Sunday, February 3, 2013

Should I go to medical school?

I have gotten several emails though my blog, some from people who found me through Mothers in Medicine, asking me for advice. I am so touched that people reach out to me. I used to answer these emails individually. I have not answered the last handful, for many reasons.

Most of all, these reasons are personal. Intern year is much different than fourth year as a medical student. I have had a lot more demands on my sleep schedule, my time, my emotions, and my responsibility. I haven't been blogging much in general.

I also did not match last year, and have spent most of this year questioning my dreams. I don't want to rain on anyone's parade with some sort of bitter reply. Which, I wouldn't necessary give, but I have to be honest in my answer. Being a single mother in medical school and residency isn't a piece of cake. But, being a single parent in this world isn't a piece of cake, either, and being a medical student and / or resident isn't a piece of cake. Foregoing medical school isn't necessarily the answer to any of that.

Here is some general advice I will share with parents, single or otherwise, who are facing decisions about medical school and residency. These answers cover a mishmash of frequently asked questions that come up in comments and emails. I looked it over, and I use the qualifier "very" a lot. I usually avoid that word, thanks to my father's influence. He told me to edit by replacing every "very" with "damn", and then to edit out the profanity. I have left them in, because this topic is very damn very challenging.

For single parents or parents whose partner will not be available for child care:

You will need to have a very, very flexible, very solid support system. For clinical years and residency, you will be expected to change what time you come and go on a moment's notice. The rotation you are on most likely will change every four to six weeks, and the demands, time wise, may change day to day on certain rotations. These hours can be as early as 5 am or even earlier, and you can be expected to stay way past midnight, even all night. Some of these times you can plan for, and some you can't. Living near family is very, very important for those of us who can arrange for that. It definitely can be done without family, but please keep in mind the expense and issues with screening and turnover of caregivers.

For people who are facing custody issues, possibly moving for residency, lack of familial support in their particular area:

I feel for you. Coparenting arrangements are very, very difficult. Depending on a lot of factors, you may need to be willing to move for residency, especially for certain specialties or even for some of your rotations. This may involve moving to a place your ex doesn't want you to move to, or moving to a place away from familial and / or social support. The judge may not look to kindly upon you leaving town with a child or children to a place where you know no one and will be working 80 hours a week, including nights, no matter how much you love your kids and parent well. And, there is a reason for that. Is it doable? Yes. Is it a good idea? Depends. Keep this in mind before embarking on medical school. This is one reason I wish I had done ARNP midwifery instead of medical school, occasionally. I wouldn't have to do the match for obstetrics residency. I had reasons not to go the nursing route then, and those are still valid.

For people trying to decide between nurse practitioner, midwifery, physician, and other avenues of the medical profession:

I really stumbled into medicine without a full understanding of how involved the process was, when it came to board exams, residency match, etc. I am still not fully informed on what it takes to be most of the other options available. Please research the nitty gritty, and you will still be surprised by the reality of how the sausage is made. I found studentdoctor.net. With all of its problems (and there are MANY), it is a decent place to find out practical details of many steps of medical school, from pre-med through fellowship and beyond, if you can fish through the trolling, bragging and nonsense.

As for whether or not you can handle it...sigh. I think we can all handle a lot. I think there are times at work, even at 4 am, in which I am exhilarated, and so happy that I chose my path. There are times when I am with my kids that are quality times, and everything seems to work out. There are times in which I feel completely overwhelmed, where I cry at work, and then cry at home because these kids who I wanted to desperately to spend time with when I was stuck at the hospital are bickering with me and with each other, and all I want to do is send everyone to their rooms. No matter what happens this March when I find out if I match in obstetrics or family practice, I will be happy as a physician. I will also have regrets. I think this will apply to anyone, no matter where their choices lead them.

For people who are older:

I was not the oldest person in my medical school. I am not the oldest person in my residency program. I think it is more of an issue with your peers than with your professors and attending physicians, who may be your age. They don't think they are less skilled, and may identify with you more readily than they do younger students. Some people may say it's a waste of investment of a medical school spot or residency spot that a younger person who would give more back deserves more. People say this about women in medicine, too, and that we want to go pop out babies and work part time when we are done with training. All these people can, um, stuff it.

