Thursday, June 6, 2013

MiM Mail: Should I uproot my family?

I've followed this blog for many years and I desperately need help. I recently had to take 1 year off from residency due to medical issues. My daughter and I are both doing well now and it's time for me to go back. Despite many challenges, this year has been a wonderful experience bonding with her. When I return to residency she will have turned 1 year old and I will be transferring to another program. The problem is I don't know where to live and I hate to uproot my family. If we stay where we are now my husband will be 15 minutes from work and my daughter will get to maintain her relationship with our part time evening nanny whom she absolutely adores (she helps me now about 3-6 hours/week). Additionally, my mother in law loves the area we live in now and would probably stay with us for maybe 6 months if we stay. The only problem is that my commute would be about 1-1.5 hours driving or via public transportation. I've been away from medicine for over a year and I want to succeed when I go back, I'm not sure if commuting is such a great idea. And I've never been away from her for more than a few hours, seeing her for a few hours each night after a long commute is going to be a huge change for both of us.

If I put myself first and move the family closer to my new program I will have a 25-30 minute commute, my husband will have a 45 mile reverse commute against traffic (50 min-1hour). But mother in law help in this scenario would be unlikely for any extended period of time. We would put my daughter in daycare sooner rather than later. There would also be no nanny help at night (my daughter loves her and she is not an easy baby!) because the nanny doesn't drive.

I only have 2 years of derm residency remaining but I have so much at stake since I will be starting a brand new program after being away for a year. I really want to put myself first and move closer to the new program so that I can give myself the best chance at success but I don't want to uproot the entire family. I feel so guilty because we have moved so many times in the past. On the other hand I don't know if commuting from where we currently live to my new program will be the best choice for my career/performance. My husband is supportive of whichever route I choose but I've been agonizing over this decision and am no closer to a solution. I keep myself up at night weighing all the options until I feel sick which I know isn't healthy. Please help me!!!


  1. What are your hours going to be like as a derm resident?

  2. Hi OldMDGirl
    I'm not sure exactly since this is a new program but I'm guessing I will be done by 6 most days. At my previous program we had didactics in the evenings as well most days.

  3. The difference in commutes is not so significant that I would want to give up MIL and nanny support. If you took public transit, that could be your study time.

  4. Hi Theresa
    I thought about that option as well. Although my MIL has not firmly committed to help us I'm sure we could steal her for at least 3 months. And our nanny could still help us out a few nights/week.

    I should also mention that in August our lease is up and we can't afford our rent anymore so we will have to move someplace new regardless.

  5. I agree with Theresa. Extra commute sucks, but it sounds like you need to get through 2 years and you have a better support system for your family. I am studying for boards now and listening to lectures on my iPhone (through the bluetooth) during my commute. In the car I just listen, but if I have down time (while waiting in doctor's office or whatever) I watch the lectures. You could do something similar with your commute. Tough choice though.

  6. I would do the commute. It's only for 2 years and helpful to have at least 1 parent closeby and who can be there to pick up a sick child etc. The family support would be nice too. But, also depends on your family's long-term plans. Does your husband like his job and plan to stay there? Where do you want to be eventually? If it's where you live now, then more reason to stay.

  7. I'm thinking staying might be best---if you move, neither of you are really close to home, to be able to run back for any childcare emergency (nor would you, as a resident, necessarily have the flexibility to do that---best to have your husband's work be 15 minutes from home). Also the family support is absolutely invaluable. Even if your MIL doesn't want to help for months at a time, for sick days or late nights/weekends, it sounds like she'll be helpful. And if your nanny will be the one caring for your little girl, all the better--trying to find someone new, particularly if--as you say--your daughter can be tricky, is no way to start off residency! Plus, yes, with a public transit commute, you really can get a lot done--reading/listening to lectures. You won't necessarily have time for that once you get home and surrounded by family stuff.

  8. I would uproot your family. Get an au pair to live with you. When kids are over one year old they need socialization. If you put your daughter in daycare part time and have the au pair at home she will have a good balance. Au pair can be your back up. They work 40 hours a week and live with you. She can be the evening help. I have two kids. It's hell. Just get through those two years and be flexible. The needs of a baby are very different than the needs of a 1-3 year old. You have worked really hard and need to finish strong so you can get a decent/good job. Otherwise what's the point of all this sacrifice?

    1. I'm inclined to agree that you may be able to more flexible with your childcare than you think. We have an au pair, and she is great. Au pairs are a great flexible option for the short term (1-2 years -- and actually can work 45 hours per week). You could do daycare 3 days per week and have her do pick ups/drop offs and have her do 2 full days. We do something similar except our daughter is in daycare full time AND we have an au pair.

      You are not going to be at your best if you spend 3 hours in the car a day. Free childcare / relatives helping is nice, but I worry that they won't be as flexible as you hope they will be when push came to shove. I know it sounds expensive and daunting, but this is YOUR training and you are important too. This is not the time to shortchange yourself.

  9. Thank you everyone for your suggestions. Even though deep down I really want to stay and suck it up for my family I'm really nervous about returning to work as a new mom in addition to finding the stamina I need for residency. I did horrible on my last in service exam because I was so sick while pregnant. I really have a lot on the line and need to do well when I return. I almost left residency for good at one point. An au pair sounds like a good idea because it's 24 hour support. My husband is stressed out by his own job and we could really use the back up help. I cringe at the thought of moving again but we can't afford our apartment anymore so we have to go somewhere in August whether we stay in our current city or move further out.

  10. Someone suggested that I get an apartment close to residency and stay there 2 days/week. That way the family wouldn't be uprooted (but we would be separated). What do you think about that idea? Would my daughter miss me terribly if daddy and world's best nanny are home with her during the time I am away? Of course I would miss her terribly but I want to do what is best for her overall.

  11. She will be fine no matter what you do. She will. It's two years when she is very young, and kids are very resilient. She'll adapt. There are nannies where you'll be living. Day care isn't evil.

    I don't know what your husband does, but if it's less taxing and more predictable than residency it makes more sense for him to commute. The au pair is also a good idea if you will have enough room for her - you can have your daughter in day care and the au pair can pick her up and start the evening routine so you're not frantic if you're delayed getting home or your husband is caught in traffic. Or you could have a college or med student work as an afternoon babysitter (we've done that for the past four years).

    Whatever you do, DON'T split the difference and have two commutes. We did that for 10 years and it was AWFUL. Worst of both worlds.

  12. I vote for the AuPair option.

    I have 3 young boys, a husband with a busy job and no family help. The way we survive is this:
    1. We have always lived very close to hospital - currently 10 minute walk for me. Living close to work is very important for me - this maximises my time with the boys.
    2. We have an AuPair who lives with us - fabulous support that is flexible and can adapt to whatever shifts I work
    3. Have someone come and help with cleaning / washing once per week

    My children have had great experiences with our AuPairs. I always structure their week so that I know what children and AuPair are doing on any particular day. There is a library story time day, a playgroup day, a swimming lesson day, a play-date day and day for running errands (I ask our AuPair to pick up dry cleaning, take mail to the post-office, take car to service... there is always something).

    I hope this helps.

    I think you will feel a lot better once the decision is made and you can start putting things in place to support your new arrangement. I wish you all the best.


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