Showing posts with label G. Show all posts
Showing posts with label G. Show all posts

Wednesday, September 16, 2009

Still figuring it out

We had my daughter midway during a two-year research hiatus from my residency. Our daughter is now five and just started kindergarten.

Because my husband and I both had flexible schedules for her first year of life, the two of us split our time with her for that first year. We then put her in a Montessori school when she was one year. We have been fortunate with this because she thrived and continues to thrive in that environment.

My husband gets most of the credit. He is the one who continues to take our daughter to school/camp/activity most mornings while I am already at work at some early hour. He is also there when I am on call or have an emergency in the hospital.

The other important thing that has made our lives easier has been his income, which even while I was in training made it so that we could afford her childcare. In addition to school expenses, we have also needed to have someone pick her up at the end of the school day (typically 4:30 pm) and care for her until one of us gets home (typically 6pm). We have achieved (in our minds) “equilibrium” with our daughter.

Fast-forward to now. I am at home on maternity leave with our 4-week old son. We are thrilled to have him – as we waited until I finished surgical residency training and fellowship and started practicing last year.

But as we have known for some time and now experiencing personally these past few months – the childcare process, particularly with infants, can be overwhelming. So far, our solution this time is a “patch-work” approach with the help of our parents who are not nearby. After the first 6 months, there is still more to figure out.

Our “patch-work” is something like the following: 2 months of maternity leave with me, 1 month with husband’s mother staying with us, 2 weeks of husband (delayed paternity leave), 1 month of my parents staying with us, 2 weeks of me (personal leave), one month of husband (delayed paternity leave).

Yes, my husband’s work offers 6 weeks of paid paternity leave, and he is going to take it.

I guess the lesson is that you have to be adaptable. And that resources and support help. But the process can be scary. Maybe looking at our oldest and seeing how things have worked for her has reassured us (perhaps falsely) that things will simply “work out” if we are diligent. We certainly hope that that is the case for this one.

Friday, September 5, 2008

Childbearing in Surgical Residency

My intent was not to make such a serious posting, but I did not succeed.

After 8 years of surgical residency and fellowship, I am happy to report that our lives are returning to some sort of “relative normalcy.” Stress the word “relative” as most would not describe it anything close to “normal.” Life as a junior staff surgeon involves frequent call, occasional emergencies, and the ability to pick up slack for my senior partners. But my life now carries with it innumerably greater amounts of flexibility than life as a resident or fellow.

I now have a small teaching group of 2 female medical students in their first year of medical school. They “shadow” me in clinic or the operating room once a week. Although both are interested in what I do as a surgeon, inevitably they are most curious about my decisions and experiences with childbearing and family life. I tell them about training. I tell them that it is hard but that family life and motherhood are great and well worth it.

It was harder than what I tell them, especially as most of my training was before 80-hours and “80-hours” is often still theoretical in surgical training. All medical training is difficult, but surgical training is perhaps the hardest. Finding the balance between family life and work duties is hard for all surgeons, particularly for women surgeons in training.

The “ethos” of surgery remains principally masculine and rigid. Surgeons are supposed to be particularly strong, not to complain, and to go along with the “status quo”. While this may sound backward and negative, paradoxically in many circumstances I find the first two of these qualities admirable, and I still believe surgery to be one of the most exciting and rewarding career paths that anyone could choose.

As most parents will testify, childbearing is one of the less challenging aspects of parenting. But decisions around childbearing and the time with your newborn are important shaping experiences.

The concept or image of a pregnant surgeon, whether or not in training, is still a foreign one to quite a number of surgeons, some of whom feel free to share their opinions. The decision and process of pregnancy for women residents (I suspect in a number of medical fields) produces anxiety and (both subtle and overt) comments. I have seen female residents leave surgical residency either for another medical specialty or leave medicine entirely as a result of issues surrounding childbearing. Two of my female resident colleagues “decided” to return to work only a few weeks after giving birth because one had been placed on bedrest before giving birth and the other was told two weeks was all the residency program could bear. Female residents that take full time for maternity leave often “owe” additional months (as it might be in other training programs) but also often suffer palpable resentment from fellow residents.

This is, in part, because typically the decision for a female surgical resident to have a child directly impacts the entire training system. And surgery, worse than most other medical sub-specialties, has not found solutions to address these issues. Most surgical training programs suffer from more limited people-power. When one person is not performing optimally or is absent for any reason, the entire team feels it. The call schedule might change from every 3rd night to every 2nd (of course, illegal under current regulations). This issue is perhaps the worst in some of the sub-specialties where the entire training program is composed of a handful of individuals. Interestingly, several of my female friends who have entered small private practices after training also experience similar pressures as childbearing would impact their partners' lives significantly.

Issues of maternity leave, parental leave, and time for other parenting duties in most residency training programs have not been traditionally prioritized. Not surprisingly, fields like surgery which have been slowest to find solutions and to transform their ethos feel much-needed pressure to start making changes -- as women now make up over half of graduating medical school students nationwide.

Personally, I “timed it” well, having my daughter during my years in research during residency. My 4-year-old daughter is beautiful, well-adjusted, and a great kid. And my husband and I have found a satisfactory parenting balance that works. I am extremely lucky, but I would like for my experience to be less of the exception.