Showing posts with label MiM mailbag. Show all posts
Showing posts with label MiM mailbag. Show all posts

Monday, June 22, 2015

MiM Mail: Medical school timing

I have wanted to pursue medicine since first being exposed to it in nursing school. Throughout nursing school and my career as a nurse I have had a desire for the knowledge, skills, decision making and leadership that comes with being a physician.

I will be finishing my prerequisites in the fall and can take the MCAT in the spring with the potential of going to medical school in 2017 with an almost 3 year old and 16 month old. (I am currently 8 weeks pregnant!)

My question is, should I apply as soon as possible or should I spend a few years with my babies while they are still babies? Would it be easier to complete school if my wee ones are are at least potty trained?

A handful of physicians encourage me to do NP, CRNA or PA but I know I won't be satisfied as a mid level. On the other hand I'm not thrilled about all the time I'll be missing with my babies!

I'm 27 years old and my husband is very supportive. We could also get a nanny at any time if needed. Looking for some words of wisdom from those of you who have gone down this path! Thanks!

Wednesday, May 27, 2015

MiM Mail: Adoption advice

My husband and I just found out via my new, shiny, residency contract that my program (4-years long, medical (not surgical)) offers a significant perk of paying about $10k in adoption fees for employees and their families. We've always talked about becoming foster parents or adopting in residency or just after, but we never realized it might be to our advantage to consider doing it a bit sooner (maybe around PGY-3 or PGY-4?). I'd love some advice from anyone who's done either of these things.

Some background -- my husband is a superstar; he's in education and has been a teacher or school leader throughout our marriage, and found an awesome job in the city we're moving to. He's also planning on starting a doctoral program part-time online, to finish when I finish residency. We're open to staying for a chief year or moving for a fellowship, although I want to do primary care and so doubt I'd do that. Obviously, all of this stuff (my husband's schedule, his doctoral stuff, being a resident) is flying around in my head, and this decision is certainly not urgent, but we got excited at the idea that we could pursue something that's long been a dream of ours, and during residency training! Anyone have any advice for an ideal time to do something like this? Has anyone else ever done so! (Obviously, there is no "ideal" time, but some are better than others, and I figure 2-months into intern year isn't one of them!).

Thanks for the tips!

So thankful for this community.
- Future mom and east-coast resident, currently box-packer and barely-a-physician in the midwest

Wednesday, May 6, 2015

MiM Mail: Feeding a family

Another long day in the life of a resident, and I find myself at home wondering what to feed myself and my family for the next week. Hubs is willing to help, but lacks creative energy in the kitchen most days and doesn't like to spend much time prepping a meal. Munchkin is young enough to be happy with basic staples pulled out night after night, though she does express boredom at times and I prefer to introduce a variety of foods.

I found an app with associated website this weekend that will let me plan a menu with recipes and create a shopping list. I'm hoping with less call in the upcoming year that we will be able to eat more intentionally.

How do you keep your family fed? Do you plan ahead and shop for your weekly menu? How often do you sit down to a freshly cooked meal, and how do you get it done?

-One Hungry Mama, aka Ladybug

Wednesday, April 29, 2015

MiM Mail: Planning for baby #2

I'm a resident, wife, and mom to one, hoping to have one or two more children. My first was born during intern year, and we're planning for a second during residency. With my first, I ended up with multiple third trimester complications that eventually led to 2 weeks of bedrest and delivery a month early. I've been an avid follower of MiM since before my first pregnancy, and I'm hoping for advice and encouragement from some of you.

I'm in a field that requires a separate intern year and am now working with people unfamiliar with my first pregnancy. All they know is what I choose to tell them. I think my current PD knows I had complications, but not the specifics. Thanks in part to an amazingly supportive PD my intern year, I finished PGY1 and started PGY2 on time. From a residency timeline I'm right on track, and I have some sense of when the "best" times could be to have another baby during my program. We'd end up with about a 2.5 year spacing. Our preference would be somewhere closer to 2 years rather than 3.5+.

My spouse is great with baby #1, does a lot around the house, and picked up a ton of slack during my first pregnancy. It was hard, but we made it through, and my upcoming schedule will be easier than it was last time.

Medically, my odds for the healthiest possible second pregnancy considering my complications are higher if we choose not to wait until after residency. Besides, at that point I'll have written and oral boards and be trying to establish myself in a practice, so I'm not convinced it would be much easier.

In many ways, I feel like I'm between a rock and a hard place. When I think about attempting #2 during residency there's a part of me that wants to believe we'll make it through just fine, but the realistic side of me expects a great deal of physical, emotional, and mental strain. I wasn't deathly ill, but it wasn't fun, and both baby and I could have gotten very sick very fast. I expect to deal with some problems again, but hopefully not all, and hopefully not the one that led to bedrest. I'll be meeting soon with a new OB to talk through everything.

I don't want to sell myself short, and if I feel like having a second soon would risk compromising my training. On the flip side, ultimately we don't want to stop with one kid, and waiting would only compound my risks. Jumping to adoption is not the right answer for us.

