Monday, February 25, 2013

MiM Mail: Path for a military wife

Hello Mothers in Medicine!

I was googling for possible stories of women who finished medical school then put off residency training for marriage and family. I came upon your site, sorted the mailbag and found none similar to my problem. I hope the lovely ladies of medicine can help me sort out my options.

You see, I'm an IMG (graduated 3 years ago) non-US citizen who married the love of my life a year ago. What makes this even more complex is that my husband is committed to the US military where he can really have a promising career. We currently live outside the US for his work, but we will moving back in a few months.

As for me, I am unemployed because all medical jobs on base require US citizenship. Off-base jobs require fluency in a language I barely even know. But, I currently work for a major non-profit organization as a medical volunteer, with the idea of having something to put my resume in mind. I am taking Step 1 in a few weeks and I'm already going crazy. What more if we have kids? Plus, I have been going crazy the past few months having no income...

That is where my problem really begins. We have a plan to adopt a dog at 1 year of marriage, then to try for kids on our 2nd year of marriage. I wholeheartedly agree with this plan. I'm almost 30 and I'm scared we won't get to have any kids if we wait 5 more years. With the military lifestyle (change in base location every 2-4 years, military parent always off elsewhere etc) there always has to be one stay at home parent... Or else you rack up thousands of dollars in childcare and worse... neither of you will be there to watch your kids as they grow up.

My career options are (1) either continue with being certified to apply for US residency programs or (2) to put it off by 2-3 years or (3) to pursue a different path all together. Option 1 will eventually have me trying to match into programs that are an hour's drive away from where we will be living. With our family plan and his military commitment, I do not have the luxury to move to a different state or even county.

Option 2 seems to be okay. But, how realistic is it for me to pursue training when I will be an old IMG, 6-7 years from graduation? Will there even be a handful of programs who will peek at my application? I can also try to do vocational programs or get a masters in something medically-related, so I would be doing something. That's when Option 3 came in...

Is being a physician really a good career path for a future mom and military wife? Perhaps, I should delve into an academic career instead. Or become a public health practitioner? Has any of the bloggers/readers met a civilian physician who married a non-physician man in the military? Please enlighten my frazzled brain.

Thank you!

p.s.
I apologize for the really long message. But, I forgot to put in that we won't have family that would be close enough to help us out with care. There is a possibility that my in-laws will live in the same state as us in 3 years, but for now, there will be no one to aide us.

I'll be a "single mom" haha.

Oh well, thank you so much for having your blog up. It was refreshing to read issues the superwomen of medicine have. so... I so wish you can help me out. :)

9 comments:

  1. I have no idea how competitive an applicant you are, so please keep that in mind and don't get mad at me.

    My understanding is that US residency spots for IMGs are more competitive than ever, and that the probability of securing one declines dramatically the more years elapse between med school graduation and application to residency. I suggest you try to get a sense of what your chances are of securing a residency spot now (3 years out) and later, and then use that information to inform your decision. It would really be a shame to put in a ton of effort to study for the USMLE steps if your chances are slim to begin with, especially if you might use that time to start on some other career trajectory.

    Good luck!

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  2. One of my great friends and senior/mentor in residency was an IMG. I had to look up IMG - like that term much better than the one I was familiar with, FMG. Times have changed.

    She came to US with her husband, also an IMG, who did an opthalmology residency/fellowship here. She learned English on the television (!!??WOW), passed the USMLE's, took that ECF/something or other, and got a great residency position. She is crazy smart, and tons of fun.

    She went back to practice in her own country. I loved hearing about the vast differences in practicing our shared specialties in different countries. She is back in the States I hear, recently - her native country is sadly a little too politically volatile to raise a safe family currently. I need to catch up with her on Facebook to see how she is doing.

    Although I don't have the current info that Rock Star MD Girl above does, I do feel for your unique situation. It sounds like you are thinking things through well. As a single mom (I know you aren't really a future one but still) - all I can say is back up, back up, back up. If not family, find good sitters. They are available to everyone in all walks of life if you take the time to look and interview.

    I know there are a couple of military wives on MiM, who have written about the unique challenges of that in the past. I would encourage you to skim around and read some of their old posts - KC and Tempeh if I am not mistaken.

    Good luck from me, too!

