Sunday, April 7, 2013

Part-time Residency

Apparently, some residency programs lately, notably in pediatrics, have been offering the opportunity to do residency part-time. According to a Newsweek story, about a quarter of pediatrics programs nationally offer this option. It sounds like the programs may offer reduced call schedule and months off, all with a prorated salary.

If anyone who has done a part-time residency wants to weigh in on this option and what it's been like for you, then that would be great. But according to the article, hardly anyone does it.

Considering a lot of pediatrics residents have children during residency and then choose to work part-time after graduation, it seems like this would be an option more people would choose. Granted, it does extend residency about about 15 months and who wants to be a resident for an extra year? Still, what's an extra year, really?

The article hypothesizes that women don't choose this option because they want to be taken seriously. We don't want to be labeled as the part-timer and have that follow us our entire career. I've noticed a general theme in medicine that women often don't want to be granted exceptions because we want to be equals. Yet.... do we wanted to be treated as equals? Yes, we want to be treated with an equal amount of respect, but I personally feel like we're not equal. So I'm not sure if I want to be treated just like a man.

If there had been a part-time option in my residency, I don't think I would have taken it. It probably depends what it would have entailed. We didn't have a heavy call schedule and the days weren't long, so the only thing they could have offered me would have been blocks of time off, and I'm not sure how much that would have helped me.

13 comments:

  1. If my residency offered part time positions, I would have taken it in a heart beat. I already have to expend residency due to maternity leave and some illnesses with my children. Having a part time position may have taken off some of the stress associated with finding coverage for all the time I had to take off anyways.

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  2. I've heard of several of this year's interns in the peds program where I'm a student doing part time. At least 4 I think. One is off every other month, extending her residency by 3 years. One is off ever 3 months, extending residency by 1 year, and another man-wife couple are each off every other month (one is on while the other is off) so that childcare responsibilities are always covered. I did not get the sense that they are less respected. Less camaraderie with their co-interns? Maybe. You'd have to ask them though.

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  3. I remember a couple of mom's stretching out med school in this manner. And being ostracized and denounced as "lazy." Oh yes, we are so lazy, us procreating women in medicine. Nothing less than 200% (pregnancy and birthing and breastfeeding and motherhood plus full time residency/doctoring) will do. Society dictates that we run ourselves into the ground, often our own expense.

    No part time for me either, residency or currently. But I imagine there are others out there (a very few) who took that option that will live longer than me. Good for them. I don't mean to sound bitter, I'm happy and proud of where I am. But what it took to take me here? I think it was a little ridiculous, in retrospect.

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  4. I am in Australia, just about to have my first baby and planning on completing my EM 'residency' (not really what it's called here) part-time. For us the system is a bit different - your 'residency' which we call 'specialist training' takes 5 years, after 2 years of general hospital rotations (which we call 'internship' plus 'residency') - similar to the UK system. So most people work for 7 years after graduating from med school before they become a consultant (= your 'attending').

    In this context many female doctors preferentially choose specialties that have greater flexibility to allow part-time work - in particular General Practice (= your 'family med'), Paeds and EM. For me, I love having the option to finish my training part-time. It means that I can have good balance between work and family, give adequate time and energy to my family and friends, and not have to spend years resenting giving up personal goals for the sake of finishing training. Basically, feel like a more balanced human being (rather than a cog in a hospital machine!)...

    Yes, it does take longer - and in our system, a lot longer. But it's not so bad when you consider that all the bad aspects of training are stretched out too and become less intense - work less tiring overall, less commuting, less nights/on-calls, more time to get research requirements and exams done... so it's not the same as if residency were to become actually longer, but with equal intensity.

    As to what people think - yes there will be people who think part-timers are lazy (I'm working into late pregnancy and I'm sure there are people at work who think I'm lazy because I can't move and walk fast anymore, darn it! - and see less patients as a result). There will also be people who think we're bad mothers because we're not at home with the kid FULL-time. And sometimes, I find that the people who judge and criticise are actually JEALOUS of someone being able to, say, have a more flexible schedule or balanced life to what THEY have...

    I reckon ('reckon' = Aussie slang for 'think') that the key is - work out what are your life priorities (is it work? becoming the next president? family life? skydiving? serving at church?) - and make decisions based on them - not on your colleagues' or bosses' priorities (which chances are, will be very different)! After all, they're not going to be there in 20 years time when one looks back on how decisions were made and life lived...!

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  5. I added an extra year to medical school to spend more time with my baby and it was one of the best decisions I've made. I'm not sure if people felt that as lazy, but I could not care less if they did, and my med school was very supportive of it. I'm now in my final year of a Peds residency (no breaks except 6 weeks of maty leave for baby #3), and I haven't personally heard of any Peds residencies offering part-time stuff. I think programs would have to get at least enough willing residents to make up one whole resident (otherwise there would leave gaps in coverage) and this has to get tricky to sustain long-term. The bottom line is, moms will always have guilt, whether they're in medicine or not, and we just have to set priorities and make the best decisions we can. People who judge often don't have the whole story, and besides... they're just people.