Where we are now, we have a lot of support outside of residency. Even if we move after training, it makes sense to have another baby while we're here. I think there would be support from my program, but I don't think it could be as robust as it was with my first. My previous PD was amazing; few could measure up. My peers have verbalized a mutual intent to help cover for each other when circumstances arise including babies, but I haven't gone into details of my first with them and don't care to unless it becomes necessary. I don't see how they could understand what I was up against, or how it would help to talk about it right now. I sure hope I don't need weekly or twice weekly appointments until the last short stretch, but we might end up there again.

I guess I have an idea in my head that if I do decide to pursue a fellowship and don't finish residency on time, I can look for a job for a year, maybe a couple years, and then continue training. I may also be happy without a fellowship. I know people say it's hard to go back to a resident's salary (or worse) after being out for awhile, but we could knock out a lot of debt in a year or two and be in a better place for me to take a pay cut, even with 2 kids in daycare. I don't think the financial side would prevent fellowship down the road if I wanted it.

Anyone have advice for how, when, and what to communicate to my program and my co-residents if we do get pregnant again? Thoughts on trying during residency with high probability for some (manageable) complications vs waiting and dealing with recurrent and possibly worse complications? What else do we need to consider? Anyone else make it through a difficult pregnancy without feeling like you lost your competence as a physician?

Ladybug

Thursday, April 23, 2015

MiM Mail: Part-time residency?

Dear Colleagues and mothers,

I'm a final year IMG who, just like my husband, soon am about to apply for residency. The thing is that I am also a mother, and that's why I'm now writing here. I consider myself ambitious and strive to become a well-educated and good physician one day. However, my role as a mother is also of great importance to me and the responsibilities and duties I feel towards my daughter is something I cannot ignore. I strongly believe that I should not have to choose between career and family, which is why I wonder if anyone has any experience of so called "part-time" residency? Is it possible to get such an agreement anywhere? Where could I find more information about this? Also, would these requests lower my chance to match?

I'm interested in paediatrics, and with "part-time," I mean about 40-50 work hours per week instead of up to 80. Naturally I understand that such a "reduced schedule" also means a longer residency and lower salary, which I do not consider a problem.

I really appreciate all the help and information I could get!

H.P.

Thursday, April 16, 2015

MiM Mail: Having children with both parents in training

Hi Mothers in Medicine,

I am a longtime reader of the MIM blog, and really appreciate being able to read your stories. You are inspiring! I am writing to request advice, especially from those who had children during medical training with a medical spouse (or spouse with a very demanding career).

I am nearing the end of my 1st year of med school, and my husband is a resident in a surgical subspecialty, with 4 more years to go. We would love to have a large family (4-5 kids), and are a bit older than the average med student/resident so waiting to have kids until after training isn’t realistic. We are ready to start our family, but I am a little nervous about being the primary caregiver (with outside help) as a medical student. I know that my husband will make a wonderful father, but given his 80 hr weeks at the hospital he won’t be able to contribute as much time-wise. Having kids is super important to us, and some days I question whether medicine was the right choice for me, but I am doing well academically and I think I am on the right path.

Our tentative plan (acknowledging things don’t always go as planned!) is as follows, and I would love to hear your thoughts about pros/cons, other ideas and tips on how to make it work! We are considering aiming for baby #1 at the end of 3rd year. I would like to take a semester of maternity leave, then complete my year of elective rotations (daycare or a visiting Grandma for childcare), have baby #2 and take another semester off for maternity leave before starting residency. Has anyone tried to/ succeeding in taking 2 separate semesters off rather than a year at once for maternity leave? Is completing 80% of my clinical rotations while pregnant realistic? Any advice about the timing of clinical rotations? I hesitate to talk to my school’s administration, when did you approach them? Is starting residency with a 2 yr and 6 mo doable? Is it really possible to do a “part-time” residency? How difficult is it to take the full 12 wks of FMLA for maternity leave during residency? Am I crazy for thinking that this sounds like a reasonable plan? Have you been through something similar and barely survived, or were you able to thrive? Any advice would be greatly appreciated!

-K

Thursday, April 2, 2015

MiM Mail: How are your kids that grew up with a Mother in Medicine?

Hi MiM,

I am an M1 with a 7 month old baby. I was so excited to start but phew, it has kicked my butt. I have great childcare and a very supportive partner but I struggle with constantly feeling behind - behind on house work, on study, time with friends. And of course, my sweet daughter. I worry a lot - is she going to be ok? Will she still be strongly attached? Will I miss being home with her more when these "little years" have passed? I would love to hear your thoughts on these. Not so much "mom guilt" but for those whose children have grown up while they have had a career in medicine - how is your relationship with them ? How are they? Do you regret being gone? Any tips as to how to treasure the time you do have without being bogged down in the never-ending "to-do" list? I spend my days off with her trying to do laundry and purée baby food while longing to just play. Balance is hard and I'm feeling the tension.

