Thursday, July 23, 2015

MiM Mail: What happens to friends and family?

Mothers in Medicine,

I'm a pre-medical undergraduate from Boston, entering my junior year. I aspire to be an Emergency Medicine physician. I'm finished with my pre-medical coursework, and the next step is taking the MCAT this Spring.

For the last two years, I pushed through my studies, blissfully ignorant to how my future career path may be incongruent with my deepest desire in life: to have children. So I'm writing to you because I aspire to practice medicine, but I'm held back by the concern that the doctor-mom work-life balance may not be right for me. I close my eyes and picture my future: My time is divided between my family and my career. I'm laden with guilt for missing pieces on either end. I'm in a perpetual state of "rushed."

I've been hunting through the Internet, and it seems as though some women in medicine feel this way. I'm attempting to be a nonpartisan hunter, because in the past my confirmation bias has prevented me from considering all of the information important for my decision.

I recently came across this website, which lists the 10 things you need to give up when you become a doctor. To be honest, I was disturbed by number six:

6. Your desire to always put friends and family first
As a doctor your job usually takes priority and you simply cannot shirk your responsibilities simply because you have prior engagements of a personal nature. Over the years I’ve known many difficult situations including a colleague who had to turn down a role as best man for a close friend because nobody could swop his on-call weekend with him and the hospital refused to organise a locum to cover him. Apart from sickness or bereavement, your first priority will be to your profession. Your friends and family may find that difficult to understand at first. They’ll come round to it with time, especially once they delete your number.

OK, so the author is a bit brute with the final comment, but as a general idea, it's that on the priority list, your career in medicine trumps the important relationships in your life.

After reading this, I thought to myself, "Well, shoot." This makes me squirm. I know in my heart that I would never be able to put my career over my family, in a general sense in life. But then I think, if any career were to necessitate this, it's medicine. It should be number one because it can be life or death; it's a privilege and a commitment.

I bet when number six plays out in reality, the choice between them is theoretical and it's all about balance. But the author does provide a concrete example of choosing between the two (with wedding example, above), and in that case, would I be able to choose my job? So... number six moves me to deeply consider my career options.

I 'd like to ask you guys how you feel about number 6. Are you saying, "Yes, medicine requires a commitment that may harm relationships, more so than other careers" or "No, you don't have to choose being a doctor over being a mom, no more than you would with any other demanding career," or "I never feel as though one is of more importance to me than the other" or whatever it is - I'd love to hear it.

Thank you so much for your time, I'm so happy to have stumbled upon your website. You are all inspiring. Wishing you the best in your dual careers.

Love and blessings. J


  1. If you read the recent posts on this site, the answer is no-- all women feel guilty all the time for ever putting their kids in daycare and it is terrible and horrible and everybody should go into nurse practitioning instead (which is also a fine choice, of course). This is like the worst site in the world for people who want to be professional women and mothers to read.

    If you read the comments, however, because this topic has been addressed about a zillion times in the past few months, and if you read actual blogs (not the ones on the side-bar, but ones like the SHU Box), or socialize with doctors IRL (my son's best friend's parents are both doctors, and she's a surgeon and they throw more parties than anyone we know, just not when they're on call), it is difficult to see or understand where all the catastrophizing is coming from. I suspect the patriarchy is involved and this website has just hit a negative equilibrium where it is uncool to write about how you're actually doing just fine balancing life and work because of all of the people who write who feel like they aren't. Or maybe it's just that people in residency really do have a lot more demands on their time than people who are established doctors. It's hard to say.

    In any case, there's a lot of great careers out there besides being a doctor and there's nothing wrong with good quality childcare. It takes a village.

    1. Thanks for reading. The thing about this site is that it allows people to voice their honest feelings and find others who understand. Working mothers' guilt is a common experience. I'm glad you don't feel that way and encourage you to contribute positively to this discussion about your experiences. Alternatively, there's clearly a lot of blogs out there you enjoy - please go ahead and do that. The great thing is no one is forcing you to visit this blog.

    2. KC, thank you so much for your reply to nicoleandmaggie. I found her comment to be condescending and unhelpful. As a physician mom, I have been following this blog for several years and have found comfort in reading about the experiences of other fellow physician moms. So keep posting these posts! As you pointed out, no one is forcing anyone to visit this site.

  2. No, you don't have to choose being a doctor over being a mom, no more than you would with any other demanding career
    -And just like any other (demanding) career, there will be times/phases that are more or less flexible. I think the site that you mention is very pessimistic and more than just #6 are inaccurate.
    - It does take a village to have a family -period-, and that's not a bad thing.
    - In medicine, there are a million different directions that you can go, including some with no/very little "call" so the scheduling conflicts that are suggested just don't exist.
    I personally have a job with quite a bit of call, but that's what I chose and we make it work with my family(husband&3kids). I also have been home for every birthday cake and graduation - it just takes planning/scheduling.

