Thursday, January 9, 2014

MiM Mail: Overthinking medicine as a career?

Hi MIM,
 
I’m in a little bit of a predicament, hoping you can help me with. I’m a college junior, hoping to apply to medical school soon, but kind of at a difficult crossroads.
 
Let me preface this by saying that I’m 20 years old and I know that it’s maybe too soon to start thinking about children. But, if there’s one thing I know, it’s that I was born to be a mom. I’ll never admit that out loud to my college junior friends, but it’s true. I’ve always loved children, and I’ve always felt that my future kids will have to be my number one priority in my life. However, my mom gave up her dreams to stay at home with my brother and I, and the regret and resentment she feels has really affected our family. I therefore try to overcompensate and promise myself I’ll never radiate that kind of resentment towards my family in the future. But then I think, what if it’s the other way around and I start to regret not having spent enough time with them? I consistently find myself up at 4 a.m. on your blog searching keywords like “balance”, “regret”…you know, really healthy things to be thinking about at 4 a.m. …
 
I know it’s all kind of presumptuous and maybe silly that I haven’t even stepped foot into a medical school yet (to look around or even interview for that matter), and I’m already worried about these things. But the thing is, medical school is an expensive road to go down, without being 100% in it. I keep reading these terrible horror stories about people who go into medicine and drop out during their third year after having used so many student loans, ect. And for goodness sakes, it seems like every other day some media outlet is coming out with a poll about how 50% or ___% of doctors wouldn’t choose the road again if they could.
 
I keep going back and forth. Physician or physician assistant. I try to convince myself toward one or the other it seems every other week. I think to myself, “Yeah, I could work on a team. I would still be able to practice medicine.  I could still help people. I think that my time spent with my kids would make up for the feeling of not actually fulfilling my original dream. Or maybe it wasn’t my dream in the first place, maybe I’m just holding onto something I thought about when I was 12. Or maybe I made it my dream so that I would never be the resentful mother.”
 
Gosh, it’s all so confusing to me. I find myself taking screen-shots of the success stories, or “satisfied” or “happy” mom/doctor submissions on your blog, and printing it out to paste my “study” wall to help me trudge through this MCAT preparation, in attempts to keep me focused and dedicated. Can anyone out there give me insight or share some advice?
 
Sincerely,
An overthinker

24 comments:

  1. The book Lean In was written for you.

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  2. I agree with nicoleandmaggie. In "Lean In," Sanberg describes this phenomenon, of women checking out years before they need to, and denying themselves, their families, and the community of their contributions in the meantime. Don't check out before you've even started!

    I won't sugarcoat it, studying and practicing medicine is difficult. If you go into it for the wrong reasons, you will hate it and yourself. The days of men and women choosing medicine for the money or the prestige are gone. It may be a cliche, but most of us go into medicine because we are called to do it. And when you have a passion, a calling, a love for the work, that is what makes it all possible.

    With motherhood and any kind of work, realize that there is no perfect balance. It really is not any easier to be a mother in other professional careers; the mothers in finance and technology and at the universities struggle too. Many young women focus on juggling the early infant/toddler years; just remember they won't be little forever and there will be a whole new set of challenges as your kids get into school (and beyond). In my house, we're struggling with 7th grade hormones right now. That's not easy no matter what kind of parent you are!

    Whatever you choose, you will have to forge your own, unique path. And don't discount the importance of choosing your future partner in this whole endeavor!

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  3. I agree with the above posters. You absolutely can make being a mom-doctor work. And, you absolutely can make being a NP or PA-mom work. What you should be thinking about is whether or not you want to be a doctor, not on whether you can make it work.

    Each stage in life presents its own set of unique challenges. Life gets more complicated as you get older, whether or not you decide to have children. You have to learn to just roll with it. In a way, that's part of the fun.

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  4. Why do you want go into medicine? What experiences have you already had? Have you worked in a medical setting in any capacity?

    If you haven't done that, do it now, so you know if that setting feels right - if it's where you fit. That's what it means, to me, to have a calling. I couldn't imagine myself doing anything else; 30 years later, I still can't.

    We can all tell all sorts of stories about people who did and didn't go into medicine and do and don't regret their choices. No one can guarantee you that you won't regret - something. No one can guarantee you anything.

    Don't forget, either, that there are real tangible financial benefits to being financially independent, especially once you have kids. Even with loans, physicians can support ourselves and our families. I agree with Docmom that choice of partner is crucial, but bad stuff happens other than divorce. Don't discount the power of earning potential.

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  5. Just came on to say "LEAN IN!"

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  6. I'm a first year medical student and had similar thoughts before applying. However, you have to realize that no matter what medical profession you go into, you choose to make your schedule work. Sure, PA and NP do not have residencies, but residency is only ~4 years of YOUR ENTIRE LIFE. What another commenter said as well-- I can actually not see myself doing anything else, including PA and NP. I want to be the doctor people trust and can confide in.