A

Monday, March 30, 2015

MiM Mail: Pressing advice needed for an IMG

Hi MiM,

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!

Thanks,
DrDel

Monday, March 23, 2015

MiM Mail: Ever too late for medicine?

Hello, I am a 34 year old working mother of two young children (3.5 years old and 14 months). I have been working as a research scientist in the pharmaceutical industry for a number of years now. I have been thinking of becoming a doctor since 2005. I applied to one local university in 2012, received an interview but was put on the waiting list thereafter. My husband is very supportive of my decision to pursue medicine and I would like to reapply at some point in the future. There are a few things holding me back from applying any time soon though. We would like to try for a third baby before it becomes "too late" age-wise. Also, I'm realizing more and more that I like to be heavily involved in my children's lives. I enjoy the home-making side of my life very much and I find it difficult being apart from them for extensive periods of time (my current job is about 40 hours a week and I'm ok with that because I get to have dinner with the family, put kids to bed and have weekends with them). I very much want to pursue medicine but I'm so scared of losing the family side of my life and that I won't really be a part of my children's memories if I'm busy in medical school and then long hours in residency and as an attending. I have no problem studying (I love it!) and working hard, but I want to be there for my family. So my question is, would it be completely unreasonable to postpone medicine for a few years, maybe 5? 10? Or whatever it takes for me to feel that I have nurtured my children to the point where they are ok with me not being there often? (I have heard of women successfully entering medicine in their 40s and even 50s). I have no idea when I would feel "ready," and I know that age can be a factor when you want to pursue certain specialties, but I'm actually interested in family medicine with a focus on OB. I'm just having a hard time envisioning myself being both a good mummy and a good doctor at the same time. I feel like one area will suffer, and for me, my family is my top priority. I have several doctors in my extended family and have talked extensively with them but they are all males so I have not had much female perspective other than what I have been researching online and reading in books. I would really appreciate your feedback on my dilemma. Thank you so much for your time.

Monday, March 16, 2015

MiM Mail: (Un)happy match day - "It doesn't matter what YOU want"

As match approaches, it is with a heavy heart that I await the results.

This is a story which has been culminating over the years, and in fact, I have many unsent emails addressed to MiM which tell the tale. I am a 4th year medical student with two girls - a preschooler and a toddler. Both of these I gave birth to during medical school (I "took a year off" and did an MPH between 3rd and 4th year). I am married, and it is not a match made in heaven. Few relationships are perfect, but I feel like ours has some really deep underlying issues that perhaps make it stand out. We had a fun relationship in the beginning - but we got married more so because of an unplanned pregnancy. We were legally married in a courthouse. It was important to him to get married prior to the birth because he was already plotting his custody rights. I didn't tell my mother, who would have counselled me against it (and she would have been right), and none of my family or friends were in attendance. I worried about our significant age difference, but he promised me support, and we framed the relationship in that way - he has no competing career, which frees me up to pursue mine while having a secure family life. (Perhaps something like this.)

I wanted to send this story in because the title of the previous mailbag letter, "Whose dreams come first?" struck me. The reason that this resonated with me so much is that my husband told me when I was explaining my rank list, "It doesn't matter what you want."

Having children during medical school has been extremely draining, and now that I am plotting my career path, I wish I had more control over what I wanted to be and where I wanted to go. I am an excellent student and work extremely hard. Despite being a full time student, I have also taken extensive care of my children, especially as babies. I have "studied from home" while taking care of my children as infants for about 3/5 years of medical school/MPH (M1, M2, MPH) so that my husband would continue to have opportunities to work. Opportunities that I don't feel he ever took advantage of.

My husband and I have no family nearby and no family equivalents. As a result, all childcare responsibilities fall completely on us, unless we pay a babysitter. We did have a regular sitter 3 days a week for about one year, which I think was an overall great experience (with the exception that I felt from my perspective that we were hiring her so that my husband could work, with the implicit understanding that as a medical student I needed to work all the time, but from his perspective I was hiring her so that I could go to school while preserving his autonomy), but she went out of town and since the financial equation didn't add up (his overall work income = cost of sitter, and that includes time that I took care of the kids for him to work as well) by mutual agreement we didn't find someone to replace her.

There is not much of a culture of stay at home husbands of doctors. I have seen several blogs out there of the proud and self-sacrificing "doctor's wives" but nothing similar to that for the "doctor's husband." These blogs tell of the hard work of the male doctors, the pride of the doctor's wife in her husband's service to humanity, her story of self-sacrifice for her husbands career, helpful recipes, and parenting tips. My husband doesn't feel this way about my career at all. Perhaps it's because this culture doesn't exist for him. We are essentially at odds about my schedule, my need to study, the housework, the possibility of needing to move.

