MiM Mail: Finances during medical school as a mother in medicine

Hi,

I am writing with a question that I would love to see what the MiM community has to offer for advice! My question is- while going through medical school as a parent, how did you handle the financial aspects of your day to day budget? Did you find that student loans were enough to live on for a family month to month? (Spouse and one child in my case). Did your spouse work at all? How did you afford childcare if the spouse worked? Also- how did you get health coverage? My school offers it and you can include your family on the plan- but it is so expensive!! The monthly premium would take up almost all of my monthly living loans and I would get very little left over. My school does not offer more assistance for families, just one set amount. I guess private loans are an option but I’m afraid of the high interest rates on those. I have also heard that private insurance plans might be less expensive per month but I really have no experience or knowledge about that and wonder if they provide good coverage (like if we were to have another baby, labor and delivery/prenatal care, pediatrician visits, etc)? I have heard a few families say they qualified for Medicaid but I am also not familiar with that at all. Last part of this financial question- how did you afford all of the other expenses like going on interviews, paying for step, etc? Does your school provide extra loans when the time comes or do you just have to figure it out on your own?

Thanks!
Rachael

Sharing an essay by a brave mother in medicine

I am thrilled to share this powerful essay by physician mom K. Hope Wilkinson. In "I'd Rather Be Dead", published in the October 2019 issue of the Journal of Graduate Medical Education, she writes honestly about the attitudes she encountered after the birth of her special needs daughter.

The opening paragraph draws in the reader:

When my daughter was born, something was clearly wrong. She was just shy of term, but she weighed only 3.5 pounds. Her initial Apgar score was 0, and she was coded, intubated, and resuscitated. On her fifth day, the neonatologist did brain magnetic resonance imaging (MRI) “for prognosis.” Specialists pointed out to us everything that was wrong: the way she flapped her hands, the tilt of her ears, the size of her chin, the crease of her palm. They constantly reminded us what most babies do: smile, lift their heads, not just be little lumps. Eventually they diagnosed her with a rare chromosomal disorder, one that is barely described in a few publications. The kind pediatrician told us we would sing to her, we would read her stories, and she would go to school because we do those things for all children, but they didn't know what else her future held...

We want to read the rest, we want to know what happens. And, we need to read the rest, because her message to us as healthcare providers is very important. I know that the author made a considerable effort to craft this piece, and that it was not easy for her to share her story. Please check out the essay and let this brave mother in medicine know that we appreciate her hard work and perspective!

5 Ways to Reconnect with your Purpose

FIRST STEP: YOU HAVE TO WANT TO BE WELL TO DO WELL.

“I had to think out of the box...” I did all the “right” things: went to college, graduate school and medical school, got married, had children. Still, when I looked at my career, things just didn’t sit well. 

I was a successful and young pediatrician working for one of the top academic medical centers in the country, and I loved my patients, but I was miserable. When I looked around, my colleagues were overworked, tired, and burnt out, too. It was the end of training: Wasn’t I supposed to have found happiness and my dream job? 

I read books like Paulo Coelho’s The Alchemist, listened to self-help podcasts like Dreams in Drive and Therapy for Black Girls, subscribed to the best blogs, you name it.

I had some serious sit-downs with my husband and friends, ones where we spoke frankly about how our happiness was our responsibility. A quote from Toni Cade Bambara’s The Salt Eaters replayed in my mind. In one scene a healer is talking to a woman with severe pain and disfigurement. She asks the woman, “Do you want to be well?” and goes on to share that there is a lot of responsibility in being well. 

I took heed and began forging my path to wellness in my career—to harmony and balance in my life—so that I could be a better me to myself, a better partner to my spouse, a better mother, and a better pediatrician. 

Here are some of the things that resonated with me on this journey:

1. COMMIT TO GREATNESS.

Reset your vision of what could have been and what should be. 

I had spent a decade thinking about what my dream job would be. But when I distilled it down to its essence, I realized I wanted to do great work with children and families. I didn’t need a big hospital system or a fancy clinic to do that—in fact, they were getting in the way of my real, authentic work. 

