wife giving birth during intern year

[Falconclaw]

Thanks for all the responses and stories guys (colleagues?), I really appreciate it. I definitely agree that I should ask the chiefs politely, I haven't met them in person yet but they seem nice and reasonable via email, and so does the PD, so I think they'll be able to accomodate me.

The one other thing I was wondering is how long should I wait to tell them? Is it too early now, and should I wait until the 8 week ultrasound, when I guess things are a little more definite?

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[ThoracicGuy]

Thanks for all the responses and stories guys (colleagues?), I really appreciate it. I definitely agree that I should ask the chiefs politely, I haven't met them in person yet but they seem nice and reasonable via email, and so does the PD, so I think they'll be able to accomodate me.

The one other thing I was wondering is how long should I wait to tell them? Is it too early now, and should I wait until the 8 week ultrasound, when I guess things are a little more definite?

Right now it may be easier to rearrange schedules than after you start in July.

 

[Falconclaw]

Out of curiosity...why on earth intern year? Who's decision was it to stop the birth control? What a terrible year to have a kid.

i got married at the end of med school and my wife has wanted to be a mom ever since she was a little girl so asking her to wait another year just wasn't a real option. also her parents do live 25 min away and have extra bedrooms so that should be helpful (that was actually a big consideration in how I made up my rank list)

i had the same concern about switching blocks around that some other people mentioned, that EDD's aren't quite an exact science....let's say the baby comes smack dab in the middle of my MICU rotation...can I take the two weeks off and then just do another two weeks on MICU another time?

 

[Birdstrike]

Thanks for all the responses and stories guys (colleagues?), I really appreciate it. I definitely agree that I should ask the chiefs politely, I haven't met them in person yet but they seem nice and reasonable via email, and so does the PD, so I think they'll be able to accomodate me.

The one other thing I was wondering is how long should I wait to tell them? Is it too early now, and should I wait until the 8 week ultrasound, when I guess things are a little more definite?

The sooner the better.

 

[Birdstrike]

i got married at the end of med school and my wife has wanted to be a mom ever since she was a little girl so asking her to wait another year just wasn't a real option. also her parents do live 25 min away and have extra bedrooms so that should be helpful (that was actually a big consideration in how I made up my rank list)

i had the same concern about switching blocks around that some other people mentioned, that EDD's aren't quite an exact science....let's say the baby comes smack dab in the middle of my MICU rotation...can I take the two weeks off and then just do another two weeks on MICU another time?

You don't have to prove justification to anyone else. What works for you and your fam works for you and your fam.

 

[deleted109597]

let's say the baby comes smack dab in the middle of my MICU rotation...can I take the two weeks off and then just do another two weeks on MICU another time?

Maybe. Or maybe they'll make you repeat the whole rotation. I can't say what they do there, but they might be decent about it. I got off my last MICU call, which saved me ~14 hours of the month. She went into labor on the last day I was there, which was a call day.

 

[gutonc]

Thanks for all the responses and stories guys (colleagues?), I really appreciate it. I definitely agree that I should ask the chiefs politely, I haven't met them in person yet but they seem nice and reasonable via email, and so does the PD, so I think they'll be able to accomodate me.

The one other thing I was wondering is how long should I wait to tell them? Is it too early now, and should I wait until the 8 week ultrasound, when I guess things are a little more definite?

I would tell them now and see if they can swap your MICU month then with somebody else who has a lighter rotation (assuming your program has such a thing for interns) that month. Definitely sooner than later is best.

 

[deleted547339]

i got married at the end of med school and my wife has wanted to be a mom ever since she was a little girl so asking her to wait another year just wasn't a real option. also her parents do live 25 min away and have extra bedrooms so that should be helpful (that was actually a big consideration in how I made up my rank list)

i had the same concern about switching blocks around that some other people mentioned, that EDD's aren't quite an exact science....let's say the baby comes smack dab in the middle of my MICU rotation...can I take the two weeks off and then just do another two weeks on MICU another time?

There likely isn’t anyone who can cover for you in the Micu. The schedules are built around the people on the rotation for the month. There’s no sick call or whatever. And it’s not like the ED where if you miss, someone else can pick up without missing a beat - the patients are complex and have often been there a while. Sure, if you miss a day, someone can cover; but if she delivers on week two of four, that would be a mess trying to get it covered. Also, the medicine chiefs likely handle that schedule. It may be worth involving them at some point (I.e. if it gets switched to her 7th month if pregnancy, there’s still a small chance - if want to let them know a couple months out - no rush, but don’t spring it on them either).

The best thing is to switch the block entirely.

As people above have noted, it may be easier to switch now. I take back what I said about confirming IUP since it does make a lot of sense to swap before July 1 and would probably be much easier.

The only thing to be aware of is: there is a reason people wait until 12 weeks or so to tell people. The rate of miscarriage drops significantly. My wife and I thought about it like this: we only told people with whom we are close enough that if we had a miscarriage, we would tell them about it.

 

[theseeker4]

i got married at the end of med school and my wife has wanted to be a mom ever since she was a little girl so asking her to wait another year just wasn't a real option. also her parents do live 25 min away and have extra bedrooms so that should be helpful (that was actually a big consideration in how I made up my rank list)

i had the same concern about switching blocks around that some other people mentioned, that EDD's aren't quite an exact science....let's say the baby comes smack dab in the middle of my MICU rotation...can I take the two weeks off and then just do another two weeks on MICU another time?

All I will point out is that you can plan everything perfectly, and then everything can change when something happens with the pregnancy. With our second child, he was born via scheduled c-section September of my intern year, so I had a scheduled vacation all set for the week after delivery without any issues. Our first child was born before I was in medicine, but he came 2 months early, with my wife hospitalized for 10 days due to preeclampsia. That first child could have been born during the worst possible rotation despite all careful planning, had I been in medicine at that time. Just be open with the chiefs and PD about your need for flexibility.