Because my husband decided on his own volition to be a stay at home dad, he now makes even more minimal income than before. He receives a $1000 annuity monthly from an accident.  I transfer money to him to pay the mortgage on his house/workshop and other bills. Most of it is money from my mother, and she is sending it via me to him with the understanding that he is supporting me in my career and taking care of her grandchildren. He says that he has "sacrificed" his work for my career, but in fact he adamantly did not want to get childcare and work. He has not given up financial security either - when we met, his bank account was completely overdrawn. He has recently characterized himself as been a "servant" of my "wealthy family." However, suggestions I have made that would make him more financially independent: renting his workshop space for income, getting a regular job, etc, have previously been shot down as inconceivable. We paid his leftover defaulted college loans - from almost 30 years ago! - with our tax return credits. I have also enabled him to pay off credit card debt. Meanwhile I feel like I have sacrificed much of the quality of my medical training for him, having lost out on the experience of a normal M1 and M2 year and career development opportunities along the way, but still taking on full expenses for the family either via loans or via my mother's contributions.

Rewind to the end of 3rd year: I am 9 months pregnant and concurrently preparing for the medicine clerkship exam,  starting MPH coursework, and studying for Step 2CK. I destroy the exams because I work hard. I am a machine! Woot! But things really go downhill over the next year. While in labor, I try to write a paper. It exemplifies my experience over the next year: working in pain. The intense emotional pain of trying to do well in school while your infant cries. I had done something similar in M1 year, but the memorization was much more tolerable than the reading and paper writing. And things are much more complicated now with two kids. My husband had encouraged me to do the MPH because of financial reasons - the fact that I will continue to have loans available and that my mom will continue to contribute to us if I am in school. After trying to write my paper between contractions, I give birth the following morning. It is a joyous day. Shortly after, I initiate total 24/7 care of our second child while taking 6 online courses, about 60 hours per week of work. His contribution is taking care of our oldest about 2/3 to 3/4 of the time, and taking her to school every morning. I work from 9pm-3am every night (the hours she most predictably sleeps) plus whatever else I can get my hands on. Even with this, he is pressuring me to do more school pickups for our oldest so that we are being "fair." In all this time, he theoretically could be working at least between 9am and 3pm M-F (and longer when I do pickups) but apparently does not since my mom is still paying the bills. I am feeling like sh*t, alone at home (online courses), taking care of baby, working, doing all laundry, washing diapers, most of the housework, plus the winter is complete hell and I can't even go outside for fresh air or a run because it is too cold for the baby. His first conclusion is that I am cheating on him with a classmate because I am withdrawn from him. !!!!?????! WTF ??????!!! I blow up. I tell him that I don't like him. That I could have done better. Someone younger, better looking, and more financially secure. Yes that is a very hurtful thing of me to say, which is why I guess I didn't say it until it really came to a head. And yes, I knew this about him going in, but I valued the support and partnership he promised more than any of those "shallow" things. I guess, when I felt the support slip away, I wished I had at least some of those shallow things left to hang onto.

He goes and talks to his friend who graduated from law school. Then he tells me that if I leave him, that he will keep the kids in the state. The other stuff he talked about "is between him and his lawyer."

I wish I had initiated something then (legal counsel?) but despite these misgivings, I had no plans to divorce him.  I felt like I had made the commitment, and I was going to do the best I could with it. Perhaps it was me (too picky? don't deserve better?), perhaps I would just never be satisfied with anyone, so I should try and make it work.  Living with him seemed and still seems like the only way I will ever see my children as a medical student or a resident, and they are young. They also love him and I don't want to take them away from him. I value what he provides for them as a father. So I kept it going. M4 starts and he now has finally taken over full childcare responsibilities.

He was not supportive during the application process and was more interested in my lack of sex drive than my career prospects. Then he blames me for not having worked hard enough to find a good program in our area and says I don't deserve "the best" that I should settle for "good enough." I feel like this is a recurring theme in a lot of his beliefs. He has a disdain for wealth. He calls me a "princess" for wanting to live in a nicer house and city. I am not a pro-wealth person and have a fairly nuanced view on the relationship between income and happiness, but he is full out against it, perhaps a defense mechanism for his personal lack of financial success or stability. I don't know if this attitude can be resolved. When I say that my career will bring the family financial stability, he says our kids can go to community college, take out loans, and that they would be happy living out of a van or homeless shelter. Maybe there is some element of truth to this. I think they will be happy anywhere they are with a loving family but I wonder if we can provide that.

I interviewed at 11 programs, 5 within our city and 6 around the country. In this process I have sought out advice from many people, only one of whom said I should make the "self-sacrificing" choice, most who said I should pursue my "dreams." Many have said that my husband can't keep the kids if I move out of state (they are wrong - our state favors keeping kids in the state and I confirmed this independently).

My mother called my husband and asked him if he will support me. He said he was not moving. Why? He was protecting himself from divorce because if he stays put, the state custody laws favor him, but if we move to another state and I divorce him there, then I would be more likely to maintain custody if he then moves out of state. I asked him whether in this scenario (refuse to move, keep the kids) he would continue to ask me to pay his bills? No, apparently he will get it together. Call me doubtful, but he could not pay his bills prior to having children. And wow, if he could actually work to pay the bills, then why wasn't he doing this all along? The wildly emotional thoughts running through my mind include:this man is going to take my kids from me AND live off my future income unless I do what he wants.

