Monday, March 22, 2010

How Do Duals Do It?

I am wondering how the women of dual physician couples have shaped their careers to manage their children and families. My husband and I are MD/PhD students nearing the end of the end of the programs and trying to decide what we should do for residency. We have a daughter who is about 1.5 and may have another child before I graduate. I knew exactly what I wanted to do until I had my daughter and now I am feeling very confused about my career. First, I haven't found any examples of dual physician couples with children who both work full time jobs at academic centers and do research etc. Second, even if I could, I am not sure I want to be away from my children so much. Here is what I have observed. 1) The mother doctor works part time. She therefore doesn't do research and usually works in a more private type practice. 2) The mother doctor works full time and her husband has a job that is more flexible and not in medicine. 3) Both people work 3/4 of a job - share a practice. 4) Both people are trying to do everything in a field they like but it isn't working and they have to choose easier/more flexible options in their field or do a bad job (ie fail to get a grant). 5) Both people choose specialties that demand the fewest hours possible. 6) One person does only research. I would like to know how dual physician couples have shaped their lives in order to accommodate their families and careers. Specifically, did your children influence what field you went into, or the center where you practice, or the amount of research vs patient care you do? What is the best strategy as a student deciding on a career after med school and what are the options?

- 7th year MD/PhD student

At times I find myself still wondering as well! But nonetheless I will attempt to answer as an academically inclined MIM married to an academically inclined physician who is also mostly in medicine, primarily doing health-related research for the government. You (yes you, 7th yr MD/PHD student and reader of our MIM blog!) have the answer, many various answers, included right there in the question you so thoroughly posed. Starting with "I knew exactly what I wanted to do until I had my daughter." That’s it precisely, we have certain ambitions and interests which we tackle full force, and then we are moved to incorporate the new people (little people, big people) into our lives as new, sometimes unanticipated (sometimes unintended) passions of ours.

The other set of answers to your questions are all there too…. in your proposed answers #1 though #6 or some combo (choose all of the above), over the course of your careers. All the while having a heightened awareness to recognize that doing a bad job (or a bad parenting job) means something has got to change quickly. You might sometimes work part time, and that might mean part clinical and part research so you have (or make) the flexibility to alter/design your schedule. Or, your partner sometimes does so. You or your husband might take a more flexible job, even within your field of medicine/research. And you might change what you do over time, or your partner might. And so on.

In my situation, I'm in pediatrics, some would say a "less demanding" field, and my husband, also a pediatrician, is primarily a health services research for the government. He does have flexibility, yet he does both research and a small amount of clinical time. I do a quite a mix of clinical, medical education, and research. The mixture keeps it interesting and allows for some tweaking or major alterations throughout the course of one’s career. We had children a few years after my residency and while his residency was coming to a close. So I guess that makes us a little older (though I didn’t have any gray hair until just recently). We found the mix that worked for our family, and we work hard; that is we work hard to get home for a family dinner every night. By dinner I don't mean spectacular meal, but rather time together mostly around the table, chewing and talking and listening to each other (vying for each other's attention, mostly!). And we work hard by day (for the most part) to get home to pick up our kids and be fully present for them, until after they go to sleep, when I tend to do a little more work (husband opts not to).

Back to your primary question: For us, having children didn't influence our choice of field (we were already pediatrician and graduating pediatric resident) but it did influence the ways in which we fulfill our academic goals. At times we do so more slowly, for example, I used to work weekends and evenings (even if not clinical, I mean work on various academic projects) and go to many academic conferences (pre-kids), and nowadays weekends and evenings are family time (when the kids are awake at least), and I now go to fewer (no?) out of town meetings or evening/weekend events. One tip, always plan to present at the national meetings that happen to be held locally in your region! Collaborate, and pace yourself.

I will mention that pediatrics does tend to be family friendly, because while we take care of others' kids all day, our colleagues understand when one's own children's issues have to take precedence. Work among people who support each other. Keep the discussion open with your partner/husband so that you can serve as a support to one another and also as a reality check as to whether the work-family arrangement is working for all of you. And remember, your kids (and we hope your husband/partner) are with you for the duration, in sickness and in health, and all that… but you or your husband/partner can tweak or even overhaul your career choices over time.


  1. Thanks for this post! I really enjoyed your answer. :)

  2. Thanks, the person who posed the question had the "answer" already.

  3. I would also add three things that may not be obvious til you're in the thick of it but have helped us a lot:

    1. Really try if possible to live near some sort of family, grandparents or aunts or cousins or anything. Childless, this may not occur to you as a big deal, but once you have kids, it is EXTREMELY helpful to have blood relatives nearby.

    2. Work hard at accumulating a variety of other "mom-types" around you. Try and befriend some who work (outside home) less than you, more than you, and about the same as you -- same goes for your partner. I find this makes a lot of difference when I am feeling stretched in any direction, there is always another family to look at and either use for inspiration or for "well, I wouldn't want to do THAT".

    3. Try and not plan too far ahead. What you want to do with a one year old in your life is very different than with a three yr old and baby, or a six, two and baby, changes a LOT, sometimes even within months. Stay flexible and reevaluate frequently. Nothing is ever set in stone.

  4. I like the suggestions of the previous commenter. In particular, I strongly second the "live near family!" suggestion!

    Also, in the interest of the second suggestion - does anyone know of a forum for MD/PhD women grappling with these issues? If not, would anyone have any interest in being part of starting one?

  5. To anonymous above, there is an annual conference (every July) called "The Early Career Women Faculty Professional Development Seminar" sponsored by the AAMC and Harvard. However, not sure how much there is a mom focus or just a woman focus. Per the website

    the program goal is "to provide an introduction to the knowledge and skills needed to follow the path to leadership in academic medicine. Topics covered span strategic communication skills to negotiation to leadership topics. Small-group sessions focus on mentoring participants in career building skills in narrative and CV development. The seminar is targeted at physicians and PhD scientists holding medical school appointments and considering leadership positions within their discipline, department or institution."

  6. @T - Interesting! I'd not heard of this. Not something I'd be in a position to take advantage of just yet, but perhaps in the future. Thanks for the link!


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