Thursday, February 17, 2011

MiM Mailbag: Become a surgeon and have a family?

Hello All,
I just found this blog and was excited to see women discussing topics that I am interested in.
I have recently decided that I want to go to med school and become a doctor (as I near the end of my graduate education). My husband is supportive and willing to sacrifice as I start the process of preparing to apply to medical schools. I am currently 28, working full time (in the energy industry) and attending graduate school part time.
After that I will need to take pre reqs and then mcat before I will be able to apply to med school. This means that I will be going to school during my 30's. I want to become a neurosurgeon, but I also want to have a family. I am not sure how to do this. Since I don't know anyone else who is trying to do something like this I have no examples and would like some advice.
I have thought long and hard about what it would mean for me to become a surgeon and have decided that it is worth the effort and sacrifice. But I don't want to forgo family and motherhood. Is there any one of you who have experienced this same dilemma. If so, please give some practicle advice. I would like to be as prepared as I can be.
Thanks so much!


  1. i'm in medical school right now (3rd year! ack!) and i had to make the same decision recently. all my life, i've wanted to be a peds general surgeon, and i made the decision a year before med school that i would give up on my dream of having a family in order to do that incredibly well. ie: i would not get married, would not seriously date anyone, would not have kids.

    cue my amazing boyfriend walking into my life.

    now, he's the single most supportive person i've ever met, he loves the fact that i'm so driven and love my work, and he encouraged me to go whole-hog and do whatever i wanted to do in medicine. BUT i come from a family of engineers, and they always told me about the engineer's triangle - the three sides are fast, good, and cheap, and you can only ever have two of those at one time. in my mind, there was the "my life triangle" - the three sides are surgeon, mother, wife, and i personally can only do two of those well at one time. so i made the INCREDIBLY difficult decision to pursue pediatrics and adolescent medicine, and have the time to be the wife and mother i wanted to be.

    now, i know a lot of female surgeons who are wonderful surgeons, wives, and mothers, but that just wasn't the life i wanted. they always have to weigh each aspect of their lives so much, and i honestly just wanted it to be easier. i believe i was meant to be a doctor, but i also believe that i was meant to be a really hands-on mother and wife. surgery just doesn't allow for that, in my opinion.

    i'm now in my surgery rotation and having a blast, but i can honestly tell you i'm incredibly happy with my decision. i can't wait to have my own practice, see patients from the time they're born and watch them grow up, and really create a continuity in their health care and health education. surgery really ended up not being for me, but i think what it really comes down to is if anything else in medicine will truly make you happy.

  2. I am an aspiring neurologist and a mother. It is hard work and sometimes when the daily grind becomes too much, I arrive on the verge of giving up ( usually it is the career that I think of giving up as the other option is not really an option!). However, I have written in BOLD letters my name with all my degreees, the ones I have acheived and the one I am working towards... and this bigger picture makes all the physical hardships worthwhile!

    A few tips:

    There will be times in your career when you will feel either inadequate as a doctor or inadequate as a mother:
    Try to remember, you are doing 2 jobs in one, so don't expect to compare yourself with your work peers ( who might be single, non-parents and young, as most of my collagues are). Also, when the feelings hit the dump at home, just try to remember that if you complete your career ambitions, you will provide a role model for your kids for not having given up on your goals. They should be proud of you.

    A practical tip is to accept all and every help that is possible and available. I don't have my parents or family around me, which makes it even harder, but I rely heavily on my childminder and my husband. And my colleagues know I can't stay late, or work thursdays.... I have made that clear.

    I hope this helps a little. I do realize that nothing prepares you for the package you have ahead of you, but know that you are not alone!

  3. Go for the med school goal and forget about the neurosurgery for now. Most med students cannot even decide on field of specialty by end of 2nd year. As you go through the various rotations you will automatically embrace some specialties and reject others. So don't torture yourself now with this decision.

  4. I'm in the same boat, A! But I'll be 30 in August and still have to take prerequisites. I've applied to a grad program for biological sciences for the fall and am waiting to hear if I've been accepted. From there I'll continue in research and/or pursue medical school.

    MiM, I'm also very interested in your advice and suggestions. I, too, am worried about forgoing motherhood.

  5. I'm a second year medical student with a 3 yr old little boy. I decided to attend medical school at the tail end of my PhD and started when I was 29. I'm currently planning on specializing in Ob/Gyn, which means I'll won't finish training until I'm 36 or 37 (depending on whether or not they extend the residency to 5 years) and I will essentially be on-call for the rest of my life.