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  3. Will you be able to stay in one spot long enough to complete residency? Locums positions and urgent care may offer the flexibility of hours and changing locations that other specialities may not. I think primary care would give you the most flexible career options if you went the medical route. Kids and residency is going to be hard. There's no way around that. So I think that's the first decision you are going to need to make. Beyond that I think the career is doable if you go the primary care route.

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  4. I'm a former military wife and now a resident and I will tell you the path isn't easy, but isn't impossible. My husband and I married just before I started medical school. He deployed during my first year and half of medical school and then we lived separately for a ridiculously long time (over the course of 3 years we say each other a grand total of 4months and 19 days). Being geographically separated is something you and your husband have to decide if it's worth it, when you apply for residency it may not be in your professional best interest to limit yourself to only hospitals that are within 1 hour drive - depending on where you are stationed this could be 1-2 places. There are military residency spots that are open to civiliians and this may be an option for you, but as far as I know there is no preferences for military spouses (but sometimes things are who you know too). IMG spots are getting more competitive and the further you are out the harder it will be, so if getting into US residency is something you want I would not delay getting the Steps over with and applying - the sooner the better! It sounds like you have great life and professional experiences and this will take you far in your personal statements as well as on your interviews. You will be a memorable candidate and that goes a long way. As far as the "single parenting" goes this is true of both residency and the military, neither one are particularly family friendly. As one of the other posters above said, back-up, back-up, back-up will be crucial for you and your husband. Depending on his MOS and chain of command, his schedule can be as unpredictable as yours which can make childcare tough.

    At the end of the day though, if getting into residency, being a military wife, and starting a family are what you want then you can make it happen. It won't be easy, but most things in life that are worth fighting for aren't easy! :) Keep you head up and good luck!

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  5. Hello,

    I am foreign born but currently a US second year medical student, married to an active duty service member, and a mom to an almost two year old. So to address all of these issues:

    - I am not an IMG but as mentioned in other comments, it looks like the prospects for IMGs for residency spots are not looking too good. They are also looking worse every year for US graduates. The current projections show that there will be a surplus of US medical graduates in 2015 (my year of graduation), making it even harder for IMGs to secure a residency spot.

    - I was older when I started medical school so my husband and I decided to have a baby right before school started. I don't regret that decision even though being childless would make medical school significantly easier. My son goes to daycare during the day and that has worked out perfectly with my school schedule so far. Even when my husband's schedule gets busy, I am able to drop off and pick up my son. I know next year will be significantly different and that my husband will have to adjust his schedule to accommodate mine so our son can be taken care of. I'm assuming residency hours are a lot like a 3rd year schedule but depending on the specialty that you are considering, you could make it work. Residencies with no night/weekend call and a 8-5 schedule would allow you to be your children's primary care giver if you chose to go that route.

    - Being a military dependent complicates the issue of parenting. My husband deployed last year during my spring semester of first year and I managed as a single mom just fine. It was not easy by any means and without family near-by I nearly lost my mind several times but concentrating on my goals helped me make it through. Outside of deployments, how flexible your husband's schedule could be depends on his command. We are lucky in that my husband can request to not be assigned duty at times where I need him to take care of our son. I am counting on that for next year.

    I cannot tell you what would work best for you but in my case I knew that I did not want to have to choose between being a mother, becoming a doctor and being a military wife. I have managed to make it all work so far and am not regretting my decision. With that said, medicine and the military are notoriously family-unfriendly so I know I'm walking a fine line.

    Good luck with your decision making.

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  6. hi....i m not in the US but am a physician(internist)and a military wife as well, and work with a teaching hospital as associate professor.hence i completely understand your problems.i had completed my internal medicine residency before i married the love of MY life,a military man...n had a kid 3 years after.i have survived through his postings and deployments and depend mostly on my family support system of my parents to take care of my 7 year old son.there are lots of issues that complicate marriage and my profession,and the military is definitely not very friendly to professional/doctor wives.the best option for you would be to somehow get through residency,and then opt for a career as faculty with teaching hospitals so that you have some flexibility.i dont know in great detail how practice is in the states,but i can tell you,if you keep moving with your husband,private practice may not be a good option right now.keep your spirits up...i m so glad there are people like us in this world,all over the world,who have married into the military AND are physicians.that gives me hope too.