    Basically, if you want a life with children and balance- you are the one that needs to make it work.

    P.S. My mom was a stay at home mom, and while I loved having her around, I know I would be totally out of my comfort zone staying at home and doing household things all day.

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  7. (Also, just a note: If your spouse gets transferred to Canada, you're much better off as a physician than as a physician assistant! My sister's friend is a SAHM right now because she can't get a job as a PA. You can't plan for every eventuality.)

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  8. As a college student, I knew that having kids was the one thing I was sure I wanted. My mom stayed home for most of my life, but I always imagined myself working (ideally part time). I wanted and still want to have kids starting in my 20s. I also wanted to be a doctor. I went ahead and applied to med school without really trying to reconcile the two. At the time, I did not realize how much reconciling is required in the short term (especially during the residency years).

    I ended up getting married right out of college and starting med school. I am lucky to have an emotionally and financially supportive husband. I feel ready to be a mom. At the same time, the medical system expects me to apply to residency and spend the vast majority of my waking hours at the hospital. (Based on what I've seen at my hospital, the average resident workweek consists of six 13(+) hour days. Surgical residents work more than that.) That would be fine if it just meant missing my favorite TV shows and a little sleep. However, thinking about missing so much of a child's life is distressing.

    This year, I will finally have to make some hard decisions that I have been putting off. At this stage, I regret going into medicine. I may change my mind in a few years when the choices no longer look so daunting. Ironically, I initially thought of my decision to enter medicine as a "calling", but it was all an abstract idea at that time.

    This is just my story. I will say that if you're fine with waiting to have kids until you're in your 30s and out of residency, it should be much easier. Most of my female attendings chose that route, and that's what most of the other female med students decide to do.

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  9. In contrast to the poster above I have met many women who chose to have their kids during med school. They had supportive husbands and had to have good childcare but they found school the best most flexible time. It's definitely possible!!!! I think it was fizzy who once posted about having kids when you want and working around it - vs running into issues with fertility etc when you are older. You can only have kids during certain years but medicine will always be there.

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    1. Second that--daughter number one came 5 days after med school graduation, 6 weeks before internship. She was our program "mascot," and I was lucky to have a lot of support from our attendings and the other interns, especially when I had to run out for pump breaks. Daughter number two came after 3 years in private practice. Being pregnant during medical school (especially fourth year) was much easier. I was maintaining my full clinic load during pregnancy for daughter number two, because I wanted to save time for maternity leave. It was months of misery--see a patient, run to the bathroom to puke, see another patient, repeat.

      In the end, just remember, it does get better! Nothing lasts forever.

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  10. I had to chime in just to say I feel almost exactly the same way (I'm the same age), right down to not admitting my feelings and concerns to others. In fact, I often close this blog hastily when a friend or relative is looking over my shoulder, because I know they'll say "why are you thinking about that, you're not even dating anyone".

    So thank you everyone, for your helpful advice. It is not just helping the author of the post!

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  11. Another voice chiming in to suggest the book "Lean In" . Its fantastic. I am a doctor and a mother, and wouldn't have it any other way. A long road but now at the end of fellowship I have tons of options for satisfying work that affords me flexibility as well. I'd 100% do med school again.

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  12. Shadow both PA's and NP's. I'm a surgery resident and mother to a 1 yr old. It is TOTALLY possible... IF you can roll with it and accept not being perfect at either. Plus, you never know what life will bring. What if you defer med school because you want a family but you don't meet Mister Right until you are 29 and then have fertility issues and don't get pregnant until 33? Then you could have already been done with residency... Just a thought.

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    1. This is exactly what I feel...why not lean in and see what happens. I ended up meeting my husband my 4th year of med school, getting married last year of residency, and trying for children during fellowship, and not getting pregnant until I was completely done with all my training. I'm glad I didn't opt out of any of that due to some hypothetical marriage and hypothetical family. I have other friends who are just now (mid-30s) marrying...I've got some that married during med school and had kids in residency and made it work...a couple who had kids in med school and now have all the time to spend with their really fun older kids. You don't know what life is going to hand you, so don't give up on a dream because you don't think you can "balance" everything when you don't even know yet what you'll have to balance. Sorry I feel strongly about this!

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  13. I think I agree with the sentiment of taking decisions one at a time. I was doing it the other way around -- trying to decide if getting married was a good idea when I knew I wanted to do medicine/research in the future. The best advice I got during that time was to make the decision that was at hand, and make future decisions in the future. I ended up getting married as a college junior, and a year later I'm a senior with a baby due any day now, applying to MD/PhD programs (I'm taking a year off to work on research at the lab I've been working on as an undergrad, and to spend time with baby). Having a supportive husband really is important. He's 100% on board with our future plans, and is hoping to be working from home (he's a software engineer) once I'm in med school.