I now do house calls and telemedicine for children and families in my area and it feels great meeting families where they are. In order to do the work I was called to do, I had to think out of the box and get out of the suffocating systems of old-school medicine. 

2. TAP INTO YOUR NETWORK. 

I have been with Mocha Moms, a support group for mothers of color, since my oldest was born in 2011. Over the years the group has shared so many stories of how other Mochas used entrepreneurship to orchestrate the lives that they and their families needed. 

I let these stories inspire and encourage me. I reached out to other physicians in my area and nationally, and learned that my story was not unique and that I was not alone. I forged great collaborations with other house-call doctors, local midwives, and other small-business owners, and now have a thriving network that I check in with regularly. 

3. KNOW THAT FINDING HARMONY IN CAREER AND LIFE IS AN ITERATIVE PROCESS WITH MANY STARTS AND STOPS. 

I am living this now. Forging a nontraditional path means experiencing things you never imagined. Sure, I don’t have a boss breathing down my neck telling me to check off a box on the computer system, but I still have a ton of paperwork. I remind myself daily that even when doing administrative tasks, I am working toward my vision and am improving children’s lives one home at a time. 

This process also requires you to let go of many of the harmful habits that have shaped who you are. Just like the woman in The Salt Eaters who for so long had been defined by her severe pain and disfigurement—to truly be well, she had to redefine herself. 

For those of us in high-stress fields and jobs, we have to redefine ourselves in a way that doesn’t use being exploited and constantly overworked as part of our defining characteristics. For me, that required and still requires self-reflection on what it means to be in service to others. Serving others does not mean being exploited or working crazy, unsustainable hours. It means being unwavering in my commitment to a life that allows me to serve sustainably and passionately for years to come. 

4. ALWAYS KEEP A PAYING SIDE HUSTLE. 

Entrepreneurship is ever-changing, but your rent, mortgage, and bills are not. 

Even though your work is fulfilling and exciting, until you are getting a regular and sustainable paycheck, you will need to keep some side hustles in rotation. 

5. FIND ALL OF THE WAYS TO BRING JOY INTO YOUR LIFE THAT YOU CAN. 

Check in with your sisterhood circle regularly. (I do that on my parenting group’s ladies-only GroupMe.) 

Check in and make time for loving relationships with your spouse or partner and commit to prioritizing your relationship with time and attention whenever you can. Try not to talk about your stressors for too long and also don’t talk about the kids on date night if you can! 

Spend time out in nature. Research shows that time spent outside improves health. 

Play outside with your kids. We try to take a family walk around the block every day and we use our local national parks for hiking as much as possible. 

As the healer in The Salt Eaters said, there is so much responsibility in being well and it ultimately rests with each one of us. Let’s be well!

Originally posted at: https://www.matermea.com/blog/5-ways-to-reconnect-with-your-purpose
* There are affiliate links in this post. If you buy something through the links, mater mea may earn a commission.

Photos courtesy of Leslie Kershaw: http://www.lesliekershaw.com/

Turning down the dial

My daughter started high school this year, and I can't believe I'm old enough to have a daughter starting high school. It feels like yesterday when she started first grade in a new school and wouldn't go into her classroom out of fear and embarrassment from us arriving a couple minutes late (I know, total mom fail. Poor decision to elaborately braid her hair that morning given my remedial girl hairstyling skills).

She's in an all-girls high school, a transition from her one-class-per-grade K-8 co-ed school, and I've been both excited and anxious for her in making new friends and managing her time with 10x more homework and being on the soccer team which involves daily practice after school and weekday games. I want to know every. single. detail. And I want to help. But I'm realizing, too, that that kind of rabid-ness may not be ideal for her development and I am NOT a helicopter mom - or at least, I don't want to be a helicopter mom! (I'm definitely not a lawnmower mom.)