 

[GonnaBeADoc2222]

There likely isn’t anyone who can cover for you in the Micu. The schedules are built around the people on the rotation for the month. There’s no sick call or whatever. And it’s not like the ED where if you miss, someone else can pick up without missing a beat - the patients are complex and have often been there a while. Sure, if you miss a day, someone can cover; but if she delivers on week two of four, that would be a mess trying to get it covered. Also, the medicine chiefs likely handle that schedule. It may be worth involving them at some point (I.e. if it gets switched to her 7th month if pregnancy, there’s still a small chance - if want to let them know a couple months out - no rush, but don’t spring it on them either).

Problem is, some in academics are above picking up the slack. The solution is always to call someone in. Instead of splitting the leftover patients between the other juniors, a senior resident, the MICU fellow, of (heaven forbid) the attending, the response is to either pull someone from another educational activity or prevent a father from being present with his wife and newborn.

The schedule can in fact be changed. It's just a matter if people feel like helping you.

 

[Falconclaw]

There likely isn’t anyone who can cover for you in the Micu. The schedules are built around the people on the rotation for the month. There’s no sick call or whatever. And it’s not like the ED where if you miss, someone else can pick up without missing a beat - the patients are complex and have often been there a while. Sure, if you miss a day, someone can cover; but if she delivers on week two of four, that would be a mess trying to get it covered. Also, the medicine chiefs likely handle that schedule. It may be worth involving them at some point (I.e. if it gets switched to her 7th month if pregnancy, there’s still a small chance - if want to let them know a couple months out - no rush, but don’t spring it on them either).

The best thing is to switch the block entirely.

As people above have noted, it may be easier to switch now. I take back what I said about confirming IUP since it does make a lot of sense to swap before July 1 and would probably be much easier.

The only thing to be aware of is: there is a reason people wait until 12 weeks or so to tell people. The rate of miscarriage drops significantly. My wife and I thought about it like this: we only told people with whom we are close enough that if we had a miscarriage, we would tell them about it.

okay i just emailed them, i appreciate all the advice from people since otherwise i probably would've waited to tell them. i totally agree about in general not telling people until later on in the pregnancy, so far the only person who knows is my wife's mother. the positive test was only two or three days ago so it hardly even feels real to me.

 

[NITRAS]

Congrats dude. Babies are awesome. People make them work.

edited: someone already said it.

I’d also make sure and be friends with your colleagues. Last minute switches is a lot easier with a friend, especially if it isn’t entirely “equal”.

 

[deleted547339]

Problem is, some in academics are above picking up the slack. The solution is always to call someone in. Instead of splitting the leftover patients between the other juniors, a senior resident, the MICU fellow, of (heaven forbid) the attending, the response is to either pull someone from another educational activity or prevent a father from being present with his wife and newborn.

The schedule can in fact be changed. It's just a matter if people feel like helping you.

Your condescension not withstanding, as an attending in an academic Micu, I can tell you that it would be nearly impossible for me or my fellow to have patients on our own. Call me lazy if you’d like, but, no, I can’t be bothered to put in stool softener or tube feed orders or call all of my own consults between being the hospital rapid response team, helping with goals of care conversations, supervising procedures, leading rounds, afternoon teaching, staffing new admissions, being around for decompensating patients and putting out other fires, etc. My fellow is probably the busiest in the hospital, so he or she can’t pick up patients solo either. You could divide them among other residents, but I think ACGME has a limit on number of patients per resident and admissions per resident per day. Believe it or not, we staff the way we do for a reason. Losing a resident is a huge problem. That would be like saying our ER could drop a resident in the middle of the day every day for a month. Sure, no one would die, but it would slow the department significantly and patient care would suffer.

 

[Falconclaw]

okay i let them know, they said to get back to them when i had more info about the due date and we'll talk about scheduling changes then. first ultrasound will be in mid july.

 

[Hamhock]

It's nice to see that everyone is "family oriented"...and has suggestions to make it easier for the parents and the program.

However, I would like folks to remember all the residents who pick up the slack. Mothers who extend residency by three months doesn't make up anything to the residents who had to take extra call for three months. This is especially difficult in small programs.

And please don't tell me you are "more than happy" to be q3 for a month so that someone else can be with his kid longer -- especially when that happens multiple times in one year.

And please don't tell me the programs "should just"...should just hire some more midlevels; should just have attendings pick up extra shifts; etc.

This just isn't realistic...it's not the way things work.

In the real world, the childless residents just keep working harder and harder. They are not compensated more. They are not given extra vacation later. They just work more.

People with children often struggle to take the perspective of those who cover for them...over and over. Yes, it's nice you have kids and that programs allow for that choice. It's not nice that this forces childless professionals to cover without compensation. I've never heard of a new parent returning and offering to cover calls of the resident who worked extra hard all month so that the parent could have it off.

HH

 

[GonnaBeADoc2222]

It's nice to see that everyone is "family oriented"...and has suggestions to make it easier for the parents and the program.

However, I would like folks to remember all the residents who pick up the slack. Mothers who extend residency by three months doesn't make up anything to the residents who had to take extra call for three months. This is especially difficult in small programs.

And please don't tell me you are "more than happy" to be q3 for a month so that someone else can be with his kid longer -- especially when that happens multiple times in one year.

And please don't tell me the programs "should just"...should just hire some more midlevels; should just have attendings pick up extra shifts; etc.

This just isn't realistic...it's not the way things work.

In the real world, the childless residents just keep working harder and harder. They are not compensated more. They are not given extra vacation later. They just work more.

People with children often struggle to take the perspective of those who cover for them...over and over. Yes, it's nice you have kids and that programs allow for that choice. It's not nice that this forces childless professionals to cover without compensation. I've never heard of a new parent returning and offering to cover calls of the resident who worked extra hard all month so that the parent could have it off.

