Tuesday, December 27, 2016

MiM Mail: Fourth year pregnancy?

Hi there!

I am currently a MS3, married to an amazing husband for the past three years, and strongly considering pathology. We would like to have a child in my fourth year. The question for us is when to start trying and hopefully have the baby, and to maximize our chances of having the child before intern year.

Our original plan was to start trying this summer, with the hopes of having a child sometime between March and May. But I'm not sure how that would work out with having a newborn as an intern. I would really like to avoid being pregnant during my intern year (or just residency in general) as well, and so I'm also worried about the short window that gives us to try for a baby.

I do not have any familial support where I live, and I'm not considering residencies that will be near family (they live in an incredibly expensive city and have very few programs around them). Our plan for childcare is my husband quitting his job and becoming a stay-at-home dad - any money he would make by keeping his job would probably not cover the cost of daycare.

At my school, we get two months off for vacation, one of which is mandated in the winter months for interviewing. I believe I can also have two more months of light rotations as well, giving me a total of 1-3 months to spend between my interview period and infant-recovery time.

So here are my current pros and cons for having a baby earlier (Fall-Winter) vs. later (Spring).

Pros for having the baby earlier:

Will have an older infant by the time intern year starts.
May be able to avoid interviewing pregnant.
More time to get pregnant.
May be able to still use my vacation months during interview season if I have my child around that time.

Cons against having the baby earlier:

May have to interview very pregnant or be at risk of giving birth.
Will probably be very pregnant during possible audition rotations.
Will probably need to have my husband quit his job (or scale down to part time) to take care of the child while I am on rotations.
Will be taking Step II pregnant.

Pros for having the baby later:

Husband can keep his job at full time for longer, maximizing our income.
Might be able to stack my rotations so that I can have 3-4 months "off" or with light rotations to be with the baby until residency.
Avoid being pregnant while taking Step II.
Will be less pregnant during interview and possible audition rotations.

Cons against having the baby later:

Will have to interview pregnant.
Stacking my light rotations and vacation at the end of the school year may make it so I have less flexibility when interviewing for residency.
May not get pregnant in the short window we have.
Would go through intern year with a <3 br="" mon="" old.="">

I would love any feedback on my tentative plans - which of these are important vs. not so important? How difficult is it having a 3 month old vs. a 9 month old baby during intern year? - and what you would recommend for my husband and I. Thank you!


  1. I am so impressed with your planning! I had two babies during residency > 10 years ago and I just did it without thinking. It was rough. I personally would avoid being super pregnant during interviews. It should not be a negative, but unfortunately it is. It screams you're not going to be plugged in, even though I found myself to be much more efficient and focused once I had children, all the way up to being chief resident. Faced a lot of discrimination, though. I did Step 3 pregnant and it was a breeze, but I had very easy first pregnancy. And go pathology - such a great lifestyle balance to be a mother. Having said all that - I would just go for it. Things tend to work out the way they are supposed to. It's not an easy road, but a very rewarding one. Having a supportive husband, as KC says, is the key, and it looks like you've got that. Good luck!

  2. A few things come to mind to consider: my initial thought is to go ahead and try to have the baby in your ms4 year, as early as possible. Ms4 is the easiest year you will have for quite some time! (but i make a complete 180 by the end of the post!)But then I was thinking when would you try for a sibling? It seems you will be child bearing during residency for sure if you plan for more than one. That is tricky. You may cause scheduling issues taking time off as a resident, this may affect your Co residents who will cover in some ways. And residency is a full time plus endeavor. Looking back I can't imagine getting through it with small kids but of course people do! And it is usually possible to extend training to make up for time lost. If you wait past residency, your time will be worth much more financially so taking off 3 months will be a much larger financial hit. The stay at home dad thing is great but has its own pitfalls so be ready! It's a whole different world when there's actually a baby and sleepless nights and guilt on both sides. After saying all that I wonder if you'd consider waiting until your career plans are more solid. I did wait until I was an attending, a year and a half in, before I had my kids. I was able to save for the months I took off. It was a relief to know I was settled in a home and career before becoming a mom. And your husband could work through your residency and support you so your loan burden/financial situation is maximized when he starts watching the baby...I know your heart wants a baby and it's great you are thinking about all the angles. Best of luck!!!