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  6. I am a psychiatry resident in a large, reasonably highly ranked program, and people convert to part-time resident status ALL the TIME here! Generally people wait (as I did) until at least half way through your second year, in order to get all of the all-or-nothing rotations out of the way (because one month on, one month off really is kind of lame). Then people can chop things up by the day or half day, depending on your schedule. It's awesome.

    And for us, we can scale up and down pretty much at will, with relatively little warning, even. I came back after my second maternity leave at 50% time for a while, dialed up to 75%, and am about to kick back up to 80%. I'll end up about 9 months behind - but boy is it a better life being 75% when parenting two little ones. No regrets at all! And if anyone thinks we're slackers when we do this, they certainly haven't let on - our call gets cut proportionally, but since a few people a year do this, it all just evens out - for every 3rd or 4th year resident with a reduced call burden, there's someone who's extended into a 5th year picking up that slack.

    Seriously. Life is so much better this way. I can hardly believe it's as rare as this post makes it sound!

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    Replies
    1. Where is this program? I keep hearing about these, but can't seem to locate any.

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  7. RCHK- please do share- where are you? Have you heard of other places that readily offer this part-time awesomeness in training scenario? This is NOT public knowledge!

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  8. I too extended medical school by 1 year to spend time with my first baby & then deferred residency for a year to spend time with my 2nd baby. I do not regret the extra time with my family at all and would have gladly chosen an extended part time residency were that an option.

    However, I would be remiss if I didn't say that I have regretted going into medicine repeatedly. No matter what the schedule, it is difficult to reconcile the many hours of their lives missed for the stress and abuse that is medical training. As a fellow, my schedule is a little easier but when I'm at work I work, when I'm at home I work & on too of this add in moonlighting to help pay off exorbitant student loans. All of this in the setting of increasing regulations and required documentation, pressure to see many more patients per day (thereby limiting actual time spent with them) and the impending threat of a saturated patient load that demands even more time and so-called efficiency for less reimbursement. I'm not sure it is really worth it.

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  9. I did a part time residency in pediatrics in the 1990ees. It was one of the best decisions that I ever made. I was encouraged in my pursuit by another med student who was at Harvard. She had started a program called Pediatric Residency Partners to help those seeking p-t residencies to find each other. (It was all by mail--no email back in 1990) She and her partner were the first ones to complete one at Harvard. By the way, it did not hold her back as she is on the faculty at Harvard. The woman that I shared a residency with is also part of the academic faculty at a major university. I went into private practice. My children are now in their 30ees and I have one grandchild. Was it offered at the school that we applied to? No...but we presented our case and they approved it. My message is ;" don't be afraid to ask..." The first time that I asked the answer was "no"---then I did more research, found a partner to share with me, and asked again....

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  10. Thank you for posting this information. I recently was accepted into medical school. I am so excited. I will be 28 by the time I start though. I really do not want to miss out on the opportunity to have children. I am not married yet. Although, I am hoping my boyfriend will pop the question in the very near future. I hear all of these mixed messages about when to have children. I have been out of school for a while now so it might be a good idea for me to focus on school in years 1 and 2. I heard 3rd year is the worst, so I will stay away from that. I was thinking of doing an MPH so maybe between my 3rd and 4th year. I know a friend who is doing that. Would that be easier? I heard that 4th year is the easiest medical school year and then I could probably get a part-time residency until I felt comfortable going full time. I would love to hear everyone's advice. I would like to have 2 children probably sometime during my training because I fear I will not be able to have children after I have completed my training.

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  11. I am a female in my late 20's and have recently received a full-tuition scholarship to medical school. (I will be starting medical school at age of 28.) I am very excited but also a little scared because I do not want to miss out on the opportunity to have children and a family. I am not currently married but I am hoping that I will be within the next two years. My boyfriend is an engineer and is looking for a job near the medical school. His family is amazing but they will not be near the medical school. My family is near the medical school but I am not sure how much help they will be (I imagine that they will be able to offer some support).

    I would like to know the best way to do this. I have been out of school for sometime so I figured it would be good to focus during M1 and M2. I heard M3 is very hard and time consuming so I was thinking of taking a year off between M3 and M4 and possibly getting an MPH (as I am very interested in this). Would getting an MPH be more manageable during pregnancy or with a newborn? Then I heard M4 is pretty easy so I am hoping that it will be manageable with a child.

    Also, what is it like to find a part-time residency? I keep on hearing different stories. Depending on how things go with my first child I may try to do it full-time some of the time, but we will see. My current interests are in FM, Peds, or Peds/Neuro. (Although that is subject to change as I have not started medical school.) However, I would probably like to have a second child during residency. Do I need to find someone to share a residency with me? Do you ask about it during your interviews? Do you start residency full-time and then go to part-time once you get pregnant? Do I do a research year during residency?

    What is the best way to try to plan this? I wish I didn't wait so long to go to medical school but this is where I am now and I have this amazing opportunity and I want to do it but at the same time I know that I would HIGHLY regret not having children or a family of my own (and unfortunately my time is limited for that).
    I plan to try to stay near family the entire time during my training, etc.

    Any advice would be greatly appreciated.

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  12. I am a family medicine resident PGY1. I am starting to look into part time residency. My child was was dx with DM1. I am having trouble finding these residencies. Is there a website that list all the family medicine residencies that offer part time positions. Thanks.

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