HH

I think this is a great perspective and also deserves discussion. I agree with all points. I think they SHOULD be compensated for extra call and shifts.

 

[Groove]

Is it even realistic for a male resident to just “take off” for 2 weeks for some sort of paternity leave? I don‘t ever remember anyone doing that. At most, people took a day or two if they could move things around. I mean, how would you even finish your rotation? Are programs including some sort of paternity leave clause these days? Now that I think about it, I can distinctly remember one of my co-residents who left early for his wife’s labor and was back bright and early for work the following day. When did all of this 2-4 week “paternity leave” for the dudes start up? I’m almost positive that wasn’t even an option during my residency.

 

[Falconclaw]

also wanted to include this one because it made me laugh out loud:

but on a serious note, is it really so terrible that dads have more of an opportunity to bond with their new children? has this resulted in some epidemic of hospital patients dying that i was unaware of? keep in mind i don't even know how much time off i want to take or should take.

 

[Groove]

View attachment 267180

also wanted to include this one because it made me laugh out loud:

View attachment 267181


but on a serious note, is it really so terrible that dads have more of an opportunity to bond with their new children? has this resulted in some epidemic of hospital patients dying that i was unaware of? keep in mind i don't even know how much time off i want to take or should take.

 

[Groove]

You got 18 years to bond with that oversized nugget. It’s still gonna be there when you get home from your ICU rotation. Suck it up. Grab some diapers on the way home and a pacifier. Quality, not quantity. Wifey will be just FINE. She may piss and moan during residency but you’re gonna be the best dad in the world when she starts seeing those attending paychecks. Trust me.

 

[deleted547339]

You got 18 years to bond with that oversized nugget. It’s still gonna be there when you get home from your ICU rotation. Suck it up. Grab some diapers on the way home and a pacifier. Quality, not quantity. Wifey will be just FINE. She may piss and moan during residency but you’re gonna be the best dad in the world when she starts seeing those attending paychecks. Trust me.

Dude. You know I have no problem with you and usually find myself agreeing with you, but this is a fairly toxic viewpoint. Just because you can push through doesn’t mean you should. It certainly is a better thing for a husband and his family to have some time off. If it’s at all possible to accommodate, the program should. I had to push through when we had our first child in training. My program did very little to help me have time off and I have a negative view of the program - not entirely because of it, but it certainly was consistent with the overall culture. Now that we have more than one, I feel like I could go back to work quickly. My wife and I figured it out. And, in retrospect, babies are easy. But at the time, man, that little ball of milk and poop seems impossible. We should try to do better if we can reasonably do better. This is a way we can reasonably do better.

And I agree with @Hamhock , people often don’t realize that someone pushing back graduation means the people getting paid back are the residents 1-2 years behind, not your coresidents. I had someone in my program do that. Some people begrudged her, but it’s kind of the cost of doing business. That’s what working at a place that is family friendly requires. And, at the end of the day, if someone takes off a month, that’s what? 16-18 shifts? That ends up being 0.5-1 shift per resident depending on class size and number of off service rotations. Even if someone takes 3 months off, that’s 1.5-3 shifts divided over 3 months. Sure, it’s not “fair” but it’s not as big of a deal as some of my classmates made it out to be.

 

[Porfirio]

Dude. You know I have no problem with you and usually find myself agreeing with you, but this is a fairly toxic viewpoint. Just because you can push through doesn’t mean you should. It certainly is a better thing for a husband and his family to have some time off. If it’s at all possible to accommodate, the program should. I had to push through when we had our first child in training. My program did very little to help me have time off and I have a negative view of the program - not entirely because of it, but it certainly was consistent with the overall culture. Now that we have more than one, I feel like I could go back to work quickly. My wife and I figured it out. And, in retrospect, babies are easy. But at the time, man, that little ball of milk and poop seems impossible. We should try to do better if we can reasonably do better. This is a way we can reasonably do better.

And I agree with @Hamhock , people often don’t realize that someone pushing back graduation means the people getting paid back are the residents 1-2 years behind, not your coresidents. I had someone in my program do that. Some people begrudged her, but it’s kind of the cost of doing business. That’s what working at a place that is family friendly requires. And, at the end of the day, if someone takes off a month, that’s what? 16-18 shifts? That ends up being 0.5-1 shift per resident depending on class size and number of off service rotations. Even if someone takes 3 months off, that’s 1.5-3 shifts divided over 3 months. Sure, it’s not “fair” but it’s not as big of a deal as some of my classmates made it out to be.

I don’t know about other programs but mine wasn’t too bad. We would activate disaster call for the births, and the residents that picked up the extra slack were given less shifts the following months as pay back. Lucky for us our PA/NP side would pick up the slack if a resident needed extra time off.

 

[Falconclaw]

You got 18 years to bond with that oversized nugget. It’s still gonna be there when you get home from your ICU rotation. Suck it up. Grab some diapers on the way home and a pacifier. Quality, not quantity. Wifey will be just FINE. She may piss and moan during residency but you’re gonna be the best dad in the world when she starts seeing those attending paychecks. Trust me.

lol someone's not exactly in the running to win dad of the year! bitter much? you sound like one of those old docs that tell young male med students never to get married cuz it's just a way to lose half your money in the divorce

 

[Groove]

LOL, oh relax people. I’m joking. Kinda.

I should have apologized in advance for all my toxic masculinity.

 

[Falconclaw]

LOL, oh relax people. I’m joking. Kinda.

I should have apologized in advance for all my toxic masculinity.

cute!

 

[thegenius]

This is turning into a ridiculous thread.....in every other profession we wouldn't think twice about someone taking time off for their newborn. Male or female.
Oh but medicine is special. The MICU will run just fine. The ER will run just fine. Every other rotation that you could possibly be on during intern year will run just fine. The ER would run just fine if no off-service rotators ever showed up in the ED.