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  14. Every dream has a price or a sacrifice, there a pros and cons to everything in life. It really depends on what you want out of life. We cannot predict the future (sometimes I wish I could) and you sometimes have to take a leap of faith in life. There is no decision that can ever be simple and with every decision there is always a little fear. I remember being in your exact same position and I ultimately decided to pursue my career in medicine because I took a leap of faith. The cards weren't in place, my mom was a single mother, I was an international student, and I had no hope for student loans. But I had a dream, a vision for my life so I read Hebrews 11 and I went for it. Personally it was the best decision I made for my life. Today by the grace of God not only am I physician but my sister will be graduating this May 2014. If its your life and purpose, regardless of the shortcomings of a life in medicine, God will make the dream possible for you. I have seen women balance a life in medicine with family etc and hope to do the same too by the grace of God.

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  15. I had the same fear, especially after not geting into medical school the first time I applied. I was researching alternatives mostly out of fear of not being able to have a family. My mom, who was a business executive and worked a lot when I was little convinced me to reapply. I am now ready to begin medical school in August, and four years of a long distance relationship. I think I finally decided that if I never tried being a physician there would always be a part of me that wondered if I could do it. I think you should shadow and speak to women in both roles and try and picture yourself there. No matter what there will never be a perfect time or career to manage family with. I know I am just going to take each day at a time and know that I am starting on a stable and exciting career! Best I luck with your decision.

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  17. I understand your fears because I had them as well in my undergraduate career. Recently, I was getting coffee with a friend whose mum and dad are both physicians. She was conflicted about her own desire to pursue a career in medicine because for years, her mother had expressed regret over becoming a doctor and the time it took away from the family. Worried, I asked what her mum’s weekly schedule looked like and I was shocked to realize that my mother worked almost twice as much as a nurse. My mum is an incredible mother who absolutely LOVES what she does. Growing up I never felt neglected for the time she had to put in to support our family of 9. Seeing her passion for nursing inspired me as a child to find my own passion and that is something I want to be able to share with my own children. Regardless of what career you do, your attitude towards it and towards the time you put in it can have a far bigger impact on your children than the actual time away. Good luck trying to find your calling!

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  18. You just can't plan for everything, so you're going to have to go with your gut and be flexible. I had my older two children during medical school, with the second due right after I was supposed to finish my 4th year clinical rotations. She came 9 weeks early, and needed special care after she came home due to complications. I never practiced medicine a day after graduation, but I do have an awesome career that uses my degree in ways I hadn't considered when I was 20.

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  20. I really needed to read this and all of these wonderful comments. I currently work in Healthcare IT and have been studying for the MCAT... for awhile now. Planned on taking it before my child was born 1.5 years ago. Working on getting it done this spring and applying this year. Work has been stressful and I caught myself wondering if it will be worse- but I know working in any profession and being a mother, you make it work and it shouldn't keep you from your other dreams. Thank you for all of the engouraging comments from you current physician mothers :)

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  21. I am a first year medical student pregnant with my first child. I am 10 years older than you so I knew that my desire to have children and to pursue medicine were going to have to overlap. I'm not going to say that my first trimester during my first semester was easy or enjoyable, but I survived. This semester is going much better already, so I see the light at the end of the tunnel that the upper class told us about. Prior to applying, I was also concerned about how I could make things work. For me I think two things have been key in getting to do both family and med school: 1) I have an absolutely amazing and supportive partner and 2) I spent a lot of time in the hospital volunteering and also shadowed as many physicians as would have me so I am 100% sure this is what I'm meant to do. In your situation I would recommend getting as much exposure to real life as a physician as possible. Whether you want kids or not, if you aren't completely sure that medicine is for you it is likely that you'll hate life during your first semester. It's just rough. Even when you know you want to be there, it's rough. The best thing you can do is get rid of your doubts about if you're on the right career path. You can't control when you'll meet the right partner or when you'll be able to conceive, so I agree with other posters to not put off your career waiting for a hypothetical family. If you can't decide between physician, PA, or NP, shadow them all and find the best fit. But find the best fit for you, not necessarily hypothetical future you. Life has a funny way of turning out very differently than expected, but often so much better than you could have imagined so try not to box yourself in based on what you think your future is going to look like.

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  22. I just wanted to say..thank you for all of the posts and comments. This is 98% my current situation. I have slowly come to realize, and my idea was reinforced here, that you cannot plan for a hypothetical future. I don't know where I'll be 10 years from now. I know where I'd like to be, with a child, or at least one in the near future, but I have no idea if that will happen. Which is why, in this current moment, I realize I want to go to medical school. It's really scary, but...as someone one said, "If your dreams don't scare you, they aren't big enough"

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