It's time to get a job. As someone who is far more comfortable when a plan is in place, I feel almost suffocated by the decision needing to be made in front of me.
I should count myself fortunate in that I have options, and they are good options. I had three offers and narrowed the decision down to two.
Option #1 is with a small practice in our current town. I could work 70% for a wonderful boss who was one of my mentors during fellowship. He allows his physicians significant flexibility in how they structure their work days. You have to see your patients, but how you do it is up to you. Call would be frequent, but reasonable and fairly quiet. I would be working with a close friends, who graduated fellowship last year. The facility itself is one of the best run and managed hospitals I've ever seen with a staff dedicated to professionalism and superlative patient care. We could stay where we are, buy a house, and send our kids to the excellent local public schools, one of which offers language immersion (for free!). We could continue in the social lives we've created here and watch our kids grow up with the children of our now-very-dear friends. At 70% I would have one day off and four shorter days, which is going to be important when Munch starts kindergarten next year.
Option #2. Move home. I grew up 600 miles away in a town that I still love. My parents, my sister, and my brother-in-law's family (with the only two cousins my kids have) are all there. My mom is retired and wants nothing more than to take care of her grand kids. The job would be very different. A large group with a strict "no part-time" policy. I would have almost zero ability to leave early for kid-needs, whether they be scheduled or urgent. The group itself is in the middle of a tremendous upheaval and has turned over most of its nursing and support staff. Many of MDs have left or are in the process of leaving, although I liked the "new hires" who I met during the interview. Call would not be as frequent, but busier. I would make more money, but we would probably spend that money on private schools.
Part time work would mean more time for kids, less stress, and less money. Moving home would allow us to access a fully reinforced support system, which could itself make full time work easier.
I also just want to live near my family again. I hate traveling for every holiday and missing birthdays. I want my parents to be a part of my kids' everyday lives instead of the sporadic treat-and-present-filled bursts that now form the basis for their relationship. My husband is equally conflicted. He wants me to work part time but also would prefer to live close to family. Work-wise, it would also be better for him if we moved.
I've come to only one definite conclusion in this week of insomnia-inducing mind contortions - I can't predict what is going to be best for my family 5 or 10 years from now. I can made this decision based only on what I think is the better option for the next few years and hope that if I need to put us on a different path, that path is either available to me or I am capable of making a difficult decision.
We are moving home.