In the PTI game of "No deal, little deal, or big deal"....this whole thing of having a baby during residency ends up being a "no deal to little deal."

Frankly....I think the biggest thing is the person taking time off has to make it up. If you take a month off....you have to make up that month somehow. Probably best to take off during an ED month because the RRC doesn't say you have to put in "x hours in the ED prior to graduation" from what I recall.

 

[Falconclaw]

This is turning into a ridiculous thread.....in every other profession we wouldn't think twice about someone taking time off for their newborn. Male or female.
Oh but medicine is special. The MICU will run just fine. The ER will run just fine. Every other rotation that you could possibly be on during intern year will run just fine. The ER would run just fine if no off-service rotators ever showed up in the ED.

In the PTI game of "No deal, little deal, or big deal"....this whole thing of having a baby during residency ends up being a "no deal to little deal."

Frankly....I think the biggest thing is the person taking time off has to make it up. If you take a month off....you have to make up that month somehow. Probably best to take off during an ED month because the RRC doesn't say you have to put in "x hours in the ED prior to graduation" from what I recall.

totally agree. part of it i think is some people are just bitter about how grueling their own residency experience was, and some of them have the attitude of, "i want to make this better for future doctors so they don't have to suffer like I did" whereas other people think "I had to go through this, why should those little ****s be any different?" Or maybe they just genuinely worry about the possible harm to patient care, although I'm skeptical that this is the main motivation.
In medicine I feel like there's this attitude that you should put your professional life first before all else, and that a personal life is really something you just do with whatever time you have left over and it's fine to have one, but only to the extent that it doesn't get in the way of your career. Now, I get that when actual patient outcomes are on the line, but I think it extends way beyond that. It's understandable I suppose when you think about the history of the profession, back when only unmarried men could even enter residency (an older doc told me how his dad had to get married in secret while he was in residency).
But the truth is, I think for many people their personal life is just as if not more fulfilling and meaningful then their medical career. But a lot of people act otherwise. I saw a bunch of couples break up in my graduating med school class because neither partner was willing to make any sacrifice at all in terms of where they went to residency. Now, maybe those relationships were doomed to fail anyway, since a lot of other couples did couples match, but it still is an attitude I see.
And I don't want to sound myopic - I know this isn't unique to medicine, and is common across many high-pressure prestigious professions. Just as on many rotations I was seen by some docs as not really a full person but just a useless third year med student, I'm sure in let's say corporate law many junior associates are seen (or at least treated) not so much as people but as work monkeys.
I don't wanna sound like I'm complaining too much because for the most part med school wasn't as grueling as people made it sound and I'm sure it used to be way worse, but in many ways the kind of superhuman expectations we have for doctors sometimes doesn't even seem proportionate to the reality of how much of a real, long term difference we're actually able to make in many patients lives.
Obvious disclaimer that this is all coming from someone who hasn't even started residency yet.
Anyway I do have to say that aside from one or two people on this thread the vast majority were super supportive and even encouraging of me taking some time off to spend with my kid (tbh I was thinking more like one or two days at first whereas some people recommended more like two weeks) and it was really nice how a lot of people even encouraged me to get excited about fatherhood and congratulated me.
Also one last point, I get that it was kind of a joke but I do think it's silly to conflate the safe space crowd with people who just want to make medical training a little more humane. As my avator would imply, I'm not exactly friendly to all the SJW PC nonsense.

 

[VA Hopeful Dr]

Dude. You know I have no problem with you and usually find myself agreeing with you, but this is a fairly toxic viewpoint. Just because you can push through doesn’t mean you should. It certainly is a better thing for a husband and his family to have some time off. If it’s at all possible to accommodate, the program should. I had to push through when we had our first child in training. My program did very little to help me have time off and I have a negative view of the program - not entirely because of it, but it certainly was consistent with the overall culture. Now that we have more than one, I feel like I could go back to work quickly. My wife and I figured it out. And, in retrospect, babies are easy. But at the time, man, that little ball of milk and poop seems impossible. We should try to do better if we can reasonably do better. This is a way we can reasonably do better.

And I agree with @Hamhock , people often don’t realize that someone pushing back graduation means the people getting paid back are the residents 1-2 years behind, not your coresidents. I had someone in my program do that. Some people begrudged her, but it’s kind of the cost of doing business. That’s what working at a place that is family friendly requires. And, at the end of the day, if someone takes off a month, that’s what? 16-18 shifts? That ends up being 0.5-1 shift per resident depending on class size and number of off service rotations. Even if someone takes 3 months off, that’s 1.5-3 shifts divided over 3 months. Sure, it’s not “fair” but it’s not as big of a deal as some of my classmates made it out to be.

That doesn't make any sense.

When I was a resident someone's baby came early so they had to take off the last 2 weeks of an inpatient month. I volunteered as I was on an elective month at the time. Three month later they took the last 2 weeks of my inpatient month in place of 2 weeks of an elective month they we're on.

It's not that hard.

 

[Hamhock]

.....in every other profession we wouldn't think twice about someone taking time off for their newborn. Male or female.

I am pretty sure that's not true. Desirable? Perhaps.
But sole proprietorships and small partnerships/companies across professions are not thoughtlessly or liberally letting fathers or mothers "take time off for their newborn". Achitecture, big law, engineering. These professions are "thinking twice".

I am pretty sure the OP -- or most posters on this thread -- would change their tune if someone else wasn't paying for their time off with the newborn. And that's what paternity/maternity leave is -- a request for others to pay (either by doing the work or contributing to a fund [sometimes through taxes]) for a parent's time off.