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  7. Hello, I am a pediatrician. Married by active duty military husband after I completed residency. We now have a 2 year old and a 4 month old. I have a great job now and am sad because we are going to have to PCS soon, I'm not sure when or where. I haven't had to move yet, my husband is a recruiter and somehow we managed to stay put the last 5 years. I have only managed because I am near all my family and my mom watched my two kids while I work. I am scared about what my future holds. I guess I am lucky in the fact that I met my husband after his deployment was over, he converted to a recruiter essentially for me even though it is not his ideal job. It is going to be difficult for me to leave a great job and all my family support. It is hard not to know anybody in the same position, I am glad to know their are other military wife/doctors out there.

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  8. Hello, I am a pediatrician. Married by active duty military husband after I completed residency. We now have a 2 year old and a 4 month old. I have a great job now and am sad because we are going to have to PCS soon, I'm not sure when or where. I haven't had to move yet, my husband is a recruiter and somehow we managed to stay put the last 5 years. I have only managed because I am near all my family and my mom watched my two kids while I work. I am scared about what my future holds. I guess I am lucky in the fact that I met my husband after his deployment was over, he converted to a recruiter essentially for me even though it is not his ideal job. It is going to be difficult for me to leave a great job and all my family support. It is hard not to know anybody in the same position, I am glad to know their are other military wife/doctors out there.

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  9. I came across this post and had to reply. I am in the EXACT same position as you KC. I know it was 12 months ago that you posted this so I would love to hear how you are going and the choices you made in the end.

    This is my story: I am a 33 year old non US citizen, IMG in general practice, who married the love of my life 12 months ago. My new husband is a US citizen, active duty military posted overseas at the moment. I joined him here 8 months ago and we plan to hopefully move back to the united states next year, pending his next assignment.

    This is my story: I was a successful, financially independent general practitioner working in my dream job, controlling my hours and my life balance for the first time. This led me to be able to pursue my love of travel, which ultimately led me to meeting my now husband. I fee blessed to have met a great man and to have the opportunity to share my life with him and have my own family, however, I was completely naive about what this would mean for my career. I too am unable to work on base as a foreign national. I am not even allowed to volunteer for the American red cross because of this.

    Here are my options as I see them when I finally get to the United states and I can do something:

    Option 1: Retrain in the US. I have spent countless hours researching this entire process from start to finish. I have contacted every family residency program in the US in communting distance from a potential base where we may be posted in the future. One - yes only one - program said they could consider my application even though I didn't meet the criteria. It seems my biggest obstacle is not my performance on the USMLE (even though this has to be flawless) or getting 12 months hands on clinical experience in a US hospital. It is the number of years since graduation - I am now 9 years post grad, and by the time I apply for residencies this will likely be 11-12 years. All other programs were sympathetic to my situation but said I just didn't meet their criteria.

    Option 2: Further education - Masters public health, PhD, MBA, online pharma courses. With the intention to try to get research experience/training to enter either public health work (my dream job is in the CDC), pharmaceutical industry, academia world, hospital administration. Even going back into lab work and using my science degree. The obstacle here is 1) Money - the cost of education in the US is insane. Even with military scholarships, you are looking at minimum of $10000 per year. 2) Will the cost pay off in the end and help me get a job in these areas? I have read so many blogs from people who say they have these qualifications but still can't find work. I don't even care about money anymore. Entry level positions paid at minimal wage is at least a foot in the door.

    Option 3: Maintaining my skills and medical registration in my home country with the intention to move back there once my husband's minimum commitment is up. Don't get me wrong, I never went into this intending to feel this way. But my husband finding work in my country in his skill area is MUCH more likely than the other way around. I am currently going back home to work for a month every 6 months to keep my registration and my sanity. I just can't let all my hard work go to waste, I just can't let it go. But I fear once we have kids, once we move to the US and get a job, and get a green card, this will no longer be possible. It does however give me some goal, some of my lost identity back for those brief periods and makes me feel like myself again.

    I need a mentor, advice and a few olive branches from some fellow mums/wives/doctors. Life has a funny way of teaching you lessons, and nothing is more enlightening than hearing positive stories of how others overcame such trying times. Over to you guys!

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