    That being said, I wanted to express something that I don't hear said very often. I have found medical school to be EASIER because I have a famiy. No one ever believes me when I say that, but it's true. When I am at school, I give 100%. When I am at home, I give 100%. Therefore, my study schedule is extremely efficient and effective and the time I spend with my son is quality time.

    At the end of each block, I ask my self two questions. First, is my son happy, healthy, and learning? Second, how can I make my work more efficient. Two years in, we are doing great.

    Don't sweat the small stuff. Don't be afraid to lean on your husband (sometimes you will have to lean on him pretty hard). Don't plan on being at the top of your class. But DO plan on having an rewarding career, doing something you love, and sharing your time with people you love.

    Follow your heart. The details will work themselves out.

  6. I second the advice on focusing on getting into med school right now and then giving yourself some more time and experience to think about a specialty.

    I don't know how much experience you've had in medicine with shadowing and such, but A LOT of medical students that come in with ideas about what they want to do change their minds along the way once they get more exposure to different fields and are able to refine their goals and interests.

    I've also noticed that many of my friends' priorities changed when they had children, and you want to leave some open space in your mind for a potential shift in priorities when you become a mom.

    I would also suggest, if you are ready, having children during your pre-req years or first year or two of med school. You will have greater flexibility then than later on.

    Good luck!

  7. I don't think you have to give any of it up. You can be a mom and a surgeon, sure. You just have to decide whether you want that kind of life. I agree though, focus on getting into med school first, and on what specialty once you're there. Most people change their minds.

    Also, why not have a baby now? I hear it's easier to do it now than during residency....

  8. The most exciting thing about what you are planning (and the most important thing to keep in mind) is that you are charting your OWN course. Think hard about what the most important things are going to be for you - there will be lots of compromises with family and with work. Neurosurgery is an increadibly tough field in terms of training length and hours in practice - so you'll need lots of childcare help which might not have otherwise been your ideal. On the other hand, you may decide to skip lectures or med school "extras" to be with family, thus tarnishing your would-be spotless impression. You can make it work for you as long as you always make decisions for YOU and not for others' expectations.

    I started out in general surgery, but left after two years of residency because I just didn't have the passion for it (went into it to impress people, including myself, with my hardcoreness - bad reason to choose a career). When I was thinking about leaving surgery, I decided to get pregnant and see if that added a new perspective. Big shock, it did - and also helped me to focus firmly on my own likes, plans, ambitions and priorities. I am a far better doctor (and human) because of that. Now in Academic Family Medicine, I am thrilled with my balance. I work very hard, but love hearing my daughter talk about my three jobs (doctor, teacher, mom).

    Also, I agree with those who suggest having kids sooner rather than later - you have more control over your life (and you make things harder only for yourself, instead of colleagues) in med school rather than residency or practice. Not to mention the whole biological clock thing - you really don't need infertility treatments added to your to-do list when you are a physician.

  9. I would like to echo the above about 1) focus on med school entrance now and specialty later and 2) start your family ASAP, if you aspire to have one. I had two children during my path residency, and having kids made me much more efficient with my time as a resident and doing research. When forced to balance career and motherhood, you can harness great energies that you otherwise would not have been aware existed.

    Having said that, two children and residency were pretty tough - I am three years into pathology practice now and am doing well, but recently became a single mom. Being a nursing mom and a resident put me into a survival mode, and it took a while out of training to work on catching my emotional maturity up to my academic achievements.

    I don't know many surgeon moms, and I know a lot of women that switched out of surgery to become mothers. I would like to point you to our own gcs15's posts - she is a mom/neurosurgeon who is an excellent writer and reading her posts/guest posts give a true heartfelt glimpse into the struggles and triumphs of a neurosurgeon mom. I hope to see her chime in here, because she has incredible wisdom.

    I wish I had a community like this to lean on when I was in training and becoming a mother. It has meant the world to me over the past year and a half. Keep leaning on the advice of others, it will make you stronger. Good luck to you, A! Sounds like with all you are juggling now, you are well on your way to succeed in all of your endeavors.

