MiM Mail: Where now?

Dear MiM,

I am so grateful that I have come across this community. I have now spent many, many hours putting my 20m old to sleep and then lying in darkness and reading your posts on my iPhone.

So, I thought I would ask for some advice....

I am 35 yr old Intern and mother of 3 boys, aged 6y, 4y and 20m. I live in Australia and have been very lucky, thus far, with balancing work and family. I was able to do most of my internship part-time with two 10-week terms of full time work.

I LOVED my part time work. I had time for my boys, I could help at my son's school, I had time to read up on topics in medicine that interested me (or I needed to brush up on), I found some time to sew (my creative outlet). Ironically, I also felt that I was a better doctor - when I was at work my heart was really in it.

I am now in week 8 of one of my full time terms and I am tired, cranky, my house is falling apart, my 4yo is waking up in the middle of the night and coming to check if I am around, my 20m old is glued to me from the moment I walk in the door, I barely know what my 6yo is up to at school.... At work, as the afternoon slips away I catch myself checking the clock and trying to speed through the jobs. I am way too tired to read anyting medical. My sewing machine is collecting dust.

And, I have to make up my mind as to where from here. In Australia, we have 2 general hospital years (Internship and Residency) before we decide what to do with our careers. In a few months time I will need to make some decisions.

I went to medical school thinking that I would do O&G. However, I realised that I was a lot more 'natural birth' camp (my 3rd child was born at home) than medical intervention - which was not really compatible with O&G culture here. Also, I was not prepared to work the hours this specialty requires.

So, what is left:

Option 1 - Anaesthetics. I like the 'doer' aspect of it, I would love to have all that knowledge of physiology, I like the science of it, I love being organised, I like putting lines in, I like OR, I like that at the end of my training I would be able to control my hours and that part time is a real option here. BUT I would need to put in at least 3-4 years of full time work (and how will I cope if I am a mess after 8 weeks of full time?). Getting on the training program is difficult; it is very competitive. I have some advantages - I have a PhD (in Molecular Biology) and research background.

Option 2 - Family medicine (or, as we call it, General Practice). What appeals is the possibility of doing a lot of women's and children's health (I love this aspect of Medicine). I would love to do a Diploma of Children's health and Diploma of O&G which could focus my FM practice a bit. I could also easily train part time. But, will I get bored (I do not like office that much), will I end up in some 'sausage factory' medical centre, will I ever be able to focus my practice to the areas that I like. There is a fair bit of discontent amongst FM doctors here - about mountains of paperwork they are expected to do, about poor pay, about pressure to 'churn' patients through... Will I become bitter?

I should also mention that my husband works full time and has a very busy job with fair amount of traveling. He is supportive of whatever career choice I make but ultimately I am the primary carer of our boys.

I am now obsessed with making a choice, chosing a path, getting settled onto something. I cycle through these options many times a day, and it all seems like a big Rubic's cube to me - I line up one side just to find out that the others are not in order.

Dear MiMs could you please give me some advice?

Dr Mum & 3 boys