  3. Like Brig said, at this stage---as an attending---I do not find that being a doctor precludes being a good mother/wife/friend/whatever. Residency was a different story. But it was a finite moment in life and on the other side, I don't regret my choices. Once residency was over, I rarely missed a special event because of call. Planning is key. Do I miss non-special events? All the time, but what working mother doesn't?

  4. I read that entire blog post and that writer is bitter or angry or not happy or something else.

    My rebuttal:
    #1 wealthy no, but never wanting financially, certainly never poor.
    #2 change the world, maybe not the whole world, but you change the lives of every single patient (good and bad, hopefully mostly for the good).
    #3 free weekends - okay - that you you do have to give up - but scheduling can always be done to accommodate things. it's harder in the training years but easier once you are out.
    #4 good night's sleep - you're a mom - that's never happening again anyway, haha, no, this is temporary and eventually you do get your sleep back, as a mom and as a doc, there might be less nights of good sleep (but still sleep), unless you are a worrier - then I can't help you.
    #5 feeling like a fool? THIS IS LIFE! everyone feels foolish no matter their profession because no one is perfect.
    #6 sometimes the doctoring comes first, sometimes the family/friends. I have lost no friends worth keeping because I'm a doctor.
    #7 who pleases everyone all the time? again, not perfect, no matter the profession
    #8 I have parties or go out all the time with my fellow ED and non-ED docs. some of our spouses are in medicine, some are not. my hubby is particularly squeamish and cannot be in conversations about medicine for very long. this has never been a problem with keeping a conversation going. we actually paid the babysitter overtime recently because we were having too much fun and lost track of time. and if you want a creative practice, pick a speciality that allows that.
    #9 you might not find your ideal job in the location you want. you may settle for less money or more call or something to stay in an area. you may move (like I did) for the perfect job. i certainly after completing training could choose where to live. (also true for any profession.)
    #10 get a doctor like everyone else. go to a yearly physical. be mindful of the tendency toward mental health issues and don't be afraid to get help if you need it.

    that blog called "doc eat doc" for a reason.

  5. Dear Med-Student,

    here does one start...the truth, ah...yes that's where all good scientists and physicians must must begin. so let me be brief and direct:

    1. Family >>> Work. Of all the things we struggle to obtain, money, sex, power...etc. There are only 4 worth fighting for: Truth, Justice, Love and Freedom. If you spend your time for anything else in life, consider it wasted.

    2. to understand why people work for money, one must research the question "what is money?" I suggest you goto youtube and search under how money is created, the fractional reserve banking system, the money changers, fiat currency, bitcoin and of course the Federal Reserve System. Once you understand what is money and how it is created to enslave you, you will begin to understand the magnitude of your (and our) struggle.

    3. Understand the nature of your womanhood and what it is you truly wish to obtain (Know yourself.) It is my opinion that the Powers which control the World have undertaken a covert and sinister war against the women's reproductively and the Family. There is ample evidence that the Rockefeller foundation was largely responsible for the funding and media attention supporting the women's / feminist movement (aka feminism). This was largely done for 2 self-serving reasons: Prior to "women's liberation" only 50% of the population could be taxed. Working women = more taxes in order to support the exponential debt of a fiat currency based economy. Working women meant unattended children. Children, who were once jealously guarded by their mothers were now willingly delivered into the "care" of mostly state-run day care and school systems -- which is another story and dimension of deception altogether.

    4. Most docs work VERY hard. We are use to it, conditioned by it and almost numbed to its overwhelmingly detrimental effects. We work so much and so hard that most of us never stop to reflect on "why?" The "real" reason is that most of us are fairly intelligent people, and if allowed to think freely, we might just figure out the fraud which has been committed against the American people and the Peoples of the World, and RESIST. So again you ask, why do we work so hard then, and what are we really working for? ... The Answer: we work for the BANKS.

    5. By now you are probably thinking how my argument is completely unintelligible, but use your own mind, forget the vapid mass media "programing" that you have been exposed to all your life and do as all good scientists and physicians to: seek truth from facts and conclusions from the rational and rigorous analysis thereof.

    Here is a list of things to start your own research:
    how money is created, the fractional reserve banking system, the money changers, fiat currency, bitcoin, the petro-dollar system, the Federal Reserve System, the birth certificate and Edward Mandell House, human farming, "peak everything," jurisdiction (or the lack thereof), the truth about school, trust law and how you don't own anything, not even own your children or your own name ... the "story of your enslavement."

    Awake, Resist, Good Luck.

    Anonymous M.D.

  6. Agree with the comment that the writer of that "doc eat doc" post is bitter/angry and that many of the things listed 1) aren't unique to medicine and 2) aren't as bad/dire as the writer paints them.

