Tuesday, July 15, 2008


I've written before about the decision of female physicians to have a child early in their career versus a child late in their career, but there's a third option I've noticed more and more female physicians seem to be choosing: no kids.

In some ways, this makes sense. We've spend four years on undergraduate training, four years in medical school, 3-5 years in residency, then maybe a fellowship on top of that. After all that, shouldn't we want to focus on our careers? Did we really spend a quarter million dollars on our education just to work reduced hours to spend more time with the kids? We could have been a mother for free.

In my residency program, many of the female attendings have chosen to be child-free. When asked why, they gave the following reasons:

"I wanted to be able to retire early."

"I thought I could either be a good doctor or a good mother, but not both. So I chose to be a good doctor."

"Kids are too much responsibility. I'd rather be a godparent or an aunt."

"I don't like kids that much."

"I didn't want to ruin my life."

A lot of people seem to be enamored with the concept of DINK. DINK is an acronym that stands for Double Income No Kids. As another resident recently remarked to me, a pair of DINK physicians really have it made. They can have a huge expensive house, they could spend their afternoons playing golf, their weekends at the spa, and their nights bathing in gold amulets (I guess I don't really know what rich people do in their leisure time). They could retire at 50.

Of course, I've always wanted kids so I see things differently. I don't see the point of a big house if I'm not going to fill it up with kids. The reason I want money is so I have it to spend on my kids. And what will I do after retirement if I don't have grandchildren to play with?


  1. I´m a spanish gynecology that had a sucessful career en Barcelona..i was of the ones that think in not have children. At 39 a feld in love, get married, and made alia (inmigrate) to Israel. Now i have one baby of 3 and other of 2. I´m the most happy woman, so much that i still dont belive that i can live without working 12 hours/day and without a telephone ring at 3 o´clok in the morning. Of course that i thik come back to work but now i have my children, my class of hebrew and my english!!!

  2. Like you, Fizzy, I never really contemplated life without kids. There's nothing like having kids to make you fully aware of the beauty, wonders, and limitations that the working mom lifestyle entails. Many of my friends are single or married without kids. I think that my kids are a blessing, but part of me wants that adult life back, with dinners and travel and, yes, spa trips. Right now, I can hardly get a haircut! But I will appreciate the next 14-15 years as much as I can before my nest is empty and I get to do all those things again.

  3. These days, haircuts for me involve going at my head with a pair of yellow scissors in the bathroom. And I barely have time for THAT :)

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  5. We waited a long time to have kids, our first being born soon after our 6th anniversary. Always wanted them, still think they're the best thing in my whole life, which would have felt hollow without them, for all of the reasons pathmom said. But all the same, the ones who don't want them shouldn't have them. And isn't it good that they have that choice?

  6. as a med student that hasn't had a romantic relationship that lasted longer than 6 months, I'm just working on not being SINK (Single income no kids)

  7. I realize that I see a skewed population but there is no shortage of older physicians in their late 30's who now very much want children, even though they were convinced, in their youth, that they never wanted children. The admonition here is to realize that our wants and desires change over our lifespan, sometimes drastically. Just because, as a 28-year-old you are sure you never want kids, don't be so sure that your mindset at age 38 won't be completely different. =)

  8. Add me to the list of people who have never wanted kids - and at 38 I've never wavered. I understand (sort of) that other people get a lot of joy from being parents, but I certainly never had any interest. I got Essure implants four years ago and consider it one of the best decisions I've ever made. Guess I just wasn't born with a biological clock!

    But I think it's a common misconception that people who don't want kids are super into their careers. I have a good job that I enjoy, but the reason I don't have kids is due to a simple lack of desire, not because I want to be a big career hound. And although the idea of early retirement sounds great, I couldn't possibly care less about living in a big house. I'm perfectly content with my 2-bedroom condo and 10-year-old car.

  9. "The admonition here is to realize that our wants and desires change over our lifespan, sometimes drastically. Just because, as a 28-year-old you are sure you never want kids, don't be so sure that your mindset at age 38 won't be completely different. =)"

    What amazes me is that I hear this sort of thing ALL THE TIME aimed at those who do not want children, but practically NEVER do I hear it aimed at those of the same age who are equally sure that they DO want them.
    Yes, as said 28-year-old you can't be sure that your mindset at age 38 won't be completely different, but that goes for the 28 year old wh is sure s/he WANTS children as much as it goes for the 28 who is sur etaht s/he does not.

  10. Electric Bonzai you're wrong. Let me enlighten you. When I dropped out of medical school to follow the Mommy track, people came crawling out of the woodwork to tell me that I would change my mind in ten years. They called me out of the blue.

    Lots of people told me that I should get my MD first and then have kids. But I couldn't do it any more. I didn't want to miss out on a family. I was sure.

    And medicine stopped having that charm. You know the magic, that used to drag me out of bed in the middle of the night to study or go to the hospital. It left.

    I don't regret my decision and I hope and pray that I won't regret it in eight years either.

  11. Wrong about what?

    I see FAR more examples of people who try to convince youngish (say mid-late 20s) people, who are sure that they do NOT want to have children, that they will CHANGE THEIR MIND, than I have ever seen the reverse.

    I think, from my own experience and my observation of social influences and the experiences of others, that this reflects a societal misbelief that the desires of those who don't want childrne are less well founded and less valid (and therefore temporary) than the desires of people who want them.

    There is another facet of 'career focus pressure' which is what you probably were experienceing.

    However, I suspect that those same people who badgered you, would have played a very different tune if you had been a childfree woman who had asserted that you did not wnat children, period.

    They may have pushed the old saw of 'career first', but I doubt that they would have been friendly to 'childrne never.'

    I still think that there is, in our society, much more willingness to take the word of a woman who says that she is sure that she will want children and to accept that she knows her own mind , than there is to do the same for a woamn of similar age who says the opposite.

    I think that your story, in my opinion, tends more to show both the thread of 'career pushing' and hte fact that there are opinionated pushy asses on EVERY side of the equation.
    There is ALWAYS someone ready to push their nose into your uterus and tell you that you are going to change your mind and wnat them after all, you should wait to have them, you need to get your act together and have them soon, you should have more than one, you should have more, you should have had less and anything else that people can judge about your own personal reproductive life.

    I get the same sort of sh-t because I don't want to have sex. And I know the sor tof stuff others get for wanting to have sex.

    I think that the self knowledge of the woman who knows that having children is of the highest importance to her and that she wants to have it is just as reliable and valid as the self knowledge of the woman who knows that she has no desire for children and doesn't want them and vice verse.
    I don't htink that either one is any more or less valid or more or less apt to be flipped around and changed.

  12. This is great info to know.

  13. Interesting to know.

  14. Wondeful post..hope you don't mind a grandmother RN lurking about. I was so sure as a 19 yr old virgin, [after watching all my siblings become single mothers,] that I did NOT want kids...that I tried to have a tubal ligation!! Went on to be an infertility patient, Mom of two sons, and now "Nana" to a three year old little boy who is the joy of my heart. Things change as we age, and priorities along with them... Patti, RN


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