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February 26 - March 1, 2015 

Family Matters

Your career and your family don’t have to collide. They may just have to compromise.

The New Physician March 2010

3:00 a.m. Wake up to baby Gavin crying sweetly in the monitor. Get up, change diaper, feed baby
5:30 Wake up again, this time to alarm clock
6:00 Make cereal for 3-year-old Olivia. Pack baby’s bag, dress Olivia, load everyone into car for day care
7:30 Listen to “valve disorders of the heart” audio recording on the way to class
8:00 Classes and study time in library
3:00 p.m. Drive home while listening to audio recording on dyslipidemia from a previous lecture
3:30 Study at home
5:00 Start cooking dinner while listening to lectures on iPod. Have dinner ready when rest of family arrives home from work and day care
6:15 Play with Olivia (she plays the teacher; the student gets sent to the “naughty corner”!)
7:00 Give Olivia her bath, tuck her into bed and read stories
8:00 Enjoy a glass of wine with spouse
9:00 Wash dishes, prepare lunches and bottles for tomorrow
9:45 Brew some coffee and start studying
1:00 a.m. Program the coffee maker for breakfast time and head to bed

It’s a typical day for Sean Vanland-ingham, a first-year medical student at the University of Alabama at Bir-mingham School of Medicine (UAB). Vanlandingham, a 34-year-old father of two, gave up a successful con-sulting career to go to medical school. His wife works full time, and child care is a joint project—even if it means going to bed at 1:00 a.m. and getting up again two hours later.

Over the last couple of generations, most families have become two-working-parent families, and more men are taking an active role in child care. As the general population has made this demographic shift, so has the medical school population. Though medical students with families are still the exception, they are increasing. This means that even when it is dad who is in school, mom is likely to be just as busy as dad is, and both are expected to warm bottles and read bedtime stories. On top of that, as the number of women in medical school increases, in some families both parents are med students. The challenges of making medical school a family project go beyond arranging for suitable child care. But as with all the challenges of a medical career, these families figure out a way to make it work.

Finding Time

How do you find time for both family and a demanding med school curriculum? It seems that all too often, there is no good answer to this question. It comes down to choosing which compromises you can live with.

“I keep thinking that if I just plan better, take more control, I can make everything work,” says Marta Rowh, an M.D./Ph.D. student halfway through her third year at the University of Pennsylvania School of Medicine. Rowh has two boys, ages 5 years and 12 weeks. Her husband is an emergency medicine resident, so sche-dules change frequently and intersect in unusual ways. Rowh’s family has found that planning takes them only so far. “What works for a while suddenly doesn’t work anymore as the children grow and our schedules change, and then we have to go back and figure out a new plan,” says Rowh.

Bill Wilson, a fourth-year at Duke University School of Medicine and father of a 2-year-old, puts it like this: “It’s important to set and keep a schedule, but you have to keep asking, So what is the new schedule?”

Then There’s The Heart

To the ultra-organized medical student, this may not sound that different from normal planning, just making slightly more complex arrangements. Medical school parents are quick to point out that it’s not that simple. Even in the most organized households, emotions play a big part. It’s hard to be away from your children as much as medical school requires. Lucy Lee had two babies while in medical school at Stanford while her hus-band was completing his surgical pathology residency. Lee and her husband are happy with their career choices (she is now a second-year pediatric resident and he is an attending), but the choices didn’t come without compromise. Lee describes on medstudentmom.com, her Web site, what is probably the biggest chal-lenge of all: “Being away from the family for such long periods of time really made me unhappy, no matter what it was that I was doing.” The guilt works both ways. Even when she was able to devote an equal amount of time to work and family, “I often felt like I was doing a mediocre job at both,” Lee says.

When planning to have children, “most people don’t think much beyond the baby stage,” Rowh points out. “It’s much easier to leave a baby than older children. Older children can tell you how much they miss you—and they are involved in so many more activities for you to miss—and that is so hard,” she says.

Many of the frustrations of medical training are worse when there’s a family waiting at home. “[On rotations] much of the work is not super purposeful,” says Rowh. “Wasting time at work or at school is more of a problem when you have something equally important to be doing at home.”

Timing

Whether it’s finding time to spend with your family or just finding enough time to get everything done, family considerations influence career choices. On her Web site, Lee details the agonizing process she went through in choosing a specialty. Lee had a résumé tailor-made for surgery, and she loved the specialty, yet she ended up choosing pediatrics. The decision was made, at least in part, because of the length of the programs. “Let’s just say I became an attending in six years,” Lee explains. “My kids would be 10 and 8 when I finished training and became an attending. That’s just a step away from them growing up to be young teens and adults, and then they move away and start their own independent lives. Of course I’m being dramatic, but these last four years have gone by so quickly that I sometimes wish they could be little newborns again.”

This kind of compromise is common among future physician parents. Bethany Enoch, a fourth-year at the University of Kansas School of Medicine and mother of a newborn, is applying to family medicine residency programs. “I chose family medicine in part because I knew I wanted a family,” she says.

Dr. Zack Berger, whose two kids were both born while he was in a primary care and internal medicine resi-dency at New York University-Bellevue, appreciates the problem. “I know people in residencies who decided to do just one year,” he says, “because they couldn’t stand to be away from the kids.”

Dr. Caroline Haynes, associate dean for medical education at Duke University School of Medicine, advises choosing a residency program carefully if you have a family. “We don’t suggest that students talk about having families during the interview process,” says Haynes, “but they should look for places that are family friendly.” The increasing number of students with families is forcing programs that want to be competitive to be more accommodating to students with families, says Haynes.

Rowh says the best way to find out what programs are family-friendly is to talk with the current residents and notice how many of them have children.

Best-Laid Plans

Whether it’s choosing a specialty or arranging for child care, even the best planning can run afoul of real life. Christine Campbell, now a fourth-year at UAB, was married with a baby when she began medical school. Now she is the divorced single mom of a preschooler.

Brain Warmus, another UAB stu-dent, encountered an even more disturbing unexpected development. Dur-ing his second year of an M.D./Ph.D. program, Warmus’ newborn daughter developed an infection and had to be hospitalized. As of this writing, the baby is still in Children’s Hospital on oxygen, though she is improving. Warmus and his wife are tag-teaming at the hospital. “The school administrators have been understanding and flexible about giving me extensions on my exams, but I’m still not getting enough sleep, let alone study time,” he says.

Money

Medical school is notorious for its financial tribulations, and so is raising a family. So how do medical school families make this work?

“Money is a huge problem,” says Rowh. “We are taking out more and more loans; it’s a constant struggle,” she says. Lee also found that during the years she and her husband were both in training, they were constantly adding to their debt. “The government sets a limit on how much you can borrow on federal loans,” Haynes ex-plains, “so students with families often have to supplement with private loans.” Some schools provide loans specifically for help with child care, so it pays to check with your financial aid office about options.

If combining medical school with a family sounds almost unmanageable, don’t despair. Lee, Rowh, Berger and many others like them will tell you that the joys of coming home to a happy family relieve as much pressure as the situation creates. Simultaneously managing a medical education and a family takes flexibility, compromise and a willingness to deal with the unexpected. These aren’t things that come easy to the typical medical student, but it’s just one more lesson.

Avery Hurt is a freelance writer based in Birmingham, Alabama. Direct comments about this topic to tnp@amsa.org.

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