“Mom, what’s that?” my four-year-old daughter asks curiously as she stares at the pink and purple colors of the page I had just been staring at and trying to memorize.
“Skin.” I reply simply, because she’s not going to have any idea what Sweet’s syndrome is, or that many of those cells are neutrophils or that there are a list of other causes of papillary dermal edema or that a characteristic histology is only one part of the diagnostic criteria of Sweet’s. Her question means that her patience for my absence is wearing thin, and I only have around 5-10 more minutes to study before she’ll want to just sit on my lap and “help” me study.
Medicine is a demanding field that requires years of study and practice. It is a constant cycle of studying, test taking, applications and deadlines. It is all consuming, and in some regards, it should be. If you don’t know your shit in other jobs, you may lose the sale, lose the customer, or even lose your job. In the medical field, you could lose a life. So in a field that is years of training, a seemingly endless competition for the med school spot, the TA spot, the test score, the residency spot, and at times literally puts someone’s life in your hands, there is no time for distractions right? Do you have to choose career or family?
I know that it is absolutely possible to have kids in medical school and residency and be successful. But let’s be real about it, and practical about it. This question and its answer are very different for each individual person. I think there are four things to consider. But first, I want to give you my back story, so you can appreciate my perspective and the potential biases and misunderstandings I may have.
My husband and I decided to try to get pregnant at the start of my fourth year of medical school. We decided in June that we would try for two months- July and August, because then I could use my elective and vacation months of April and May for maternity leave, before having to report to residency training in the following June. If we didn’t get pregnant, we would wait a year or two before trying again. We got pregnant the first month. I had my first daughter at the end of March. My second year of dermatology residency (PGY3), we decided to give our daughter a sibling and got pregnant with our second daughter, who was born April of my second year. Obviously, I did not do most of medical school with any kids and have pretty limited experience regarding that, but I can extrapolate from my experience in residency.
Ok, so back to the four things to consider regarding having kids and pursuing medicine as a career.
- What are your goals?
Do you want a super competitive residency spot? Do you plan to do a residency and fellowship, etc, etc that will extend you to PGY6 or more? How much work are you going to have to put in to meet these goals, and is it possible to balance the time commitment of kids, with the time commitment of study in med school, extracurriculars, research and residency?
Because I didn’t have kids in medical school, I was able to focus my studying to obtain great test scores and grades and publish case reports in order to be a good candidate for dermatology. In general, dermatology is not one of the most time demanding specialities during residency, although there is an above average amount of study and focus on academics, more on that later.
- What kind of student are you?
If you are super smart or have a super good memory and can be an excellent student without having to spend extra time studying, then you will easily have some time left over to spend with your kids after studying. If you know that you will have to dedicate a lot of time and tutoring to stay afloat, it may be difficult to find any extra time for your kids.
I am the type of student who has to study a lot and repeat the material over and over in order to remember it. However, after doing this, I do retain it pretty well and I am a good test taker. So I really need to spend a lot of time on the foundation of material, but can relax my time after I have “put in the work”. So again, having a kid in medical school would have really been a struggle for me as I wouldn’t have been able to commit all the time that I did to studying. Again, this is just me personally. However, because dermatology is such a demanding speciality academically, my first year was a crazy load of material to memorize and I needed a lot of time to be able to go over it again and again to get it down. This is where scheduling my time and my support network came into play.
- How much support do you have?
To me, this is the most important thing. In general, I believe in the statement that it takes a village to raise a child. Children, especially when very young, are extremely demanding of your time, sleep, emotions, etc. To do it all alone and manage to study for medical school and residency is nearly impossible. However, it is very doable with a strong support network. Whether that network is a spouse, family members friends or nannies, there needs to be people in place to give you the ability to be at work when you need to be, and to have extra time to study.
I owe so much to my husband, who at times functioned as a single parent while I was in training. This was especially true my intern year when I was often working 12 hour shifts and would go days without seeing my daughter. It was true my first year of residency when I would spend the entire weekend before a test studying at work. It was true when I had to travel out of town for 6 weeks to do a rotation my second year, seeing them only every other weekend. And it was true leading up to my board exams my final year of residency, when again I would shut myself away to study for hours at a time. A lot of spouses would resent this burden, and I have seen marriages struggle as a result. We had a nanny as well to help ease the burden and give him a break as well.
- Finally, what are your priorities?
During medical school, after a long hard day of studying, I would enjoy going for a run or watching Office reruns with my husband. Those little breaks were filled with bath time and story time once I had kids. If you are already a parent, you know the extreme level of selflessness that goes along with that. If you are going to get burned out by not getting that down time or alone time, you really need to think hard about your career choices. It all depends on your priorities.
Having kids has changed my whole life perspective in a beautiful way. It has allowed me to see what is really important in life. Getting a B + instead of an A doesn’t make me a worse doctor or person, but spending that little bit of extra time I could have used to study, in order to play pretend with my daughters is absolutely worth it. My time with them is exhausting, but in the same way, is so refreshing. I love seeing the world through their eyes. I am frequently in fits of laughter at their antics and my heart is so full when my eldest gives me a cuddle and tells me I’m the best mom ever. I wouldn’t want to do this life without them. There are sacrifices that I have to make, but to me, they are worth it.
“Hey Mom, that’s skin!” My daughter says proudly a month later when she catches me reviewing another H&E photo. Silently I’m grateful that she didn’t come up while I was reviewing genital lesions, and I answer her with extra enthusiasm in my voice “Yes it is! I’m proud of you for remembering.”