Long story short I submitted my rank list while sobbing. My top programs are somewhere in the middle of my list, probably never to be realized. I have given up on the possibility of living near my family - consisting of my mom and sister. In fact, I did not even rank my preferred specialty first given I was so disillusioned, and I really regret this as well. I often wish I had submitted the list I wanted and dealt with the fray rather than be here in this limbo, unable to change or withdraw my rank list. But it was my children that he threatened to keep from me. My children. It made me crazy. (He would say: no, he did not threaten that - all he said was that "I'll keep them in the state" - he is a stickler for legal language.) My mother withdrew her financial support of him and he is now calling her evil and manipulative. She will no longer help us buy a house that he would live in. Nor should she. He now says that since I'm not paying his bills that I need to share half the parenting, including school drop offs at 8:30am (long after I am supposed to have reported to the hospital), BUT that I should NOT quit medical school. I don't know if he actually expects me to do this, or if he is just holding it over my head that I CAN'T do it.

He is looking at my future resident's salary, most likely the local program I ranked first, and salivating with the income "boon" - not concerned about what it means to me. I have watched my fellow "MiM" classmates give up their dream residency for their husband's careers, and I felt bad for them. I feel less bad for those who make the practical decision because of close-by family who are supportive. Now I feel bad for myself. I do not want to pay this man's mortgage with my blood, sweat, and tears. But he has my kids, and I will not have the hours in the day to take care of them for a long, long time.

We are in counselling now and I feel worse and worse about him the more I think and talk about it. I don't think I can forgive him for the position he postured. As far as the possibility of divorce goes, I am sincerely worried that I would lose custody of my children because of my work hours. I could drop out of residency after my contractual period and then divorce him, at possible loss to my career. Then there is always the possibility of a match day miracle, whereby I get the program I actually wanted. I suppose if that happens, I will have to be nice to him if I have any hope of making the move with my family. Or, I will submit a waiver to my dream program. Or I will visit my kids on my day off. Or at this point, do I actually want that program anymore, given that I have already started to plot a career that would be better for a single mother or co-parenting situation?

I know I am not his ideal wife. I don't idolize him and will probably never be in love with him. But I have given him so much of my life. I am willing to work with him in a partnership and possibly even an affectionate relationship for mutual benefit. Perhaps I am willing to settle for "good enough" in this "romantic relationship" part of my life, but not at the expense of settling for "good enough" in the professional part of my life? He probably feels the same way. He is willing to settle for "good enough" in our relationship if we don't move and everything stays status quo, but requires my adoration to move. But I can't fake adoration. I alternate from feeling like maybe I am a "privileged princess" to think that I could actually rank the program I wanted first - big whoop, who cares, you're going to be a doctor no matter which program you go to - to feeling enraged that I worked so hard against so many odds and am placed in this situation where I have to settle.

Maybe the best solution would be to get divorced after Match but prior to graduation, drop out after the contractual 45 day period of residency or apply for a waiver, enjoy a year with my children in the interim while HE works, and apply in a more single-parent friendly specialty with the new understanding that I am restricted locally, and with a feasible plan to co-parent. Compromise like hell, but more on my terms and with more warning.

It took me some time to get oriented on my career path with some bumps along the way as a young adult. Now I feel like I am pining for my own lost potential of self-determination that I was finally on the brink of realizing. My sister recently married a nice young man she has been long distance dating for years, who will follow her unpredictable and highly specialized career anywhere, and is excited to do so, a comparison that is painfully made. I will never get to marry a nice young man who is willing to unconditionally support my career. I will never have the experience of my family celebrating my wedding day. I will never feel deeply head over heels in love with my husband. I will never have autonomy over my career. I have what I have. Such beautiful and wonderful children! So much! Everything!

But so hard.

Well, that is my long story. I don't know what kind of advice I am looking for. Past experiences? Commiseration? Strategy? A reality check?

Thursday, March 5, 2015

MiM Mail: Whose dreams come first?

My name is Jenny and I am 24. I am a single mother to a beautiful 6 year old and a handsome 5 year old. Their father is not really a part of the picture. I receive no financial support from him and he sees the kids once a week for about 8 hours.

I am a research assistant at an amazing lab and absolutely love research. I have planned on going back to grad school soon. The grad school where I'm located also has a med school and there is a MD/PhD Program. I have always dreamed of going to med school. It was my dream since I was 12. And even when I became a teen parent, I still knew I wanted to go to med school. But I never thought I'd had to go as a single parent, so I've gone a different path which has led me to research. As I start to prepare to apply my heart screams with such a passion that it becomes difficult for me to hold back the tears. Med school is where my dreams are. Research driven physician is where my heart is. It's what I've always wanted. But I'm a mother now and a single mother. The program is ideal because of the stipend. I cannot take 4 years off work to go to med school when I have children. But with a stipend I could get by. And I know I have to apply. Even if I don't get accepted, I have to apply. But if by some miracle I do get accepted would it be right for me to go? I have been in school for the majority of my children's lives. If I was to do the program, my kids would be adults when I finished. My daughter would be 19, my son going on 18. I would have spent my children's entire childhood in school. How is that fair to them? I would be so busy with school there would be no dating, no man to step up and be a step father. It would just be us with me always in school and studying. My kids will be adults. I'll be 37. And eventually that will happen anyways, but how much will we sacrifice if I kept going for my dreams? Isn't the mother supposed to put the child's dreams first? I don't know what to do. I feel either choice I make will break my heart. I would appreciate any feedback.