I just hope the OP has gratitude (or maybe even expresses it!) to the residents who will be covering for him. I am sure it's tough to get up for a crying baby you love dearly at 3am -- but it sounds a lot better than the 36 hours of sleepless call someone else has to do so that you can 'wake up' in your own bed to care for your baby.

I feel like there's this attitude that you should put your professional life first before all else, and that a personal life is really something you just do with whatever time you have left over and it's fine to have one, but only to the extent that it doesn't get in the way of your career.

And there's the rub. Somehow, the 'personal life' (ie choices, interests, and activities) of some residents should be treated with respect, while the 'personal life' of other residents should be sacrificed to maximize the 'personal life' of others.

That is, the choice -- and, yes, in this time and country, it certainly is a choice -- to have a baby is great. If that's how you want to spend your 'personal life' time, great. It is often commendable and sometimes should be honored (to an extent).

However, this choice is no more honorable or commendable than many of the choices that childless residents make in their 'personal life'.

The difference is that a parent's choice in his/her 'personal life' requires uncompensated sacrifice from co-workers -- not just in increased work to cover for them, but by taking away from the 'personal life' time of the co-workers. To add salt to this wound, the attitude in this thread and from many parents is one of blind privilege: they don't see the imbalance and they often become outraged when even greater sacrifices by co-workers are not unquestionably provided.

HH

 

[NITRAS]

An intern should be able to pay his friends back over the next 2 years....

I was a third year chief of a relatively small program. There were babies born in each group. It worked out pretty fair.

Having babies is normal. Pretty much every program will be able to handle it, preferably without extending the residents training.

PS the whole thing about the academic attending not stooping to actual patient care is hilarious.

 

[thegenius]

The difference is that a parent's choice in his/her 'personal life' requires uncompensated sacrifice from co-workers -- not just in increased work to cover for them, but by taking away from the 'personal life' time of the co-workers. To add salt to this wound, the attitude in this thread and from many parents is one of blind privilege: they don't see the imbalance and they often become outraged when even greater sacrifices by co-workers are not unquestionably provided

So should a couple in residency ask permission to start a family?

 

[thegenius]

Some are suggesting that even taking 3-5 days off for whatever reason is just too much to ask of the program.

Heaven forbid you get diagnosed with a medical condition that requires you to take off a few days. Like appendicitis.

The sacrifice that other people make if you end up with acute appendicitis.

 

[deleted547339]

That doesn't make any sense.

When I was a resident someone's baby came early so they had to take off the last 2 weeks of an inpatient month. I volunteered as I was on an elective month at the time. Three month later they took the last 2 weeks of my inpatient month in place of 2 weeks of an elective month they we're on.

It's not that hard.

Your missing the fact that most of an EM residents time is in the ED. There are very few electives in 3 year programs. It makes a lot of sense to simply divide up the burden between the remaining residents on service that month.

 

[VA Hopeful Dr]

Your missing the fact that most of an EM residents time is in the ED. There are very few electives in 3 year programs. It makes a lot of sense to simply divide up the burden between the remaining residents on service that month.

That's my fault, I was only going after part of your post. When you broke it down in your 2nd paragraph it worked pretty well. It was the MICU part I was addressing.

 

[Hamhock]

So should a couple in residency ask permission to start a family?

No, but a couple might ASK for some adjustments and acknowledge the sacrifice that others must make for this choice to start a family during residency.

There's a big difference between asking for accommodation (and working with residency leadership to minimize the impact on others) and demanding schedule changes and coming off as if it is your right to start a family AND force others to accommodate.

Indeed, the resident might offer to make some extra sacrifices to help the other residents or the program during his/her four years. Such collaboration might go a long way...

[ignore my answer if your question was just rhetorical -- I can't determine this over the internet, given there is no vocal inflection or facial expression to go along with your question]

HH

 

[Falconclaw]

I am pretty sure that's not true. Desirable? Perhaps.
But sole proprietorships and small partnerships/companies across professions are not thoughtlessly or liberally letting fathers or mothers "take time off for their newborn". Achitecture, big law, engineering. These professions are "thinking twice".

I am pretty sure the OP -- or most posters on this thread -- would change their tune if someone else wasn't paying for their time off with the newborn. And that's what paternity/maternity leave is -- a request for others to pay (either by doing the work or contributing to a fund [sometimes through taxes]) for a parent's time off.

I just hope the OP has gratitude (or maybe even expresses it!) to the residents who will be covering for him. I am sure it's tough to get up for a crying baby you love dearly at 3am -- but it sounds a lot better than the 36 hours of sleepless call someone else has to do so that you can 'wake up' in your own bed to care for your baby.



And there's the rub. Somehow, the 'personal life' (ie choices, interests, and activities) of some residents should be treated with respect, while the 'personal life' of other residents should be sacrificed to maximize the 'personal life' of others.

That is, the choice -- and, yes, in this time and country, it certainly is a choice -- to have a baby is great. If that's how you want to spend your 'personal life' time, great. It is often commendable and sometimes should be honored (to an extent).

However, this choice is no more honorable or commendable than many of the choices that childless residents make in their 'personal life'.

The difference is that a parent's choice in his/her 'personal life' requires uncompensated sacrifice from co-workers -- not just in increased work to cover for them, but by taking away from the 'personal life' time of the co-workers. To add salt to this wound, the attitude in this thread and from many parents is one of blind privilege: they don't see the imbalance and they often become outraged when even greater sacrifices by co-workers are not unquestionably provided.

HH

Of course I will be grateful to anyone who covers for me while my child is being born and immediately thereafter. I would think that the vast majority of parents in that position are grateful.

My wife works for IBM and automatically gets 3 paid months off, no questions asked. Most professions are indeed pretty generous with parental leave.

Although it's obviously subjective, I actually don't agree that having a child is "no more honorable or commendable than many of the choices that childless residents make in their 'personal life'."

