Should I have Kids in Medical School? It Depends.

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“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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.” 

Kate Kimes, D.O.

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The military is offering to pay for my medical school- what’s the catch?!

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As many of you start applying for medical school, the main focus is usually just getting in! However, the other main consideration that most people have is the cost. This may be particularly scary if you already have a lot of debt for other reasons, such as undergraduate loans, or if you are most interested in a lower paying specialty. This can be intimidating!

Often, this is the time that most people hear about the Health Professional Scholarship Program (HPSP), which is a scholarship program that each branch of the military (Army, Air Force, and Navy) offers to pay for medical school. If you have prior military service or ties you may have an interest based on those reasons as well. There is also a military medical school, but it works differently, so we won’t get into that now. So what exactly is this program?

HPSP offers to pay for all of your medical school tuition, fees, books, board exams, supplies, health insurance (if required by your school), and offers a small stipend as well (mine was around $2k/month). In return for this scholarship, you are required to “pay back” four years of active duty service time. The military also has residency programs, and most HPSP students will complete their residency in the military (although there are a few civilian deferred spots as well). Because you are active duty during residency, you are paying back your medical school time, but you are concurrently accumulating more time to pay back- you must then work as an active duty physician to pay back for your residency years. Make sense?

For me, I attended a civilian medical school, and basically you would never know I was in the Army other than everything was paid for and I went to an “officer training” for 6 weeks my first summer. I matched into dermatology at the Army program in San Antonio and I am now in my last year residency. That means that this summer I will have paid back my medical school obligation. However, they just trained me (and paid me as a Captain) for four years, and I owe that time back. So now I will go work in Alaska for 4 years, as an active duty dermatologist on base. After that, I can leave, or sign up for more time.

I am very grateful to the Army. It is amazing to walk away debt free from a rather expensive medical school. My husband and I had many additional opportunities including him going back to school, because we had my stipend and other costs were covered. My residency training has been exceptional, and I get to take care of some incredible veterans, active duty members, and their families. I am well compensated as a resident, and my family all have free health care through Tricare. This has been particularly extraordinary considering my oldest daughter broke her leg one year and my baby had a 10 day stay in the NICU. I didn’t pay a penny and the care was incredible.

What’s the catch? Being in the military is full of uncertainty. I was given a list of places to choose for payback, but there were no guarantees of where I would go. Sometimes people get what they really don’t want. The pay is less as a board certified physician. There is always the risk of being deployed, although this varies greatly by specialty. As a medical student, the number of residency spots can really vary each year. The military doesn’t force you into any speciality, but if you don’t match into what you wanted, you can either scramble into another spot that is left, or you can choose to work as a general medical officer until your commitment is up. Military medicine is currently undergoing a huge overhaul, with a focus on specialties that are considered essential to war-fighting (think: trauma surgery, ortho, ED, etc), with less and less focus on others. This is going to change a lot of things.

Which branch should I choose? Everyone has their own unique reasons for choosing one branch over another. Some have family traditions or commitments. Others choose based on potential bases where you could be stationed. Others choose based on lifestyle. I chose Army because it is the biggest branch, so it had the most number of residency spots available. The pros and cons of each branch can really vary by specialty- so if you know what specialty you want to do, try to talk to someone in that specialty to find out what it’s really like. Reach out to me if you have no contacts, and I will help if I can.

Kate Kimes, D.O.

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Training to be a doctor takes too long- right?

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For those making tough decisions, I wanted to share a mindset altering moment I had years ago

My junior year of college, I was struggling to decide if I wanted to go to medical school or not. My original plan was to be a physician assistant. Two of my biggest mentors were PAs, and I so admired them. I was working through my pre-requisite courses, and I had completed my certified nursing assistant certificate in order to start gaining clinical hours. I was working part-time on the orthopedics floor of my local hospital, and as an as needed/on call position in the emergency department. I had it all planned out, I was working as much as possible to gain the 2000 clinical hours I needed in time for graduation, I would take the GRE after graduation, and apply to PA school. Just two additional years and my whole life and career would be ahead of me! 

However, as I spent more time in the clinical environment, I noticed how limited the scope of practice could be for the PAs. I noticed that most of the fun and interesting procedures were being done by the physicians. While the PAs I worked with were super smart, hard-working, and compassionate, their thought process wasn’t always the same as the physicians. I didn’t really want to spend an additional 8 years in training, but I didn’t want to feel like I missed out on my true calling. I was conflicted.

I went to talk with my best friend about my uncertainty. She worked at a local coffee shop, so I ordered a coffee and sat with her, explaining the pros and cons of each scenario. Before she had the chance to weigh in, one of her co-workers spoke up. What he said was so enlightening!  He mused “One of my best friends from high school is finishing his internal medicine residency this year. We graduated at the same time, and yet he is months away from being a doctor! It is crazy to me that someone my age is a doctor. The time is going to pass either way, at the end of it, what do you want to be doing?”

Well, I went all the way, and now I am in my last year of my residency. The time did pass either way. The friends I have made along the way and the experiences I have had have been absolutely incredible. I love what I do. That’s not to say there weren’t sacrifices. I have been away from my closest friends and family for the last 8 years. I have missed countless weddings, birthdays, parties and celebrations. I have had two children without my “village” of family to help me raise them. My husband has been mostly helpless in where he gets to live, has spent numerous evenings watching me study, and has had to act as a functional single dad while I was away at conferences. But the future couldn’t be brighter.

You can never know what the future will hold, or truly know the best option for you. However, if your focus is on the time, if you are scared to dedicate yourself for such a long time. I encourage you to mull over those words: “The time is going to pass either way.”

Kate Kimes, D.O.

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