For people who have a history in the "natural" birth community, i.e. doula, midwife, or are just crunchy types looking into medical school:

There is definitely room for us in all aspects of the medical community. I was pleasantly surprised by the diversity in my medical school and in the medical community. One of the first events I participated in for medical school was a social event at a bar, and one of my classmates, a massage therapist, was a few sheets to the wind and offering to balance my classmates' chakras in a wobbly kind of way. I sat next to a grandmother who caught her own grandchild at a home birth all of my second year.

However, medical school is long. Residency is long. It is a grueling, intensive slog. Make sure you are doing it to become a physician. If you want to be a doula, be a doula. I will not be a doula or a lay midwife if I am an obstetrician, or even if I am a family practitioner. It is not worth the effort to go through all the extra training, and the infrastructure is very inflexible and unforgiving. You potentially will be choosing battles constantly, and need to know your place as a matter of respect and experience and survival. Does that mean always stuffing it?  No. But, it means often stuffing it.


If there's anything I missed, please add it in the comments.



11 comments:

  1. The childcare issue is huge. HUGE. I would go so far to say that you need to plan (financially) on having hired help if you don't have 1. a spouse with a flexible schedule or 2. parents/family around to help.

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    1. It really is. It's not insurmountable, but it really is huge. I had a student ask me how long he would have to be there on the weekend, and I said I wasn't sure - the surgeons were on call that day. He said he wanted to know, so he could tell his babysitter.

      He asked again later, and I apologized again, and said I still wasn't sure. This whole rotation is unpredictable, and it's fairly light as far as surgery goes. I almost wanted to pull him aside and say "Look, I'm a single mom. I'm sorry, I get it, but you're going to have to figure out flexible child care as soon as possible."

      He has quite a few more clinical rotations after this, and then residency. I feel for him and wish I had more resources to offer him, but I don't.

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    2. It really is. It's not insurmountable, but it really is huge. I had a student ask me how long he would have to be there on the weekend, and I said I wasn't sure - the surgeons were on call that day. He said he wanted to know, so he could tell his babysitter.

      He asked again later, and I apologized again, and said I still wasn't sure. This whole rotation is unpredictable, and it's fairly light as far as surgery goes. I almost wanted to pull him aside and say "Look, I'm a single mom. I'm sorry, I get it, but you're going to have to figure out flexible child care as soon as possible."

      He has quite a few more clinical rotations after this, and then residency. I feel for him and wish I had more resources to offer him, but I don't.

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  2. When people ask me questions about whether its possible to be a mother and go to medical school and do residency, I tell them that anything is possible... It's what you're willing to sacrifice that.is the real question.

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    1. Yes, it's possible. Women (and parents in general) make all sorts of things possible. Medicine is a great career, and a demanding career. It is hardly unique, though. It is not like the choice is between being a mother and being a doctor. But, yes, parenting involves sacrifices. A demanding career involves sacrifices.

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  3. Thank you for this. Really. I don't have the words to express how helpful this post is, while I sit here contemplating and kicking myself for things I can't change. I like being reminded of reality, and coming out the other end thinking I STILL want to be a physician. Something is wrong with me, right? :oD

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    1. You truly are my superhero, MomTFH. You are raising some beautiful boys who will have high standards when it comes time to make their match, if they so choose. I can certainly empathize with much of what you say, but I also see that in many ways you are going a route that is much more demanding time-wise than I did. Your patients are going to be so lucky, already are!

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    2. @Tiffany - No! Nothing is wrong with you. There is nothing better than having goals and working towards something that excites you. It's just good to have full information about possible challenges along the way.

      Good luck!

      @Gizabeth - big smooches. You're the wind beneath my wings;)

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  4. Excellent post. I do the same with folks who are considering a career in medicine; think about the nitty gritty and if there is anything else that you would love as much, DO IT! If not, press on, you can do it! I love being a Pediatrician but goodness it's hard.

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  5. Thank you for this. I truly appreciate it, and I need to see other mothers who were able to do it for motivation. I have a five month old who is super independent (and just as busy). I need help learning how to juggle mommie time and study time. Do you have any advice for me?

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