How Do Duals Do It?

I am wondering how the women of dual physician couples have shaped their careers to manage their children and families. My husband and I are MD/PhD students nearing the end of the end of the programs and trying to decide what we should do for residency. We have a daughter who is about 1.5 and may have another child before I graduate. I knew exactly what I wanted to do until I had my daughter and now I am feeling very confused about my career. First, I haven't found any examples of dual physician couples with children who both work full time jobs at academic centers and do research etc. Second, even if I could, I am not sure I want to be away from my children so much. Here is what I have observed. 1) The mother doctor works part time. She therefore doesn't do research and usually works in a more private type practice. 2) The mother doctor works full time and her husband has a job that is more flexible and not in medicine. 3) Both people work 3/4 of a job - share a practice. 4) Both people are trying to do everything in a field they like but it isn't working and they have to choose easier/more flexible options in their field or do a bad job (ie fail to get a grant). 5) Both people choose specialties that demand the fewest hours possible. 6) One person does only research. I would like to know how dual physician couples have shaped their lives in order to accommodate their families and careers. Specifically, did your children influence what field you went into, or the center where you practice, or the amount of research vs patient care you do? What is the best strategy as a student deciding on a career after med school and what are the options?



- 7th year MD/PhD student

At times I find myself still wondering as well! But nonetheless I will attempt to answer as an academically inclined MIM married to an academically inclined physician who is also mostly in medicine, primarily doing health-related research for the government. You (yes you, 7th yr MD/PHD student and reader of our MIM blog!) have the answer, many various answers, included right there in the question you so thoroughly posed. Starting with "I knew exactly what I wanted to do until I had my daughter." That’s it precisely, we have certain ambitions and interests which we tackle full force, and then we are moved to incorporate the new people (little people, big people) into our lives as new, sometimes unanticipated (sometimes unintended) passions of ours.

The other set of answers to your questions are all there too…. in your proposed answers #1 though #6 or some combo (choose all of the above), over the course of your careers. All the while having a heightened awareness to recognize that doing a bad job (or a bad parenting job) means something has got to change quickly. You might sometimes work part time, and that might mean part clinical and part research so you have (or make) the flexibility to alter/design your schedule. Or, your partner sometimes does so. You or your husband might take a more flexible job, even within your field of medicine/research. And you might change what you do over time, or your partner might. And so on.

In my situation, I'm in pediatrics, some would say a "less demanding" field, and my husband, also a pediatrician, is primarily a health services research for the government. He does have flexibility, yet he does both research and a small amount of clinical time. I do a quite a mix of clinical, medical education, and research. The mixture keeps it interesting and allows for some tweaking or major alterations throughout the course of one’s career. We had children a few years after my residency and while his residency was coming to a close. So I guess that makes us a little older (though I didn’t have any gray hair until just recently). We found the mix that worked for our family, and we work hard; that is we work hard to get home for a family dinner every night. By dinner I don't mean spectacular meal, but rather time together mostly around the table, chewing and talking and listening to each other (vying for each other's attention, mostly!). And we work hard by day (for the most part) to get home to pick up our kids and be fully present for them, until after they go to sleep, when I tend to do a little more work (husband opts not to).

Back to your primary question: For us, having children didn't influence our choice of field (we were already pediatrician and graduating pediatric resident) but it did influence the ways in which we fulfill our academic goals. At times we do so more slowly, for example, I used to work weekends and evenings (even if not clinical, I mean work on various academic projects) and go to many academic conferences (pre-kids), and nowadays weekends and evenings are family time (when the kids are awake at least), and I now go to fewer (no?) out of town meetings or evening/weekend events. One tip, always plan to present at the national meetings that happen to be held locally in your region! Collaborate, and pace yourself.

I will mention that pediatrics does tend to be family friendly, because while we take care of others' kids all day, our colleagues understand when one's own children's issues have to take precedence. Work among people who support each other. Keep the discussion open with your partner/husband so that you can serve as a support to one another and also as a reality check as to whether the work-family arrangement is working for all of you. And remember, your kids (and we hope your husband/partner) are with you for the duration, in sickness and in health, and all that… but you or your husband/partner can tweak or even overhaul your career choices over time.