Of course having kids is a very personal choice, and I don't think that choosing to do so bestows some sort of moral superiority. However, is bringing another human into this world and raising it and supporting it to adulthood just as valuable to society or commendable as going skiing or reading a good novel? I don't think so.

Now, that doesn't mean I think that other people should be forced to pay for my kids, or really that I'm entitled to much of anything. I mean, I will obviously insist (if it comes to that) on at the very least being present for my child's birth. But no, I don't have that sense of entitlement more broadly.

And someone made a good point, if you get acute appendicitis, should you wallow around feeling guilty for the fact that other people have to pick up your shifts? Obviously not. Absolutely, you should be grateful to people who cover you, but it also should be expected that you don't have to come in to work an hour after getting out of the OR (obviously this is an extreme example since you wouldn't be capable of working while recovering from anesthesia, but I'm just making a point.)

But I guess from a hospital policy stand point, I think the important question is, do we want to create an environment where doctors can be comfortable having children? And I think the answer to that question is yes.

I am 100% in favor of strong collegiality - yes, it would be very appropriate to pay back a resident who covered you by doing the same for them during a time of need.

 

[John Red]

In this exact situation only baby will be here < 6 months from start date. GME and residency coordinators are aware and definitely gave some recommendations regarding scheduling etc. Never thought about reaching out to chiefs but will be doing that ASAP. Made sure to schedule an ED month during expected due date, but babies tend to have a mind of their own.

How plausible would it be front-load or back-load shifts for a given month with work-hours restrictions?

 

[Hamhock]

Although it's obviously subjective, I actually don't agree that having a child is "no more honorable or commendable than many of the choices that childless residents make in their 'personal life'."
However, is bringing another human into this world and raising it and supporting it to adulthood just as valuable to society or commendable as going skiing or reading a good novel? I don't think so.

This attitude is just gross. Do you think that the personal lives of childless adults is just filled with self-gratifications like skiing or reading novels? Why would you compare these?

In fact, many childless adults are making fantastic, selfless contributions every day of their personal lives.

I can easily make an argument that people who choose to have children are doing it for selfish reasons that satisfy an often innate and biological desire; not to contribute to the improvement of society. Sometimes it is great when parents have new babies...but it clearly something they do for themselves and their families, not for the betterment of society. And that's OK. We should all choose to pursue our personal lives as we see best fit. ...but don't tell me you are doing something more honorable or commendable that the activities of childless adults.

Is your new baby adopted? Why not? There are plenty of newborns is great need of being raised to adulthood by someone who wants to do something commendable and honorable in their personal lives.

The personal lives of childless adults are often devoted to community (health, education, end-of-life care) and the general betterment of people around them, genetically related or not. So, you may not agree with me, but I stand on solid ground when I say that having a child is "no more honorable or commendable than many of the choices that childless residents make in their 'personal life'" and should not automatically be treated so.

And someone made a good point, if you get acute appendicitis, should you wallow around feeling guilty for the fact that other people have to pick up your shifts? Obviously not. Absolutely, you should be grateful to people who cover you, but it also should be expected that you don't have to come in to work an hour after getting out of the OR (obviously this is an extreme example since you wouldn't be capable of working while recovering from anesthesia, but I'm just making a point.)

Yes, appendicitis is an OK example. It is not an elective absence, like a pregnancy -- but it will do for this discussion.

Every time a resident is out for appendicitis (or something similar), I have seen the resident return and nearly automatically make up the call shifts to the covering residents.

I have NEVER seen this with parents. Not once.

Perhaps you are part of a new bread and you will make up the shifts that were covered for you. If so, great. Please pass this on to others...but be careful when you suggest that to returning mothers who have missed more than a month often. I doubt many mothers will feel they should make up the shifts like you are suggesting you will...just like appendicitis....not exactly.

HH

 

[PTPoeny]

This attitude is just gross. Do you think that the personal lives of childless adults is just filled with self-gratifications like skiing or reading novels? Why would you compare these?

In fact, many childless adults are making fantastic, selfless contributions every day of their personal lives.

I can easily make an argument that people who choose to have children are doing it for selfish reasons that satisfy an often innate and biological desire; not to contribute to the improvement of society. Sometimes it is great when parents have new babies...but it clearly something they do for themselves and their families, not for the betterment of society. And that's OK. We should all choose to pursue our personal lives as we see best fit. ...but don't tell me you are doing something more honorable or commendable that the activities of childless adults.

Is your new baby adopted? Why not? There are plenty of newborns is great need of being raised to adulthood by someone who wants to do something commendable and honorable in their personal lives.

The personal lives of childless adults are often devoted to community (health, education, end-of-life care) and the general betterment of people around them, genetically related or not. So, you may not agree with me, but I stand on solid ground when I say that having a child is "no more honorable or commendable than many of the choices that childless residents make in their 'personal life'" and should not automatically be treated so.



Yes, appendicitis is an OK example. It is not an elective absence, like a pregnancy -- but it will do for this discussion.

Every time a resident is out for appendicitis (or something similar), I have seen the resident return and nearly automatically make up the call shifts to the covering residents.

I have NEVER seen this with parents. Not once.

Perhaps you are part of a new bread and you will make up the shifts that were covered for you. If so, great. Please pass this on to others...but be careful when you suggest that to returning mothers who have missed more than a month often. I doubt many mothers will feel they should make up the shifts like you are suggesting you will...just like appendicitis....not exactly.

HH

I don't know what your program does for maternity leave. But many programs make women taking maternity leave take more calls overall than anybody else. My program didn't and I just had to get in my calls over my time here so I chose to make up some of my calls before I went out and the rest during my extra time. But frequently women have to make up all their calls from maternity leave (either before or after) and then also take regular call during their extension and therefore end up taking more calls than normal for a residency.

Programs also interpret the various board rules very differently with regards to extending training.

