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Medical Trainees Should Be Allowed to Have Children Too

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“You won’t be able to get away with that once you’re a resident,” my attending physician hollered at me as I excused myself during a routine portion of a surgery because I was suddenly feeling queasy. Even though I was not ill, I was housing a tenant with a more persistent occupancy than a typical stomach virus. Thankfully, after a few sips of water and a few minutes of rest, the feeling subsided. I put my hand on my belly to acknowledge the baby girl growing inside and thanked her (and my hormones) for settling down so I could return to the surgery. I quickly scrubbed back into the case, not least from a sense of duty to the patient on the table but also because I anticipated my attending’s impatience would become pronounced. I quietly observed for a moment to identify the anatomy and sequence of the case before involving myself in the surgery again.

As is often the case in the surgical suite, the rules are different for trainees, especially women. To be fair, attending physicians have earned that right. Like many before them, they have knelt at the altar of medicine in duty and in sacrifice to claim such privileges that are near-heretical if expected by a trainee. While not entirely egalitarian, I understand the general premise behind this. What is difficult to understand is why medicine often punishes women for having children during this process.

Prior to attending medical school, I had a demanding nursing career in neurosurgery. Even though I wanted children, my career focus reigned powerfully in my 20s. Being a new clinician in a complex surgical field, I acutely recognized the conflicting demands of incremental clinical experience on one hand and motherhood on the other. Subsequently, as a nontraditional medical student in my 30s, I was hesitant to have a child, not because I did not want one, but because I knew it could interfere with my perceived capability as a future surgeon and potentially prevent me from being as competitive with my peers.

This feeling does not purely come from my own insecurity. I witnessed many women before me get chastised for their change in energy, their occasional absence, and, worst of all, for the changes in their bodies. I also watched my female mentors suffer being passed up for a promotion they had earned during pregnancy, gossiped about for not being “as dedicated,” and saw how people (not only men) made assumptions that women’s priorities would shift away from their patients. Yet I cannot stop myself from suspecting that this sentiment that is accepted by many women in health care need not be canonical. Because when it comes to motherhood, I contend that the opposite is true. Motherhood generates a kind of compassion that is a gift to patients. It not only transforms us from a biologic standpoint to care more, but it also requires a type of self-sacrifice that no amount of structured medical training could replicate.

Unfortunately, women continue to be afraid to have children in medicine, especially during the training years when having children becomes a guileful strategy rather than a celebrated milestone. Medicine need not ward off capable women from having children at the timing that makes sense for them. Having children while in medical school is considered a feat rather than a norm. In tangible ways, too, women continue to sacrifice their bodies after a child is born (e.g., nursing and sleepless nights), which again is often viewed as a distraction instead of celebrated for its complexity and simultaneous selfless compassion.

Medical professionals can change this culture by embracing women who choose to pursue a rigorous medical career while simultaneously becoming pregnant and having children. It is true that pregnancy, breastfeeding, and the newborn phase can be time-intensive, which is challenging in a medical environment. However, these are not limitations for women in medicine but rather another test of the mettle mothers possess. Encouraging women during their pregnancy, giving grace for its demands, and checking in during the postpartum period are small ways to make change. Institutional change can begin with clearly outlined policies for pregnancy and postpartum that protect new parents rather than generate additional layers of punishment. Guidelines may be even more important in the trainee environment. Medical schools and residency programs do not uniformly have policies in place like most corporate health care systems, and these policies can help protect parents in medicine.

I have always said that surgery is my great love. However, on the day my daughter was born, I realized that I have another great love. Surgery and motherhood do not have to be separate quests as one can fundamentally motivate the other. Surgery is my career passion, and I want to continue to be relentless in this pursuit though now I have the joy of showing my precious girl the world through the eyes of an empowered mother and future surgeon. My hope is that being a mother not only informs me how I provide care but helps others recognize the newfound dimensions gleaned from parenting.

I am hopeful for a future when women training in medicine can enjoy pregnancy and newborn bliss without worry or fear of a reprimand. Many women experience this now, yet regularly I speak to medical students who ask how they can possibly have a child and continue in training. Many women delay parenthood until they are an attending physician simply because it is culturally challenging to do otherwise. In an era when seeking balance has become a ubiquitous topic, I argue that parenthood and career choice are never in balance. As such, instead of pursuing balance, let us choose to accept parenthood for its imbalance and acknowledge that having children need not preclude us from being dedicated, multi-dimensional medical professionals. In fact, if a woman in the OR needs to step out for a moment because she is training to be both a surgeon and a mother, we should celebrate her strength.

What policies would you suggest for parents-to-be in training? Share in the comments.

Alexandra E. Richards has more than 10 years of experience as an ICU nurse and subsequent nurse practitioner and is now a third-year medical student pursuing a Doctor of Medicine degree hoping to become an orthopaedic surgeon. She is a proud Army spouse and mother to a darling daughter.

Image by Tatyana Antusenok / Getty

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