So, I'm working on dialing down my innate drive to interfere and letting it go a little. Not entirely, let's be realistic, but a conscious effort to allow her to find her own way. I know she'll come to me for guidance if needed. I know it's okay to fail. I know she needs to learn. I know she will do just fine.

It amazes (and horrifies) me when I hear stories of parents being weirdly involved when their kids are of grown age. Like graduate students' parents calling the school to take care of things for their adult children. Those stories inspire me to let go now. That's doing favors for no one.

I'm resisting. And turning down the dial. And taking deep breaths. So she can breathe and grow too.

Financial Literacy Is Self Care

What exactly constitutes self care? It's different for everyone, but one thing's for certain: it's not just pedicures and massages. It's much more foundational than that.

Self care is...

• Recognizing that you must know yourself and pay attention to yourself before serving others - at work and at home. It's being attentive to YOUR particular physical, mental and emotional needs.
• Maintaining your health by keeping up appointments with a doctor, dentist or other wellness practitioner.
• Ensuring your ability to tackle challenges each day by gaining energy through nutritious food, exercise, and adequate sleep.
• Preventing defaults on your emotional bank account. And one type of withdrawal that could easily lead to a default is having problems with your real bank account.

Self-care frees you up to focus on what's most important to you

About a year and a half ago, I published this post about financial wellness. Well, I'm back on the soapbox after being motivated by a great group of financially-minded physicians in the social media sphere. We all descended on the FinCon Money and Media Expo last month, and it was an awesome display of what community can do.

I don't consider myself a financial blogger; my focus is wellness with an emphasis on how we should better know and take care of ourselves as busy women physicians. Money is a huge source of stress for many of us. Just like gaining self-knowledge, gaining financial knowledge will improve your self-care and in turn your overall health and happiness.

Figuring out how to do this in a time-efficient and effective manner is the crux. There's a TON of information out there, and it can be confusing. Here are some resources that I've found useful for learning more about finance, especially at pertains to women physicians, from some awesome ladies that I met at FinCon:

• BC Krygowski writes about downsizing and avoiding the dreaded lifestyle creep that seems inevitable as physicians transition from residents to attendings and grow their families. Ever felt like you're outsourcing everything in your life because you have no time, which in turn means you have to work more to afford the outsourcing? She and her husband (both doctors) transformed their lives over the years from New York McMansion owners to a more simple existence for their family - which translates to both of them working much less than they used to and traveling + writing much more (she also writes fantasy books).

• Eliza Minimal MD "retired" from medicine before she even turned 40 to pursue the things she's most passionate about: educating her children and traveling to far-off places. She's now back seeing dermatology patients in a clinic 1-2 days a week because she missed the mental challenge of medicine, but she exemplifies a life of minimal, intentional living. She recently published a very powerful post about stories we tell ourselves, that we're "haves" or "have-nots", and how they're completely up to us.

• Barbara Hamilton blogs at Tired Superheroine about financial wellness and navigating work-life balance as a female physician in a male-dominated field (interventional radiology). Check out her blog for practical tips about time management and simplifying life as much as possible with a young family and a leadership role in her practice.

• Bonnie Koo of Wealthy Mom MD spent years working at Morgan Stanley before attending medical school and training as a dermatologist. Her blog focuses specifically on money issues for women physicians - considerations for high income earners, blended families, couples with a significant earnings differential, etc. I've been interviewed for her "Real Women Physicians" series, and I've also guest posted on her blog to discuss parenting issues around money.

Bonnie happens to be offering a new course this fall called Money for Women Physicians*. It's an 8 week, live interactive course that marries financial education with mindset coaching only open to women physicians. A big bonus: completion of the course also awards 5 CME credits, which means you can use CME funds or pretax educational accounts for the tuition. Enrollment is only open this week (October 7 through October 14), so if this is of interest to you, please check it out!

I consider all of these ladies to be not only blogger colleagues but friends. They're examples of women employing financial empowerment as a means of self care. I hope you find as much inspiration in their stories as I have!