 

[Falconclaw]

This attitude is just gross. Do you think that the personal lives of childless adults is just filled with self-gratifications like skiing or reading novels? Why would you compare these?

In fact, many childless adults are making fantastic, selfless contributions every day of their personal lives.

I can easily make an argument that people who choose to have children are doing it for selfish reasons that satisfy an often innate and biological desire; not to contribute to the improvement of society. Sometimes it is great when parents have new babies...but it clearly something they do for themselves and their families, not for the betterment of society. And that's OK. We should all choose to pursue our personal lives as we see best fit. ...but don't tell me you are doing something more honorable or commendable that the activities of childless adults.

Is your new baby adopted? Why not? There are plenty of newborns is great need of being raised to adulthood by someone who wants to do something commendable and honorable in their personal lives.

The personal lives of childless adults are often devoted to community (health, education, end-of-life care) and the general betterment of people around them, genetically related or not. So, you may not agree with me, but I stand on solid ground when I say that having a child is "no more honorable or commendable than many of the choices that childless residents make in their 'personal life'" and should not automatically be treated so.



Yes, appendicitis is an OK example. It is not an elective absence, like a pregnancy -- but it will do for this discussion.

Every time a resident is out for appendicitis (or something similar), I have seen the resident return and nearly automatically make up the call shifts to the covering residents.

I have NEVER seen this with parents. Not once.

Perhaps you are part of a new bread and you will make up the shifts that were covered for you. If so, great. Please pass this on to others...but be careful when you suggest that to returning mothers who have missed more than a month often. I doubt many mothers will feel they should make up the shifts like you are suggesting you will...just like appendicitis....not exactly.

HH

Im just talking about my personal opinion about the virtues of being a parent vs other common ways to spend your free time. If you know these angels who spend most of their free time engaging in end of life care and community health, great. You can make an argument that that's as beneficial to society as having children, sure. Based on my own experience, the vast majority of people iv met only do those things to get into med school and only a small minority of them actually have a serious commitment to those things. But that's not even relevant.

Sure, parents aren't mainly motivated by a desire to benefit society. I'm not some kind of socialist. If anything, I have more faith in Adam Smith's invisible hand, that parents raising kids for selfish reasons who do a good job end up doing society more good than someone volunteering in a soup kitchen. But again this doesn't have anything to do with medicine. I'm sorry that you've dealt with ungrateful and entitled parents. That sucks. People should have to make up time off, sure. But there should also be a hospital policy allowing for parental leave.

Iv been a childless adult for my entire adult life. Obviously I think childless adults need a personal life too. There's nothing wrong even with spending that time in purely recreational pursuits. Thats mostly what I'm doing now in this period btwn med school and residency.
I feel weird that this is even a discussion. I feel like your beef is really with some inconsiderate parents you've encountered in your life, not me.
But if you want me to explicitly say it, sure, I think it's fine to be a childless adult! Kids aren't for everyone.

 

[Birdstrike]

A lot of this is the difference between having you first child, versus subsequent kids. With my first one, everyone's anxiety was high. There's a level of uncertainty where you don't know exactly what's coming or what it's going to be like (and you think you know, but you don't). But you do know it's going to be a huge moment in everyone's life. Because of that, the temptation is to clear the deck, take a bunch of time off, to help out and enjoy the moment.

With my second kid, I was doing what @Falconclaw is doing, and trying to prepare ahead of time, but we were infinitely more prepared. I remember a colleague of mine, who by then already had four kids, saying, "Why are you going to take time off for a baby? Are you going to breastfeed the baby yourself? Are you going to stare at it for the 22 hours per day it sleeps, are you going to stay up all night burping it, then work all day the next day with no sleep, for weeks on end? After being off a week, then what? What changes? Doesn't the baby still need all that? Don't take time off. Save the week off for later, when you can use it."

It seemed like an outrageous attitude at the time and I don't agree with it.

Then baby #2 comes. I had a full week off. I was in turbo-dad mode. I offered to do night feedings with pumped milk that week, and nighttime diaper changes so my wife could get caught up on rest after labor, and all that. My wife's response was, "Don't bother. I have to be up every 3 hours to either feed this baby or pump, anyways. I might as well slap a new diaper on, too, while you sleep. There's no point in both of us being up all night, and zombies during the day. You sleep at night. Your job is to do as much as possible during the day time, in case I need to nap from the total exhaustion of being up all night."

Then, during that whole week I did as much as I could, but my wife had the whole "new baby thing" on such lockdown, there wasn't as much for me to do as either of us had expected. Mainly, I hung out with our then 2-year-old, keeping her out of trouble and did some chores, food, etc, and watched the baby if and when my wife napped. Then at the end of the week, it was off to work, she stayed home with the kid, and before you know it, it's all flown by and your kid's addicted to youtube.

At the end of the day, what you want to do, is whatever makes your wife most comfortable and whatever will allow you to look back later, and say you did the right thing. And what that is, might change with subsequent kids, if you have them.

 

[Birdstrike]

As far as the "have kids or don't" debate, I don't think there's any right answer. It's what works for each person or couple. I am personally glad my wife and I had kids. I wouldn't change it. But it is a irreversibly tremendous amount of work that changes every moment of your life forever, though. It's easily as much work as having a second full time job, especially if someone's heart is not in it. It's been worth it in my case, but may not be for everyone.

 

[Falconclaw]

A lot of this is the difference between having you first child, versus subsequent kids. With my first one, everyone's anxiety was high. There's a level of uncertainty where you don't know exactly what's coming or what it's going to be like (and you think you know, but you don't). But you do know it's going to be a huge moment in everyone's life. Because of that, the temptation is to clear the deck, take a bunch of time off, to help out and enjoy the moment.

