Family Planning in Residency: Is it Possible?

I read a recent study that looked at the rates of residents starting a family during training. Surprisingly, it is on the rise!

Of course this caught my eye since I am now pregnant in my third year of residency. Starting a family is a stressful blessing that should take time and preparation. There are financial and time concerns to consider, as well as stability at your job and any upcoming life transitions.

As doctors, it isn’t quite that easy. Sure, we have job stability but the pay is pennies during residency and the majority of us have massive debt from medical school. We also know that a move is most likely in our near future. Most of us will move when we transition to fellowship or a full-time job. We are also completely over-worked and already are carrying an ample amount of stress.

So why are the number of residents starting families now on the rise? Because we are aging! Ok, it’s not that easy, but that is a major component. We spend so many years in school that most of us won’t have finished our training until our early 30’s. Besides that biological clock ticking, we are very aware of the increased risks that come with pregnancy and advanced maternal age (> 35).

Residencies are Slowly Changing

One big change is the ACGME has begun cracking down on work hour violations during residency. These work hour restrictions allow more time at home with family, albeit a very small increase. The transition with the work hours has slowly led more programs to become more aware of the work-life balance.

Another big change is related to physician burnout on the rise. We know we need more balance as physicians. As a result, many residencies are becoming much more accepting and accommodating to residents with young children. They aren’t giving them extra time off or giving them special treatment by any means, but they are willing to work on their schedules to knock out some harder rotations before the birth, and then plan more relaxed rotations after delivery.

Is it possible?

Many medical students and residents wonder if it is possible and I would say, yes! Every specialty is different and I suspect it will be difficult having a child during your intern year of surgery. I am internal medicine and I would not have had a newborn in my intern year either. But there are other specialties that aren’t as stressful during intern year. Many programs also ease up in hours during the final year of training. So plan accordingly and if you need to wait, you can always plan on a child near the very end of your training.

Family Planning in Residency

My husband and I have a very well thought out, planned pregnancy during our third year. We discussed this in our intern year and planned on creating a difficult 2nd year in order to allow more electives during my 3rd year. Of course this didn’t work out completely as I spent my first trimester on inpatient wards, working 12+ hours, 6 days a week, trying not to throw up and exhausted. I will also be wobbling through the ICU during my 8th month of pregnancy. But overall, my planning worked and I have a pretty spectacular schedule all things considered. I also planned the delivery to occur right before the end of my senior year which will give me a full 3 months of being at home, without taking extra time off, before starting my “real job”.

Family Planning in Residency

Yes, it is possible and I think it is great that the incoming residents are starting to acknowledge a healthyt work-life balance. What may be right for one is not right for another so planning is everything! Give your program the heads up that you may be starting a family and see how they feel about this. You might be surprised at how well they receive this information.

No Special Treatment!

Also, do not expect special treatment from your program or from other residents! They will not give you less work and your co-residents will not be picking up your shifts for you. The heads-up really just allows them to work with your schedule, still completing all the necessary requirements but in a way that is helpful for everyone. If you have the attitude that you should get special attention/hours, your co-residents WILL push back. Be respectful of others time and realize that everyone has commitments outside of work and you are not special. Doing this will allow much more compassion when there is something you need to leave for, like an illness or even just a special family function.

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