Thank you,
Jenny

Tuesday, February 17, 2015

MiM Mail: Missing life before kids

I am a family doctor in southern Ontario but previously worked in remote northern Canada for 3 years. Up north, I worked in full-scope practice, including OB, ER, home visits, hospitalist, fly-in communities, medivacs and nursing station phone support. When I became pregnant, I could not have my job modified to have a healthy pregnancy. I was concerned about extremely bumpy boat rides to get to and from clinics, helicopter transfers, working in very cold environments, nearly being flooded, stray dog attacks, dust, bugs, and not having safe shower or tap water in certain fly-in communities. I had asked to not work nights but was told this was not an option due to lack of staffing.

Sadly, I left the community I had intended to stay in all my life. I moved near my extended family in southern Ontario. We bought a farm, and my husband stays at home with the baby and farms. We have the wonderful support of 4 grandparents. We now have a very happy toddler and another baby on the way in the summer.

Down here, I run my own clinic four days/week. I am doing walk-in clinics on the weekend. Although I enjoy it and have a very reasonable schedule, I am growing antsy to do more. I find that down here, even the simplest issues are referred to specialists. Compared to the north, people are not very sick when they see me. I enjoy being home with the baby, but only for a few days a week. I am happier working as a physician the rest of the time. I miss the action and adventure of northern medicine. I keep looking at job openings in the north and trying to figure out how this could work. What I always seem to conclude is what is best for me isn't best for my family.

The things that are keeping me from going back up north? Well, for one, I am 16 weeks pregnant. I plan to have two kids, so after this one, pregnancy won't be a limiting factor, but breastfeeding will. My husband doesn' t want to move north, as there are no farming options for him there. He has farm animals that require daily care, so even doing locums and bringing him with the kids isn't possible. I could go alone, but that would be very stressful on a baby and toddler.

Maybe I should just stay put and accept the current situation. I just feel like my skills are being lost for every year I don't use them. I would love to hear some advice or suggestions from others.

Monday, January 12, 2015

MiM Mail: Starting medical school, need encouragement

Hi MiM,

In six weeks I am supposed to start my first year of medical school. It's been a long time coming. I trained as a nurse, worked as one for a while, and then decided to pursue medicine. I finished off the prerequisites I needed, applied and got in (to a medical school in New Zealand - where I am from originally). My husband and I had a surprise pregnancy right before I was supposed to start medical school so I deferred for a year. I now have a gorgeous six month old and have been enjoying working casually as a RN. However starting medical school beckons, and I find the idea now terrifying. The unknowns of how to manage it all with a baby. I have an extremely supportive husband but he is also studying a PhD so is busy. We have great childcare sorted - our baby will be at the university day care right around the corner from the medical school. I'm not really struggling with the idea of leaving my baby as I'm not the full time stay at home type, but I am afraid I will find school all consuming and miss out on her. Also from a financial perspective having us both studying sucks - my husband gets a small stipend we can survive off but it's hard when our friends are buying houses and taking dream vacations, and we can only afford meat once a week! I suppose I am using this post and community as I imagine many others do - to seek out encouragement and to hear stories from those who have gone on before. How did you do it with a baby? Any ideas on how to manage financially? Is it worth it in the end? Etc. Would love any encouragement, inspiration, advice you can spare.

Thanks so much,
A.

Wednesday, December 31, 2014

MiM Mail: Defer or start medical school with a newborn?

Hello MiM!

I am a mom of two kids - one in school, one starting next year - currently in university in and applying to medical schools in Canada. MiM has been an inspiration since I started working towards a career in medicine, and I am thankful for all the stories that have been shared here.

To get right to the heart of the matter, I am pregnant with our third child and due in late August. I'll likely be delivered 1-2weeks early due to my history, so by the start date of the med schools Kid 3 will only be a few weeks old.

Acceptances come out in the spring, and I need to decide (if I get in!) whether to defer for a year or whether to start med school with an infant just a few weeks old at home, which will also have meant a big move while 7-8 months pregnant. I would imagine, in the circumstances, I could likely get permission to do the first few weeks' work from home, something I have heard of med schools allowing before.

My husband will be taking eight months parental leave for Kid 3 in addition to any leave I take, so we won't have to deal with putting a tiny infant in daycare and I will have help at home during that transition time.

