I need some advice.
I’m a 34yo IMG who graduated and returned back to the USA a few years ago, keeping busy with research and odd biomedical-related jobs, but I’d basically given up hope that residency (and medicine) was in my future years ago. During that post-graduate time I also met and married the love of my life. We’ve been trying to start a family for the last couple of years, but were eventually diagnosed with unexplained infertility. It’s been incredibly frustrating – we’re both perfectly physically/genetically healthy and under 35, but what happens so naturally for others just wasn’t happening for us.
Over three months ago, in December, an opportunity fell in my lap to interview for a one-year preliminary position in Internal Medicine with a large community program that is currently not in the Match. The interview went well, I was immediately offered a position, and signed a letter of intent on the spot. During that time, knowing that we were not getting any younger and you just never know what the future holds, we decided to progress on to IVF. First attempt was a bust, and absolutely emotionally crushing for both of us. Then last month we transferred a couple of frozen embryos into me, and yesterday I got the results from my first beta-hCG blood test – big ol’ positive! In fact, it’s looking like it might well be twins (instant family!). I’m still being incredibly cautious about my optimism, but we’re both certainly happy at the news.
So now I’m left wondering how to handle this upcoming prelim position; they sent me my contract a couple of weeks ago, but I admit I’d been dragging my feet and sitting on it for a while, wondering how this whole IVF thing would play out and how I could/would juggle the two. In an ideal world, I could talk to my program director (who is incredibly nice, so far) about the possibility of starting this one-year gig next year (they’ll still need interns next year, right?). I know this is a job, not some schooling I can defer, but it seems, based on anecdotes here on MiM and elsewhere, that it’s a remote possibility. That being said, I know I’m incredibly replaceable, and I already got the sense that I was offered this position out of pity. My husband and family and friends say to sign the contract (otherwise I lose leverage) and then discuss the pregnancy with the PD and hope for the best. Meanwhile I’m worried that once I sign the contract, I enter into a binding agreement for the year, which makes it difficult to potentially postpone it until next year (if that’s an option). I wish I could discuss it with my PD, but I’m afraid of scaring him away to the point he’ll just decide I’m too much trouble and just walk away.
Maybe I’m just over-reacting, but I’m really not looking forward to the idea of basically spending the last two-thirds of my first pregnancy as an IM intern at a busy community hospital. I know from stories that internship and pregnancy by themselves can be physically and mentally difficult (and frankly, part of me fears them both), so to have to deal with them concurrently – especially as a ‘geriatric’ pregnancy, possibly with multiples – is just NOT something I’m looking forward to dealing with. It’s particularly worrying for me because I know this is an opportunity for me to shine and potentially continue on within the field of medicine, but I have the very real concern that I will simply not be at my best if I’m pregnant during internship and therefore not do my future any service.
I know I put myself in this position, but I'd welcome any advice!