* The link for the MWP course is an affiliate link, which means that if you purchase the course through this link, I receive a fee. You are welcome to go through other means, but using this link in no way changes your purchase price or course experience.

MiM Mail: Considering medicine as a new mother in her 30's

Hi there! I've just discovered this blog, and have been binge-reading posts for the past three days!

I am a 35 year old brand new mother to a baby girl, living in Toronto, Canada. I have a successful career in Management Consulting (commerce undergrad, MBA), and while I enjoy many aspects of the work I am not personally or emotionally fulfilled by it. I began my undergrad in science, and for a variety of reasons (including a lack of confidence and discipline at the time) I decided being a doctor was not for me and I transferred programs. I've questioned this decision, off and on, for the past ~10 years. At the risk of sounding cheesy, with the arrival of my daughter I feel an overwhelming sense of responsibility to provide an example of pursuing a life and career that is meaningful and fulfilling. And so, I am considering applying to medical school at the ripe old age of 35 (I'd need to start from scratch with post-bacc and MCAT, and so I'd likely be at least 37 beginning medical school).

I'm hoping some of you might provide some insights / POV on the following:

Has anyone here pursued a similarly non-traditional career change? If so could you share your application preparation and process? As much detail as possible would be extremely helpful, including MCAT prep and approach for gathering the necessary volunteer and shadow hours.

Has anyone here pursued this path at a similar stage (mid-late 30s + kid(s))? I could be mid-forties by the time I complete training. Am I totally insane? Are the extraordinary costs (foregone income, tuition, time) to my family too great? How awkward/uncomfortable/lonely (or not) is it to be so much older than your classmates and colleagues?

Can anyone provide more detail on the hours and schedule during medical school and residency? I know it's intense and unpredictable, but exactly *how* intense and unpredictable? I come from a career with long hours and lots of travel, so I'm trying to understand specifically how my work/life balance would change during school, residency, and practicing. My interest is in either OB/GYN or FM (at this point).

Thank you in advance to anyone that is able to help me think through this very difficult decision. This is a wonderful community and resource.

Meghan

Two kids, and being tired.

Last night at dinner, I looked at my husband and said, running my finger through my hair, "I don't know why, but I'm just so tired." He looked at me quizzically, "well, you get up at 4:30, work all day, have two kids, and are studying for two sets of board exams all evening."

It feels obvious when you say it like that, but I don't know that we give ourselves room to be tired.

Since I last sat down and reflected, we took another foster placement, and now have two kids, 11 months apart (now, 15 months and 26 months). It sounds ridiculous to say this (or write it, I suppose) but I fell victim to some hubris in planning to expand our family. I think by around age 18 months or so, I felt like we had this "having a kid"-thing figured out. Parenting one kid with two of us wasn't that hard, once we adjusted our lives to having a kid, to not doing things in the evenings with our friends without lots of pre-planning and babysitter scheduling, to daycare pickups and dropoffs and sorting through bins of hand me down clothes. I distinctly remember saying to J, on the night before they dropped off our daughter, "it can't be that much harder than having 1."

Wrong. Wrong wrong wrong. (I know all the parents of multiple kids are laughing at me right now).

Two toddlers is SO much harder than one. Someone is always pushing over someone else, taking the book the other was looking at, shoving the other out of the way to run over to the speaker and click the play button. The first few weeks, especially, felt like they would never end. (I think that's a blog post in itself, for another day, though I do so want advice and opinions on how to build resiliency in a little one).

But there's also such funny moments - the jabbering back and forth in the car, or watching them on the baby monitor after they've been put down for the night, holding onto the bars and ducking down and standing back up and laughing at each other. They find so much joy in each other - it has been such a gift, and such a way of introducing that joy to me. And we are so thankful for that.

I would love to know your tips for growing your family. We are unique in many ways, I know - transracial, adoptive, and many other adjectives. But also we are the same, and I would love to know what worked for y'all in battling the craziness that is toddlers x2.

But good grief, am I tired. One set of boards down, one to go. (Being med peds seemed like a great idea 4 years ago...)