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As a Physician-in-Training, How Did You Make Having Children a Possibility?

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We are excited to launch a new advice column focused on early career female physicians and physicians-in-training. Topics will include physician wellness and work-life balance, negotiation, leadership, overcoming adversity and bias, motherhood and more. Questions will be answered by a rotation of experienced female physicians who are part of the Doximity network.

As a physician-in-training, how did you make having children a possibility? We can lump all vacations for the year together for a three-week paid leave (though recommended time for maternity leave by physician groups is 12 weeks), but anything beyond that requires FMLA, an extension in training, and a resultant delay in taking boards or doing a fellowship by a year. I fear delaying this too long due to soon becoming “high risk” based on my age alone.

Sincerely, In Training

Dear In Training,

Excellent question and a very valid concern. Several issues come to mind: first, I understand the age at which women are considered “high risk” for pregnancy has gone up, and how much that risk increases is overrated — doubling a risk from 1–2% is not terribly relevant. Second, 12 weeks off after a baby is recommended after a CS, and would be wonderful, but is in no way necessary health-wise for most women. It’s a trade-off.

What I did…I waited until the end of residency to conceive, choosing to deliver during my fellowship. I was in a program where I could front-load my overnight calls so I had them largely out of the way by the time I delivered. Yes, that meant I was even more exhausted during pregnancy, but I was 29 and could handle it. Then I had 3 kids back-to-back, taking only 5–6 weeks for each birth. It was hectic, but it worked. I went down to 0.8 FTE as soon as possible, and took a large pay cut to not take call. For me, it was worth it.

In my case, 12 weeks at home would not have been beneficial. I crave intellectual stimulation and adult interaction. I missed my babies like crazy when I was at work, and shed more than a few tears, and was intensely jealous of the nanny, but I came home to a clean house, with dinner on the stove, and a happy baby that I could focus on completely for a few hours each evening and all weekend. I believe the nanny, though expensive, was key to my happiness and success as a working mother. It was a financial sacrifice, but once you have more than one kid, it’s close to break-even.

As a program director I counselled many residents who, through choice or circumstance, began their families during residency. Most chose to take a full (6-week) maternity leave, even without the accumulated vacation/sick time, and then extend their residencies. Some went on to understanding fellowships. You can never get those first weeks back, so if you are inclined to stay home, do it. If you only feel like you’re supposed to want to stay home, then don’t. As long as you provide a loving environment, your children will thrive.

No situation is perfect…you optimize what you can, then make it work.

Good luck to you!

Tammy Euliano, MD

If you are an early career female physician or female physician-in-training seeking advice or support and would like to submit a question, please do so here. All questions will remain anonymous.

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