With my second kid, I was doing what @Falconclaw is doing, and trying to prepare ahead of time, but we were infinitely more prepared. I remember a colleague of mine, who by then already had four kids, saying, "Why are you going to take time off for a baby? Are you going to breastfeed the baby yourself? Are you going to stare at it for the 22 hours per day it sleeps, are you going to stay up all night burping it, then work all day the next day with no sleep, for weeks on end? After being off a week, then what? What changes? Doesn't the baby still need all that? Don't take time off. Save the week off for later, when you can use it."

It seemed like an outrageous attitude at the time and I don't agree with it.

Then baby #2 comes. I had a full week off. I was in turbo-dad mode. I offered to do night feedings with pumped milk that week, and nighttime diaper changes so my wife could get caught up on rest after labor, and all that. My wife's response was, "Don't bother. I have to be up every 3 hours to either feed this baby or pump, anyways. I might as well slap a new diaper on, too, while you sleep. There's no point in both of us being up all night, and zombies during the day. You sleep at night. Your job is to do as much as possible during the day time, in case I need to nap from the total exhaustion of being up all night."

Then, during that whole week I did as much as I could, but my wife had the whole "new baby thing" on such lockdown, there wasn't as much for me to do as either of us had expected. Mainly, I hung out with our then 2-year-old, keeping her out of trouble and did some chores, food, etc, and watched the baby if and when my wife napped. Then at the end of the week, it was off to work, she stayed home with the kid, and before you know it, it's all flown by and your kid's addicted to youtube.

At the end of the day, what you want to do, is whatever makes your wife most comfortable and whatever will allow you to look back later, and say you did the right thing. And what that is, might change with subsequent kids, if you have them.

Hmm. This would be my first child. Maybe a week off would be enough? I was thinking of doing it more to be able to bond with my child than thinking that I would actually be able to be super helpful, esp since my wife's family lives in the area.

 

[Birdstrike]

Hmm. This would be my first child. Maybe a week off would be enough? I was thinking of doing it more to be able to bond with my child than thinking that I would actually be able to be super helpful, esp since my wife's family lives in the area.

You may find that you bond with with your baby very quickly. But take off as much time as you can get, and afford.

That being said, what’s more important than whether you take 3 days, a week or 3 months off after birth, is how much family time you have over the long haul. If you get huge time off for immediate post birth period, that’s great. But if you are constantly working 2 months in, when the baby makes eye contact first the first time ever, learns to walk around a year, needs someone to tell them stories at night during elementary school or needs someone to teach them to ride a bike when they’re five, then the immediate neonatal period will pale in comparison.

 

[thegenius]

Having had two kids....you will be more important when grandma and grandpa are no longer there helping out. I was more helpful 60-90 days out than at the very beginning. I think a week of at the beginning should suffice, but see if you do a few weeks off 2-4 months after he/she is born.

 

[TooMuchResearch]

It's nice to see that everyone is "family oriented"...and has suggestions to make it easier for the parents and the program.

However, I would like folks to remember all the residents who pick up the slack. Mothers who extend residency by three months doesn't make up anything to the residents who had to take extra call for three months. This is especially difficult in small programs.

And please don't tell me you are "more than happy" to be q3 for a month so that someone else can be with his kid longer -- especially when that happens multiple times in one year.

And please don't tell me the programs "should just"...should just hire some more midlevels; should just have attendings pick up extra shifts; etc.

This just isn't realistic...it's not the way things work.

In the real world, the childless residents just keep working harder and harder. They are not compensated more. They are not given extra vacation later. They just work more.

People with children often struggle to take the perspective of those who cover for them...over and over. Yes, it's nice you have kids and that programs allow for that choice. It's not nice that this forces childless professionals to cover without compensation. I've never heard of a new parent returning and offering to cover calls of the resident who worked extra hard all month so that the parent could have it off.

HH

Our program did a good job of covering maternity leave with things like "elective" time and leaves of absence. Some of got to do third year months as second years to cover leave, which was pretty awesome.

 

[TooMuchResearch]

Is it even realistic for a male resident to just “take off” for 2 weeks for some sort of paternity leave? I don‘t ever remember anyone doing that. At most, people took a day or two if they could move things around. I mean, how would you even finish your rotation? Are programs including some sort of paternity leave clause these days? Now that I think about it, I can distinctly remember one of my co-residents who left early for his wife’s labor and was back bright and early for work the following day. When did all of this 2-4 week “paternity leave” for the dudes start up? I’m almost positive that wasn’t even an option during my residency.

Dudes in my group (not residency) routinely take 4-8 weeks off when their wives birth their kids. Some then also cut their shifts significantly for a few months after that.

They managed to swing 2 weeks for me in residency, the end of an off service rotation that didn't need me and the first week of an ED block (don't worry, I'm sure I paid that back later in the block).

 

[TooMuchResearch]

Some are suggesting that even taking 3-5 days off for whatever reason is just too much to ask of the program.

Heaven forbid you get diagnosed with a medical condition that requires you to take off a few days. Like appendicitis.

The sacrifice that other people make if you end up with acute appendicitis.

That's true, I forgot we had a couple of residents with surgical problems or critically ill loved ones who were suddenly gone, we managed just fine on no notice.

 

[thegenius]

That's true, I forgot we had a couple of residents with surgical problems or critically ill loved ones who were suddenly gone, we managed just fine on no notice.

Yup man, life goes on.

Ok I'm done with this thread

 

[enalli]

I think all the increased work hour restrictions are terrible. I mean, residents can't even stay in the hospital long enough to follow a patients course from day through the night for a simple normal call schedule. If they can't even experience what's it's like to work all day and work with little if any sleep that night, then how are they going to prepare for the real world?

What were typical residency shift lengths in the ED back in the day? Nowadays, ED shifts are capped at 12 hours, which always seemed reasonable for the pace of a typical residency-associated ED.