Medical

Having Children In Medical School

When my husband was in medical school, we had a social gathering for medical students and their spouses (part of our Medwives Group) as a way to meet new people as well as offer support. During the event, we asked everyone to anonymously write down a question or concern about medical school and put it in a box. We would review the comments later to learn what kind of help and support was needed.
To our surprise, almost every concern in that box was, “Should we have kids in medical school? When is the best time?”
Medical students are typically in their mid twenties to early thirties, which for many couples, is the time that they start discussing and deciding to have children. Given the unique challenges of medical school, some advisors will encourage students to postpone having children until their medical training is complete. However, the reality is that when a couple is in their child-bearing years and looking at four years of medical school plus at least three years of residency, many couples don’t have the time or the desire to wait.
Having a baby during medical school is a big decision. Let’s look at some considerations that may help you and your partner make the decision.
What’s Your Situation?
Every couple has a different timeline and situation. For some, they may be a bit older going into medical school. They may already have children or definitely want to have children regardless of timing. For other couples, they have some flexibility and really want to time a pregnancy as best as they can.
To help you brainstorm the best timing for your situation, here are a few questions to ask yourself:
1. How soon do you want to have children? Are you in the “sooner-the-better” camp, or the “we can wait for a good time” camp?
2. Take a look at your school’s schedule and atmosphere. If you could time it perfectly in regards to time off and flexibility, what would that look like? If you have a baby, how supportive would the faculty and advisors be?
3. What kind of support would you have? Do you have family nearby? Will one of you plan to stay home with the baby, or will you need childcare? Is quality childcare affordable and available?
4. Who is having the baby – the medical student or the partner? Timing can be a more important factor if the medical student will be the one pregnant.
Timing a pregnancy
So when is the “best time” to have a baby? Should you have a baby in medical school, residency, or wait until after?
You will hear a range of advice and that is because everyone has different experiences in medical school and residency. Some years are harder than others, and the consensus on which year is the hardest varies with each medical student and couple. For one couple, the most challenging year might be MS2, for another, it might be MS3.
If you are fortunate enough to be a couple that can easily get pregnant, waiting for a “perfect time” might work out. However, keep in mind that you never know if you are that couple. Difficulties conceiving or carrying a pregnancy can affect anyone, and even if a couple already has a child, they can still experience secondary infertility. Ask yourself and your partner if you are you okay with waiting for “the right time” even though it’s not a for sure thing. Some people are, and some people are not. Again, it depends on your situation.
To find specific advice on this topic, your program advisor might offer some recommendations. You can also do an online search and find numerous sites that talk about pregnancy timing in medical school.
So what is the consensus regarding the best timing? It seems that many professional advisors and personal accounts recommend having a baby during first and/or fourth year of medical school. These are the years that typically provide the maximum opportunity for flexibility and time off.
First year is usually a lighter year, with most of the time being spent attending lectures. Many programs now offer lectures online, so the student could watch the lectures and study at home, and only have to go into class for mandatory meetings, presentations, and labs. The schedule is usually more flexible and lower stress than other years.
In fourth year, the medical student chooses their rotations and their residency interview schedule. It is possible to front load rotations and to arrange the interviews in a way as to maximize time off. It’s also possible to end up having at least two months with very little school commitments, and there is some time off after graduation before residency begins.
With that being said, it does not mean that if you have a baby at any other time, it will be a disaster. Whenever a baby comes, you and your spouse will make it work.
In my personal experience, we were in the “soon-the-better” camp because we had difficulty conceiving and we started the medical school journey in our 30’s. We really wanted a family, so waiting for a specific time was not an option for us. We ended up having our daughter in December of MS2. This would be considered a “bad time” by most people. However, it worked for our situation because I worked part time and I could do most of the caregiving. When I was at work, my husband watched our daughter while studying for Step 1. In retrospect, that seems a bit crazy, but at the time, it was a workable arrangement. Good for us, maybe not good for someone else.
My husband is now in his intern year, and we are due with our second child this month! Intern year is also considered a “bad time” to have a child, but we are making it work. We have arranged his schedule so he can have about a week of leave after the baby arrives and we’ll also have family in town for awhile.
Medical School vs. Residency
Is it better to wait to have a baby during residency instead of in medical school? Again, it depends. It depends on the resident’s specialty and the type of program. Some programs will allow time off for having a baby with maternity and paternity leave built into their time-off packages. If the resident wants extended time, say beyond a week or two, they may have the option to delay their rotations. They could have the time off, but would complete the program later.
Taking time off during medical school or residency does have some financial consequences, so it is important to consider your options if you find yourself in that situation.
The downside of having children in residency is that the schedules can be unforgiving, exhausting, and stressful. The upside is that the resident is more likely to have the ability to change their schedule because there is a team of people that can cover their shifts. It’s not ideal to have the team members pick up extra shifts in their absence, but it is doable.
What about waiting until after residency? The consensus here is that once the resident is a practicing physician, opportunities to take extended leave are much harder, since you won’t be working with the same type and size of team as in residency. This is probably more of concern if the physician is the one that will be pregnant and will need maternity leave to deliver the baby and recover.
With Match coming up in the spring, if you and your spouse have a baby on the way or are seriously considering trying for a baby soon, carefully look at the leave offerings as your spouse does their interviews and ranks the programs. Once Match happens, if you are already expecting a baby, let the program director know as soon as possible. They may be able to setup a rotation schedule that works best with the baby’s arrival.
Do What’s Best For You
If you ask around, you’ll find that people have had children at every point during the medical school and residency journey. Bottom line is that there really is not a “best time” for everyone. There are times that might be more flexible and less demanding, and times that are not. You have to do what is best for you and your future family. Seek advice as needed, but know that you will ultimately be the ones to decide if the timing is right.
Support will be key. You need as much support as possible, whether that’s from friends, family, or hired caregivers. The medical student spouse will be the one ultimately taking on more of the parenting responsibilities and this can be a overwhelming and lonely task. It is up to you as a couple to figure out how best to support each other and the new baby, in addition to meeting the demands of medical training.
Final takeaway
Having a family is hard work, regardless of what field you’re in, and starting one in medical school will complicate things no matter the timing. However, it doesn’t mean that there is a better time. Medical training is long, but it does have an end date. You will get though it whether you have the additional complexity of raising kids or not. It’s up to you as a couple to decide how all the pieces of your puzzle fit together so that you have the lives you’ve envisioned now and in the future.
About the Author
Amy Rakowczyk is a medical spouse, mother, blogger, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and two-year old daughter, with another daughter one the way, due in November. She enjoys helping other spouses navigate the world of medicine and actively participates in support groups and activities. Her husband is a first-year Family Medicine resident at UTMB Galveston and did his medical training at The Ohio State University. Amy blogs at  http://www.amyrakowczyk.com.

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Amy Rakowczyk is a medical spouse, mother, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and tw...