    As a peds ED attending at an academic hospital, I certainly work hard. But I can also arrange my schedule so I'm home for birthdays, important school events, family events and even things like concerts with friends. Yes, there are things I miss and evenings/weekends I have a shift when I'd rather be home. But that's not unique to my job, or even medicine. And while I may not be changing the world, I am able to impact the small piece of it in which I live in a way that I find very satisfying and meaningful.

    Regarding #10 - I've found it's important not to just keep an eye out for mental health issues, burnout, etc, but to work on actively preventing them. I get a massage every 4 wks on the nose, go to yoga regularly and make time for life outside of medicine. I feel much better, both physically and mentally, when I do these things. Find what works for you and make some time for it.

    Overall, there are days when I'm not so happy about my job (those night shifts, for sure!) and it's not the easiest path sometimes, but being a doctor and a mom are 2 very fulfilling things that aren't mutually exclusive. If it's what you really want to do, go for it!

  7. I'm an Emergency Medicine attending now 2 years out of residency; I have 2 toddlers at home and an amazingly supportive stay at home husband. I definitely missed some big family events during residency, when I had much less control over my schedule and worked longer (and more unpredictable) hours. The nature of Emergency Medicine means I have to work nights, weekends, and holidays so there are moments I miss out on. Every group handles things differently, some make the new grads work a bunch of nights, weekends, and holidays until they get some seniority, my group does a rotating holiday block schedule for everyone, and then individual providers are free to make switches if desired. Since becoming an attending, I have been able to find coverage for all of the events I felt were very important to be there for. If you are going to feel like a failure by not being there for every Christmas, Thanksgiving, etc then you are going to have a hard time finding a suitable job in EM (or pretty much any medical specialty for that matter), but if you are concerned about whether you will be able to be there for the BIG days, the shift work nature of Emergency Medicine makes it fairly easy to obtain needed flexibility in the schedule, as long as you join a supportive group with enough physicians to cover for any unexpected gaps in the schedule. The closer you get to solo practice, the tougher it is to have flexibility in any specialty. Whatever speaks to you during your rotations, there is a way to make it work with family, although some paths will require more support either from your spouse, family, or hired help and/or more financial sacrifice (part time, etc) to find a balance that works. I work 15 shifts per month, 10 hours each and make a good living; most of the docs in my group work closer to 12 shifts each month as they are further out from residency and have those massive loans paid off. I think any job you do outside of the home will have days where you wish you were home. I missed my daughter's first steps while working a horrendously busy shift, which I watched on a shaky iPhone video later that day. But, my husband the stay at home dad missed our son's first steps while out to dinner with some friends so even choosing not to work doesn't mean you are there for everything. My best advice is to just find something you love to do (whether that is emergency medicine or something else) rather than making a choice based only on perceived lifestyle. Residency sucks for every specialty, but it's temporary. But, it you are going to be away from your family to work, you might as well do something that is at least intermittently awesome

  8. It's not unique to medicine and once residency is over, it gets much better. I missed two weddings when I was in residency and I was supposed to be in both wedding parties - that wasn't just because it was residency but because I was in CA and the weddings were on the east coast. The travel time and cost of the tickets made it impossible. Both women are still good friends and neither of them has ever held it against me. Since then I haven't missed anything essential.

    Even in residency, my schedule wasn't the biggest block to a social life - my husband the science graduate student had it much harder than I did.

    I have had to tell my daughter that I couldn't do things because I was on call. She survived. I survived. I've also had to tell her I couldn't take her places because I'd made plans with friends. It's not the end of the world to say "no" to your kids.

    Residency is temporary and lifestyle can be managed in almost every specialty. Do what you love. Don't feel guilty about it.

  9. I think the short answer is that life isn't perfect. It never will be and that's true of any job you do and any specialty you choose if you did become a doctor.

    However what is also true is that medicine has so many different specialties that I'm sure if one spent time searching and finding out you could find one that would suit (most) of your needs.

    I'm an attending and a new mother who is blessed enough to have the best bosses in the world who have allowed me to work part time for now. It's tough still but I haven't missed any significant milestones and most of the time when I'm at work baby is with my incredibly supportive mother.

    Granted not everyone has that kind of support in and out of work and I still have many bad days where I'm torn between doing more at work and rushing home to baby. Or struggling with little sleep as I try to bulldoze my way through an overbooked clinic.

    But you know what? Nothing about being a doctor or a mum is easy. That's the truth. But are they both awesome jobs? Yes they are. What you have on your side is the fact you know what you want. So you can plan. Figure what specialties suit you early. Figure out when you want to be a mummy. There are pros and cons of having kids while training and the same for having them after.

    Things kind of just happened for me but I think planning ahead means you can get what's best for you.

  10. I work 3 days a week in family medicine, have no call, and 5 kids :). It took a while but I found a situation that works for me!

    1. That sounds like my dream life! (I am starting my first year at a Canadian med school in two weeks.)

      If you would be willing to share a little more about what kind of situation this is (so I can be on the lookout for it) I'd be very appreciative!


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