I am hoping to hear from MiMs who have experience with having babies during first year. I have a few months to mull over my options, and if I don't get any acceptances it won't be necessary to worry, but ultimately I would prefer not to take an entire year off from my education if I could be okay with just taking a few weeks at the start of the year.

Your input is much appreciated!

Thank you,
MiM in Canada

Monday, December 29, 2014

MiM Mail: Advice for non-traditional mom

Hello and thank you for your blog! I am wondering what advice you might give for a slightly older mom considering medicine after the baby-phase. My husband and I are both teachers at an international school and we are looking to transition to living back in the States near our families. I am considering applying for medical school for the fall of 2016 and have completed all the prereqs, taken the MCAT, and have all my letters of rec on file.

We have four children, ages 12, 10, 5, and 17 months. I would start medical school with my oldest beginning high school and my youngest being three years old. I am in my late thirties, and investing in a career in medicine would combine my pure love of science with a passion for extending the tremendous care-giving roles I have had over the years.

I have hesitated to go down this road because of the tremendous financial investment as well as the time required, but I have loved my various experiences in health care throughout my career up to this point. I would love any personal advice on whether this path is worth it!

Thanks,
Sara

Monday, December 22, 2014

MiM Mail: Med school with young children

My name is Megan. I have 2 children. My son is 2 1/2 and my daughter is 7 weeks old. I am only 20 years old.

When I was younger my dream was to become a physician, specifically an OBGYN. When I had my son at the mere age of 17, I figured that dream was over. I decided to settle on nursing with the hopes of becoming an L&D nurse. I started going to school; while taking pre-requisites for the nursing program, became a CNA. I started working as a CNA at a hospital and had my daughter when I was 19. Having a second child while still being a teenager didn't stop me from going to school. However, working in the hospital made me realize: I DO NOT want to become a nurse. Most of the nurses complained about their jobs, seemed bored, and I did not want that to happen to me. I want a fulfilling career that makes me reach my full potential in life. I didn't want to just settle.

So I decided to go back to what I really want to do in life: become a physician. I am really determined, and very excited, but it seems like everyone around me can't stop telling me how hard it's going to be.

I guess I'm writing this to ask for support and advice from mothers who went to med school with young children. My kids will be 5 and 3 by the time I start med school. Any support and advice is appreciated. And another question, did anyone with young children have anymore kids later on in life? I'm not sure if I'm okay with being done at 2.

Thanks in advance.

Monday, December 15, 2014

MiM Mail: Year off

Hi MiM Community!

I am in the middle of a year off, and at a bit of a crossroads. I got pregnant with my second child in the middle of MS2, took the Step 1 7.5 months pregnant (not recommended), and gave birth at the end of August. My school told me that I would only be able to take 6-8 weeks off max (8 was stretching it) if I wanted to continue with MS3. If I wanted/needed more, I had to take a year LOA and come back next July to start rotations with the next class. When I had to be off my feet during my 9th month, I decided to just take a LOA and enjoy my year off with my new baby and toddler.

I'm now 4 months into the time off and unsure what to do. I have been dabbling in continued research, but my heart is not as into it as I thought it would be. I do miss school and really look forward to going back and finishing, but all the plans I had for this year pre-baby (research, volunteering) just doesn't seem as exciting. Is it so terrible to just be a mom for a bit? Am I selling myself short for future residency applications?

I did OK on step 1. Not great, not terrible. I am not necessarily interested in a very competitive specialty, but I am very geographically limited (to basically the one big city I am in now) due to the abundance of family and support, and my husband's job. I know that this is my last chance to take my older daughter to ballet, join mommy groups, take my baby to music class, etc. Can I just enjoy my time without feeling guilty about not progressing my medical career? Or is that just not realistic and I should "get my act together?"

Thanks again for being an amazing community!

-Boxes

I am a MS3- to- be with a 2.5 y/o and a 4 month old. I love having an active lifestyle and looking for interesting things to do with my family around our wonderful city.

Monday, December 8, 2014

MiM Mail: Geographically-limited MiM applying to residency

Hi there!

I'm a mom in my third year of medical school with young kids, lucky enough to be going to school in a city with a lot of family help and where my husband has a great job. I've recently decided to geographically limit myself to my current city for residency, for the aforementioned reasons. Although we are in a big city, my chosen specialty only has one residency program with about a dozen spots (at my home institution). I will also be needing to apply for a prelim/transitional year of which my city has three programs. I think I would be a reasonably good applicant in my chosen specialty if applied broadly, however I'm obviously making a risky decision. That said, I'd prefer to remain unmatched and do research for a year or two than move us to a new city at this point while my kids are so young.

The residency program director at my school meets with all students applying to residency, and I would like to get some advice on how to broach with him the topic of only applying to his program. I have only met him once and he knows that I have kids. I want to avoid looking not committed to medicine obviously, and I know that I could be a great physician but being close to my parents/sibs for childcare help and not uprooting my husband and kids would be quite important to my overall success and happiness. Additionally, my dad has metastatic cancer and I know if I was doing residency in another city I would not be around to see him much. Any advice for how to approach this conversation would be much appreciated!

