Balancing Medicine and Motherhood

Alan Poulson/123RF.com

We all did well in high school, went for the best college we could get into, made great grades, and worked even harder in medical school to get that coveted residency. What is the difference between women and men physicians? The natural ability to have babies. Why should we worry about balancing medicine and motherhood? Because it is one of the hardest jobs you will ever face.

Women were traditionally the parent who raised the children, while their partner made the money. That paradigm is no longer true. Working in medicine and being a good parent is possible, but you will have to work at it.

I ran that treadmill of college, medical school, residency, and fellowship, only to find that there was something still missing in my life: a husband and kids. As an Obstetrician Gynecologist/Urogynecologist, I knew all too well what working women went through in order to have both a career and family.

Some women had their children early and then developed a career. That is much more difficult to do in the field of medicine. The majority of us have our children once we have established our career. Different specialties offer their own challenges based on call schedule, number of days worked per week, weekend call, and the degree of involvement that your partner takes in parenting.

I was lucky enough to have a husband who agreed to step down from his full-time job in order to support my own. I had twin boys, followed by a daughter 17 months later. We both had our hands full. I worked in academic medicine, which had fewer nights on call and fewer weekends than my private practice colleagues. I also had a 12-week paid maternity leave allowed by the University. When I returned to work, my husband would bring the twins and camp out in the call room for my weekend duties so that I could be with my sons and continue to nurse them. I planned appointments in my daily schedule in order to pump breast milk when at work.

Some of my colleagues hired full time nannies either for the day or live-in. Many dual physician couples went in this direction. There was an inherent financial cost with that method, as most of us still had medical school debt. Some had a parent or grandparent move in with them in order assist in caring for their children.

When my sons were toddlers, preschool offered them social interaction with other kids for a few hours each day. At this point, my husband started to do some consulting work, and we hired a wonderful college student to help out in the afternoons. The difficulties for me came with missing school plays, Thanksgiving parties, and first milestones. My husband was wonderful and videotaped the ones that I was unable to attend. It was almost like being there. If I knew in advance, I scheduled time in my calendar in order to attend at least some of them.

Once the kids were school age, it became a bit easier, as they had a longer school schedule away from home. I moved into private practice in order to work part-time prior to the birth of my third child. I was in a group with two others and took every third night call and every third weekend. Even though I only worked 3 1/2 days a week, it was more difficult for me, as I was frequently called to work in the middle of dinner, playing a game with the kids, or reading them a bedtime story.

Some women choose their specialty based on their desire to have a family; others follow their dreams. Determining an ideal group practice size ahead of time will enable you to spread out your calls.  You may be busier when on call, but you will have fewer times away from your family. Other women choose to work part-time while their children are young. This is a good option for women in certain specialties; however, obstetrics and surgical subspecialties make this harder. Most women want their own obstetrician to be available to them and have a good chance of being delivered by her. For surgeons, we own the care of our patients and want to be there every post op day and for emergencies.

Job sharing is an option in some specialties. Internal Medicine, Family Practice, Pediatrics, Anesthesiology, Dermatology, Pathology, and Radiology have been easier specialties for many of my friends who wished to job share. For those with high malpractice premiums, however, the take home pay will be much less than full-time work, as the premiums are the same for both.  There are now hospitalist positions in which part time work is much easier to obtain.

Consider your own occupation disability policies. If you were to have a pregnancy complication that required you to miss significant time from work, the money would be very important.  If you decide on a sabbatical, remember to maintain your licensure, board certification, and DEA certificate. Each specialty board will have its own rules for what is required of you while you are not working.  Remember to speak with your malpractice insurance company about what you will be required to pay while you are not working.

It is essential to take special vacations as a family when you get time off from work. Even just a day at the beach or a picnic at the park became important events that my children still remember.  Trips to Disney and rented beach houses on private islands were always met with joy and laughter. Take lots of pictures and videos.  Making photo books of special trips or vacations is always fun to do with the kids and will serve as lasting memories.

In the midst of everything, you must find time for yourself. Waking early in the morning before the kids arose allowed me to go for a run or work out. You must also nurture your relationship with your spouse or significant other so that you are not just roommates taking care of your children as the only bond. Hiring an overnight sitter and arranging a hotel room and dinner reservations allowed my husband and me to maintain our love for one another. We are all capable of balancing medicine and motherhood with a little planning and a lot of creativity.