying a destination wedding is "cheaper", you really are just allocating a much greater cost to the guests than making the event itself "cheaper." (The family member with multiple children is going to spend a small fortune attending your wedding compared to someplace local).

Second, these days lots of career people have babies in their early 30s. It's becoming the new norm. You aren't high risk until 35+ and even then odds are still high that the child will be normal. Or you could even freeze young eggs and decrease risks further.

Third, I don't know that I ever advocated taking a year off. (I actually don't think that works well for this career path honestly, and the couple of people I know who took a year off never came back.) I just suggested after residency your hours are going to be much more controllable than during. It's tough to find childcare for 80 hour work weeks including weekends and overnights.

 

[rokshana]

I've been looking at figures and the average wedding in the states is 29k while a destination wedding seems to be 10-20k. 20k if the guest list is about 50 people, but I'm thinking just like 10 people (parents, sibling, immediate family).

I think it's risky to start having babies at 32, since fertility declines at 35 especially if I want to have more than 1. I'm not sure how quickly I'll be able to get pregnant and if there are issues, I'm probably screwed with little time to consider other possible options in fertility technology. Is it even really wise to to take a year off between residency and my real job. I keep hearing there are issues with health coverage and other things (will I forget what I learned??). I don't really hear of people taking a year off after residency to have a baby. Is it maybe more feasible to take a year off between residency and a fellowship if I choose to pursue one?

you wanna do fellowship in there and aim to have 3 kids before 32? i know people want to have it all but….come on!
like L2D stated its not like you can't have kids after 32…and plenty of people have children safely in their 30s….

better you take the time off while in med school….easier to explain the gap time then….

 

[Igor4sugry]

--Just started my 2nd year of medical school in Texas and I'm going to be 26 a few months from now.

--I am now considering destination wedding in Hawaii with just our immediate families as a cheaper and less stressful option.

--Will I be able to have kids in residency and when exactly? Are you allowed to have more than one pregnancy in residency (at least 2)? How much longer will it take to finish if you do have kids? I am considering PM&R, pediatrics, and psychiatry right now since they are of interest to me, less competitive (I'm an average student), and shorter relative to other residencies.

Speaking as a PGY-III resident couple with two kids in diapers.
**First of all, your husband must be on board with this, otherwise it will simply not work.

[1] Definitely stay in Texas, your money will go much farther than in California. Plus matching in CA is not easy.
Particularly if you are planning to have kids in residency you need to stay in low cost areas (i.e. NOT the East or West coasts).
$90-120k will be plenty for a family. You will likely have daycare or a nanny. Many people/attendings do this.

[2] two indebted graduate students panning a destination wedding to Hawaii as a cheaper option? Come again?

[3] Some other things to think about. You are only 1 year into med school. Fiance is far away. Hold off on the wedding until you guys move back together. Many things happen in med schools throughout the country in terms of long-term relationships.

[4] Psychiatry is the most family friendly of them all. I'm not sure why someone mentioned peds to be it. Nothing in primary care (i.e. IM, Family med, Peds) is family friendly due to inpatient rotations and call. You need to pick specialty with lowest call requirements. There are previous posts on this. But Psychiatry, Pathology, Derm, PM&R, RadOnc come to mind.


[5] Consider having your 1st child in beginning of 4th year. Then another in PGY-II and then another in PGY-III.

Residency is relatively easy time to have kids (again only with a low call specialty) because you have more people to cover for you.
Don't take time off in med school its too much of a liability. You can always go off-cycle in residency, plenty of people do that (not just for pregnancy reasons).
Consider that in some jobs you will not be offered maternity leave until you work for 1 year.