Thursday, December 4, 2014

MiM Mail: Anesthesiology or psychiatry?

Hi everyone!

As many others have shared, MiM has been such a valuable resource to me since embarking on the path to a career in medicine. Now, I have a more direct question for you all. I have been considering specialties, and while I still have plenty of time to decide, the pressure to make arrangements for research this summer and beyond is weighing on me, especially because I'm interested in two very different fields for obviously different reasons: anesthesiology and psychiatry. 

Anyway, some background first… I am a first year medical student and my partner is a fourth year, currently interviewing for residency. He is pursuing ENT and has mentioned interest in the possibility of pursuing a head and neck fellowship eventually… We have no children yet but starting a family is a huge priority and we both envision a timeline within the next 5 years (i.e., during medical school or residency for me). 

Because family life is extremely important to both of us, and it’s already becoming clear to me that his field will be a lot less flexible in this regard, I’m seeking any advice on deciding between the two specialties above. I know that balancing family life in a two-physician family is going to be extremely difficult regardless and so I am willing to make some career decisions to account for that. It seems that both anesthesiology and psychiatry can make for good lifestyles eventually (though with drastically different levels of compensation) but is there more I should know? Are the residencies drastically different? Is the difference in salaries going to be too stark if pursuing manageable hours (or even “part time”)? I know both can be flexible, but are those lower hour positions more realistic in one field? Anything else I’m missing?

I should also note that because we’re both from, and hope to remain in, a relatively undesirable area near what is considered a highly underserved area, I would seriously consider the NHSC scholarship if I chose to pursue psychiatry. I could also earn an MPH in one year at no cost through my medical school’s MD-MPH program which is something I have also considered (my pre-medical school studies were based in the social sciences).

Thanks so much!

T

Monday, November 17, 2014

MiM Mail: Middle of career life crisis

I feel like I am in the middle of a career-life-crisis.

I am a mother to an almost-3-year-old, and a 9 month old. I am an OB/Gyn. And, I love being both.

After residency, I joined a large private practice. Even after I had my son, I was fairly happy with my schedule. I worked about 3 1/2 days a week in the office, one day on call per week, and one weekend on call per month. But, I thought it was a pretty good life for an OB-Gyn. I sometimes missed holidays, wedding anniversaries, and important family events, but realized that those things came with the territory. After all, babies don't take holidays from coming into this world.

About two years ago, we moved to our home state to be closer to family. In doing so, I changed career paths. I now work as an OB hospitalist, doing about seven 24-hour shifts per month. It's a different role than I ever thought I would have. I see patients in the hospital that have no physician and take care of OB emergencies when their on call physician cannot make it to the hospital in time. In short, I still get to deliver babies and help women in emergent obstetrical issues, which is very rewarding. And, I get to have a lot of time with my children. Now, for example, when we sign up for a 2 week swimming class, I only miss a couple classes, whereas before, I would have only made it to one class. I get to go to the park, the zoo, the mall carousel, and all the daily little things that a lot of mothers in medicine have to miss out on.

I feel guilty even saying this, but when I first transitioned to this job, I definitely had to adjust to being at home so much. I felt guilty at times, because there were definitely moments when I (and my son, for that matter) felt bored. I would call my sisters and ask what they do each day with their kids. But, now, we have gotten into our groove. We have play dates, learning activities, favorite fun spots, and of course, naptime. So, before I know it, the day has passed and we are on to the next. And, just when motherhood starts wearing me out, it is time for me to go to work the next day. And, actually, it is a nice break to get away and have some career time. My 3 year old son asks every morning if I am a doctor or a mom. With this job, most days I spend "being a mom", and only some days do I spend "being a doctor".

So, what's the problem? One of the reasons I went into OB/Gyn was the hospital-office balance. I loved forming long-lasting relationships with patients that continued throughout life stages, multiple pregnancies, and through difficult diagnoses. There is something about delivering someone's baby that bonds you to them. You become important to them. It almost feels like you should be invited to sit at their table for Thanksgiving dinner. And, now, I don't have that relationship. So, I keep looking at job opportunities and wondering if I should return to private practice so that I can have relationships with my patients like I had before. The thing is, that if I make that career jump back to traditional OB/Gyn private practice, I will be giving up a lot of time that I have with my kids. So, I worry that I would end up in a "grass is not always greener" situation. I'm not as familiar with the business aspects of medicine, but to the best of my knowledge, it is difficult to keep a practice afloat (paying overhead, salaries, benefits, malpractice) in the OB/Gyn world and work only part time, so full-time it would be.

I know you guys can't decide my future. The truth is, that getting it all in writing is actually helping me process it all. But, any advice would be nice. Is it possible to have a part-time OB/Gyn practice? Should I just count myself blessed that I get so much time with my kids, even though my particular position as an OB/Gyn is not quite as fulfilling as it once was? How do I not feel guilty thinking all these thoughts?

Sincerely,
Confused mommy doc