Friday, February 15, 2013

MiM Mail: Pregnant and matching, oh my!

Hi MiM,

I also have a Rank List dilemma...

I am a fourth year medical student applying for a categorical spot in Child Neurology. I just found out I am pregnant with #1! We were not really trying but it was a pleasant surprise, despite the fact that I am due in early October which will be four months into my intern year, yikes!  So, I will be entering residency visibly pregnant and then after a too brief maternity leave, I will have to finish intern year with a newborn. Ideal? No. But I am not going to take the year off and I am lucky in that my husband is further along in his medical career and will have a more flexible schedule than me. We have NO IDEA where we will end up as there are relatively few spots in Child Neuro thus I applied widely and will be ranking programs from coast to coast. By matching categorical that means I do Peds for two years followed by three years in Neurology but at the same institution.  I know that Peds tends to be more family friendly than some other programs but I got a sense that some programs were much more supportive than others. None of the programs I interviewed at are aware of my pregnancy as I just found out myself.  I don't think I need to disclose this and fear that it would only hurt my chances of ranking.... But if anyone has been in a similar situation or thinks that I am wrong I would love to hear her advice.

My other question is whether or not I should let the "family feel" of each program influence my rank order. Several of my top programs are very academic and I think the residents tend to be a bit younger (thus less likely to have families already) and so I wonder if it will be an issue for me to be pregnant/out for maternity/breast-feeding/etc. Part of me thinks that intern year going to be difficult no matter where I go and that I'll figure it out and make whatever I need to work. But the other part of me (the emotional, tired, newly pregnant part) wants to be a program that will be supportive and celebrate with me. I feel like I did interview at programs like that but they were mainly General Peds programs.  Thus I would have to take an extra year to complete Peds and then reapply for Child Neuro fellowship as an advanced candidate in a year. I'm not crazy about the idea of taking an extra year to train when I already know what I want to do.  Nor do I want to have to reapply and interview again. Furthermore, I think it would be disruptive to my husband's career to have to move again in three years as well. But again, if anyone has been through a similar situation or has any advice I would love to hear it.

Many thanks,
Pregnant and matching, oh my!

7 comments:

  1. I can't comment from the position of a mother, but as a resident I see absolutely no reason why you should disclose your pregnancy to the places where you applied. As for the "family feel" of the program, I think it's something that you should take into consideration, but not over all other factors (like taking six years vs five to complete your training). The people you work with and the supportiveness of your work environment have a huge impact on satisfaction in residency, and I'm sure that's even more the case when you're becoming a parent during the process.

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  2. More than the extra year, its the reapply & re-match that seems daunting...it would be hard to go through all that while you're busy with residency, and tempting to NOT go through it, particularly if your husband is in a job he loves & not in a good time to move. I would definitely go for the categorical residency spot. "Family friendly" is hard to judge and honestly residency in & of itself is not the most "family friendly" endeavor out there---there is only so much a program can do---thus the differences between a "family friendly" one and another may be minor and not worth including in your decision-making process. Also Peds in general is (relative to other specialties) family friendly across the board---even "young" residents may start having babies soon enough. And no, you do NOT have to tell anyone you are pregnant during interviews.

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  3. You are not alone. I've also recently found out I'm pregnant - due mid-Sept. I'm already 32, so we definitely have to make it work. I've applied for general surgery, which is much less forgiving with family stuff. With this new information, I've actually re-ranked to put the community program where my parents live first, even though I see myself in academia long term. Luckily residents get good fellowships (some academic) from there, so my aspirations are not completely shot. When I interviewed there, the residents specifically told me they were family friendly, which I'm hoping is somewhat true (they had 1 female resident when I interviewed, who was not married or in a relationship...but all of the men were married, many with kids). Anyway, I'm prepared to be wildly unpopular with my co-residents and attendings because of this. And I cannot possibly imagine how it will work with all of the antenatal appointments, especially in T3. Not to mention the sleep deprivation of residency + child-rearing. However, I'm sure it will work out and be worth it in the end. I just really hope that I match at home so we have some support! Right now I'm feeling VERY overwhelmed by the whole idea of what is coming.

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  4. Not quite the same situation, but I found out I was pregnant the first month of my intern year. It was a rough year between trying to figure out how to be a doctor and trying to figure out how to be a mom, all in a new city on the other side of the country from all o our friends and family, but my husband and I got through it, and I can't imagine life without my little girl. I wouldn't put too much emphasis on a "family friendly" program if it doesn't line up with your educational goals, but it always helps to go somewhere where the residents generally seem happy, as hose programs tend to be a little more accommodating, to the extent they can be within the RRC guidelines. I wouldn't tell the programs now, as it could affect your ability to match but it is important to let the program where you do match know as soon as possible so you can start working together to set up your schedule around your planned maternity leave to prevent your fellow residents from needing to make last minute changes for you later. Good luck, and congratulations!

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  5. Intern year is tough regardless, but being in a program with people that are a good fit for you (be that academic or more community oriented) makes it much easier. I think with the added stress of a newborn being somewhere you are happy will be all the more important, so choose what feels right for you. As a peds chief who gets to schedule 80+ residents, I'd advise you to tell you program as soon as you match (not before though, it's none of their business yet) - scheduling for your leave ahead of time will be much, much easier on you and your fellow interns than changing schedules after they're set. Most peds programs are going to be accommodating - it would be a little hypocritical not to be, you know? Good luck with the match!

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  6. Thanks for bringing up this topic. Once in a blue moon I am asked about it, and although I totally support not disclosing until after the match (not anyone's business, and no one is objective around issues of pregnancy, whether they claim to be or not), I worry about my advice. Glad to see it is echoed above. I sent your letter in a link to a friend tonight, so she could see it and comments as well. Good luck to you! In mothering and in Child Neuro.

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  7. Comment sent in anonymously:

    I also found out I was pregnant during interview season, and I also did not disclose my pregnancy until the day after I matched. I did not want it to affect decisions about the rank. I feel I have been punished for being a mother throughout residency. When I told people in my program I was pregnant I was accused of lying. I recommend going for the program that seems more "family friendly," even if it means an extra year. I realize no residency is extremely supportive, but I think my experience could have been a lot more pleasant. Good luck!

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