Family,  Time Management

Starting a Family in Med School

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Ever wondered about starting a family in med school? Read on. It is officially one month before Mark and I are going to start our TTC (trying to conceive) journey! We got married in December of 2018 and wanted to start trying after our one year wedding anniversary. Although I am very serious about building my career, I am also one of those women who dreamed from a very young age of having a family and being a mom. We want four kids, at least that’s the plan. Our TTC journey could be longer for whatever reason, and we have no control over that part, but we can at least get the process going earlier. Please send all of your best wishes our way!

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I was kind of reluctant to share this because I feel as if there is, whether or not it actually exists, a stigma around talking about family planning when I should be “focusing on school”. As much as that might be true for some people, I am one year away from the big 3-0 and I want to have a big family. I realize that being a mom in school is going to have its challenges, but I’m ready. Additionally, I realize that there are other women who might be facing the decision to start a family or wait for a more convenient time, career-wise. I hope this post is useful to you.

There’s never a right time, but there may be a time that makes the most sense to you. For example, we could have waited until I finish residency, but I would be 33 and I might have to lower my expectations about family size. It’s a trade-off between financial stability, flexibility with time, fertility concerns and priorities. The truth is that we can have everything that we prioritize, and those priorities take turns occupying first place. 

I also posted 10 ways we are getting ready for baby #1, and if you want additional resources, visit https://www.mommd.com. There are forums and blog posts about starting a family in med school and other concerns pertaining to motherhood and medicine.

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Why M4 Year of Med School?

There was also no specific reason for us to wait until M4 year. Starting a family can be feasible during M1 or M2 year without having to delay academic progress significantly. Your summers are somewhat free, and most lectures are not mandatory. M3 year is a little bit harder because clerkship hours are less flexible. We are only allowed to take two days off for excused absences, including sick days. M4 year was perfect for us, because we wanted to wait until after our one year wedding anniversary to start a family . We wanted a year to adjust to married life before we brought a life into the world. There are also additional logistical reasons why we waited.

Before we decided this, I also needed to figure out what my plans were in moving forward with my training. I had to decide to continue with the MD/PhD dual degree, take a research year for a more competitive specialty, or pursue some other pathway. This decision was big and caused a lot of anxiety. Now that I have finally decided to choose Family Medicine as a specialty, I have a much clearer picture of how we could make starting a family work with our priorities. There are a lot of moving parts, and it might take some time to figure out an ideal time to have a baby that works for you and your partner. 

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Things to Consider for M4 Year

Here’s why M4 year is a great option. The graded clerkships are done, there are no more shelf exams, and Step 2 CS/CK are taken early on in the school year. Scheduling is flexible and a lot of students have some unscheduled time set aside for interviews or vacations. The only downside to M4 year is interview season. This typically runs between October and January depending on what specialty you are interviewing for. You can choose whether or not to be visibly pregnant at that time to avoid biases and inappropriate questions. Some specialties are more family-friendly than others. The other thing is, as you approach your due date, your doctor may advise you not to travel, since labor can start at any time. I would aim for a due date before or one month after interview season. This way interviewing won’t be interrupted by family life, but you can still have enough time to bond with baby before starting residency.

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Other Points to Consider

There is no single best time. For example, if I decided to pursue Dermatology and have a baby during a research year, I might have to decide if I want to have a newborn at home while I do the recommended 2-3 away rotations. If all of your away rotations are local, then this is less of a problem. Your choice may also depend on whether or not you have a reliable support system nearby already. Although we don’t have any family nearby, we have an extra room in our home for our moms to stay in when they fly up to visit. They can stay for weeks at a time, without having to find hotel accommodations, and they can arrange to come help during periods when I need more help and Mark is swamped at work.

In terms of money, waiting for M4 year gave my husband and I a chance to put some money in our Emergency Savings account. We will hopefully be prepared for any unexpected emergency expenses during the first couple months of the baby’s life. Having savings gives us peace of mind knowing that we are not going to be financially stressed if we lose an income for a few months. We may be decently well-off now, but the only thing that separates us from poverty is an unexpected financial disaster. 

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Strategic Scheduling

Starting a family in medical school requires strategic planning. In terms of scheduling rotations, try to schedule less physically demanding rotations toward the end of your pregnancy. This way, you can have some time to rest, stay hydrated and eat regular meals. Schedule electives that will allow you to work from home or with light hours closer to your due date so that if you have to be out, you won’t be missing too much.

Front load your rotations so that you can finish your requirements and have free time closer to your due date. Some students have been able to finish early and have months off to stay home and spend time with their baby before starting residency. If this isn’t feasible, maybe you can take one month off and finish up your credits on the back end. Our school has a policy that allows us up to one month after the graduation date to complete all of our requirements. Check your school’s policy and meet with your advisor to make sure that you have some room to be flexible. If not, applying for the following residency cycle is also an option, but more feasible if your partner is working.

My Specific Plan for Starting a Family M4 Year

I had to get a little creative. My specific plan involves splitting up my M4 year. I started my M3 year about four months behind my class. It will be difficult to finish up my requirements before the deadline for May 2021 graduation. Unless very specific things get scheduled, I definitely will not finish in time. I spent a lot of time stressing over this. Instead of leaving my fate in the hands of the registrar’s office, I am planning on fulfilling some of my M4 requirements by December 2020, including Step 2 CK/CS, my competency exams and my sub-internship. I will then take three months of maternity leave, and complete the rest of my M4 requirements before interview season in 2021.

Taking another year isn’t so bad if it means I can have some scheduling flexibility, and the ability to spend more time bonding with my infant before I start residency. I don’t want to be frantic, rushing around from life event to life event. I want to be able to savor these precious moments, because I know they will go by so fast. 

When thinking about timing for starting a family in medical school or otherwise, there are a few things to consider. Your support system, your resources, and your career goals all will determine what course is best for you. If being a mom is important to you, don’t let anyone tell you that you can’t do it. I hope this post gives you some insight into how you might approach planning when to start a family during your training . Let me know in the comments how you have or are planning to work motherhood into your career!

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