  3. This is such an exciting time for you! Many MD/PhD students tend to have their children in the last few years of medical school and residency because we generally cannot wait until becoming an attending. That being said, our administration happily accommodates mothers and fathers during the final medical school years and plenty of friends have had their children in residency. This is life and in my view, if you and your husband are in this adventure together, do what feels best. Perhaps you could try now and see how it goes (sometimes it takes longer than we would like) and take a few months off to avoid the inability to fly due to late pregnancy during interviews and restart trying again when it works out for timing. Like they said above... it tends to work out the way it should: planned or unplanned! Good luck - the chaos and struggles are so worth it!

  4. Or maybe take a gap year to do reasearch if the timing doesn't work out perfectly. We medicine people tend to think if we just try hard enough we can make everything work out perfectly, but you will likely see that children have a way of shoving that notion right back in your face. Good luck either way! Btw there is nothing wrong with spacing more than 4 years for siblings, or even with (gasp!) having only one child if that's what you want.

  5. I'm a current pathology fellow and it seems like just yesterday I was in your position! I had my first baby in March of my MS4 year. It worked out so most of my interviews were before I was obviously pregnant. Plus, my school was very flexible and let me save all of my vacation for the year, so once I had my baby I was pretty much done with med school!
    Starting intern year with a 4 month old isn't easy, but frankly, intern year isn't easy no matter what. I had my second baby at the end of PGY2, and like Giz, I ended up chief resident.
    Honestly, if you and your husband think you might be ready for a baby, just go for it! There's no perfect time, and it will be hard no matter what. But good too, of course :D Good luck!!

  6. I was an older/non-traditional student and had my first baby at the beginning of MS4 year. My husband was an MS4, too. There were a couple of hard months but overall the year was so much lighter and more flexible than this year (I'm an intern in pediatrics). And also, you have holidays in med school!!! It worked out GREAT. So, my personal experience leads me to say go for it as early as you possibly can! Give yourself plenty of time in case it takes longer than you think. As mentioned above, you could take a break in trying for a couple months so that you aren't setting yourself up for a December/January during interviews due date.

    As far as sibling spacing- we are planning to wait until fellowship so we'll have at least a 4 year spacing. I also know I might have problems conceiving the second time around and end up with a single child family. My husband and I decided we were ok with this possibility, particularly as waiting until we are "done with training" to have a family could lead to no children at all! I have spoken with older women in medicine who were unable to conceive once they ultimately tried- who knows if they would have had success earlier on, but they had regrets about not trying sooner. Those stories really spoke to me.

  7. I think medical school is a great time to have a baby! I had several friends who had babies in medical school and the flexibility in time off, holidays and weekends, and support are unparalleled. I'm now a PGY4 and am trying for baby #1 and have a lot of hurdles. I am also in a surgical residency which muddies the water further.
    If I've learned anything from life, this blog, etc its that you have to do you! There will never be a good time so whenever you are ready is the right time.

  8. Good job on choosing pathology! I knew several people who had babies during medical school and a lot more who had babies during residency. I waited until I finished training and was an attending before having a baby which was the best decision for me though it doesn't sound like you are thinking about that. I felt like by waiting until I was finished with everything I had enough money to not have to worry about affording childcare and I have ultimate control of my schedule. I would probably try to avoid having a baby first year of residency. This is when you'll have the longest hours as a path resident and the least control over your schedule. It would be easier with a stay at home spouse though. Good luck!

  9. There is so much to think about! My husband and I just went through this as well.

    I am an MS4 about to graduate and had my daughter last summer. She's 7 months old now, and will be nearly one when I start residency this summer. I was able to complete nearly all of my MS3 rotations and a couple MS4 rotations while pregnant (not easy, but doable). I also took Step CS and CK a week apart, around my 32-33 week mark.

    Having some extra vacation time built in (along with research electives and online classes) really helped me establish a great breastfeeding supply and a close bond with my daughter. I am so grateful for the flexibility that is the MS4 year.

    If you do have a baby pre-interview season and decide to breastfeed, you will have to find places to pump. At first I was hesitant to ask residency coordinators for accommodations, but quickly decided that any program worth ranking would be one that supported breastfeeding.

    Whatever you decide, good luck!


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