  10. My advice would be to have children as soon as possible, as hard as med school is it is way easier than residency.

  11. I am definitely going to chime in here, but it will take a little while to set out what I want to say, and today is incredibly busy - check back, I'll have a comment for you by late tomorrow (Saturday)! :-)

  12. I could not have done it. I barely stuck with it in my "lifestyle specialty" residency after my now 2.5 y/o daughter was born. It was the hardest thing I have ever done. I DEFINITELY deferred having a second one (and did not plan the first one). Now I'm 38 (after residency, fellowship, and lots and lots of research), and who knows if it will happen or not. When they are born, they are completely dependent on you, and the decisions that you make about your life will shape theirs forever. The day only has 24 hours.

    That said, life gets a lot better (in my field, at least) after residency. Two months into my first "real" job, I am very glad I stuck with it. It is rewarding work, I am able to balance it with raising my daughter in a way that does not make me feel like I am neglectful to her. I lean on my husband, and I accept all the help that friendship and money can get me.

    Someone on here recently posted the "ten rules of balancing". Highly recommend it. Especially the "marry well" part, that is crucial. Whenever I was just a hair's width from throwing in the towel, it was my husband who said to me: you know, I support you in whatever you decide to do. But I think you should be working.

    One major dream I let go of on the way was continuing to do lab research. I love research, but job satisfaction is only one part of general life satisfaction, and I just was not able to see any way of balancing it with my family without killing myself.

    It was a long, hard path, and it was very dark at times. I am glad I walked to the end of it, and I am happy where I am at now. But had I known in advance, I am not sure I would have chosen it.

  13. Finally - sorry to keep you waiting so long!

    You have set out some difficult goals for yourself. It will be a long, hard road, but if you are serious and dedicated, you can do this. I am excited for you! The life you want to build is challenging and endlessly rewarding.

    I was one of four women who went through my neurosurgical residency program (there may have been more by now). All of us had children either during residency or shortly thereafter. The other 3 each have 2 children; I have one. All of us have supportive spouses.

    This does not mean it wasn't difficult. We all faced a lot of ugliness from male colleagues. One of the four women chose to work part time, which really means 75% time in neurosurgery (I wouldn't recommend this). One did a Ph.D. after completing residency; she stayed in academics and minimized direct patient care. The other 2 of us are both in thriving private practices. So we all chose slightly different paths, but we were all able to make it work.

    My advice to you:

    1. Make absolutely sure that your husband understands what this career will require before committing to it! You will have family time, but there will be late nights and lots of sacrifices. If he's not totally, 100% supportive, either the marriage will fail or you will drop out of residency. He will need to be willing to do a fair amount of childcare and housework.

    2. Grow a super thick skin. Be ready to take whatever crap comes your way and let it all slide off, because there will be a LOT of it.

    3. Examine your reasons for wanting to do this carefully. I'd love to hear why you want to be a neurosurgeon. You have to love it, want it so much that nothing will stop you. If you can imagine being happy doing something else, you may want to think again. mus is right - the path is very long and is at times very dark. Your desire and dedication has to be enough to pull you through the valley of the shadow.

    4. Read Fizzy's post about the light at the end of the tunnel. The hard work doesn't stop after residency. Know that going in.

    5. Look up WINS, the organization for women in neurosurgery. It mainly focuses on the academic and political side of things, but it will show you that women have done this. You can too.

    6. If you have not already done so, shadow a neurosurgeon in a busy practice. See if you like it and if you fit in. That's how I made my decision years ago, as a naive college senior.

    I would be happy to answer any questions anytime. Again, I would love to hear why you are considering doing this. All encouragement to a potential future colleague! :-)

  14. One other thing (7.) - The reality is that neurosurgery is very competitive. You will have to do very well in med school and have good letters of recommendation. If you don't meet certain minimum requirements on paper, you won't get any interviews. So you must go into med school prepared to work very hard from the beginning. This is not to discourage, it's just the reality - same for other competitive specialties like ophthalmology. Developing good organizational skills is a big help in managing a family and schoolwork/residency.

  15. Hi. I am an orthopaedic resident about to graduate and thinking about starting a family soon. GSC15, why do you recommend against working part time? Or 75% in neurosurgery? Is it salary issues? Respect issues? I'm curious because I am considering jobs now and would like to pursue a 75% option.

  16. GCS15, !'m curious why you recommend against working 75%. Is it salary issues? Respect issues? I'm an orthopedic resident about to go into practice and am considering negotiating 75% positions. I have heard similar advice, but I am unsure why.


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