Medicine with a Family - Questions from a potential medical student

[GreyhoundsRUs]

So, I was contacted by a gentleman who is on the wait-list to our medical school. He has 4 kids, and this would be a career change for him. When I spoke with him on the phone, he said he was interested in orthopaedics, but not surgery. He recently sent me a few questions, and I figured I'd tap into the brain-trust here for some answers. I also think this would be a good resource for people who come to our site

Here we go!

1.) What medical specialties would best allow me to spend time with and take care of my family? Worst?

2.) It seems like work conditions during medical residency are largely based on who you are working for. If so, what should I consider when searching for a medical residency. What steps can I take to make a good choice for my family?

3.) How possible would it be for me as a resident to have enough flexibility in my schedule to drop what I'm doing and go help my family with an immediate need?

4.) More restrictions have been placed on resident duty hours recently. How well do institutions follow duty hours guidelines? Do you expect duty hours to change in four years? If so, how?

[ladymoreta]

Ooh fun! Can you just tell him to thank his lucky stars he was wait listed and tell him to choose a different career now? Just kidding, kind of...

1.) What medical specialties would best allow me to spend time with and take care of my family? Worst?

Best: Anesthesiology. Worst: Surgery. I'm a little biased.

2.) It seems like work conditions during medical residency are largely based on who you are working for. If so, what should I consider when searching for a medical residency. What steps can I take to make a good choice for my family?

Look for residency programs with a lot of residents who are married with kids. At interview dinners, talk to the spouses about working conditions. We don't have to worry about repercussions from telling you the truth about a program.

3.) How possible would it be for me as a resident to have enough flexibility in my schedule to drop what I'm doing and go help my family with an immediate need?

Not really a possibility. Your wife will need a good support system of friends who can help in an emergency.

4.) More restrictions have been placed on resident duty hours recently. How well do institutions follow duty hours guidelines? Do you expect duty hours to change in four years? If so, how?

Ours follows them very carefully and has implemented the new intern restrictions for all years of residency. What they tried this year didn't work, so next year, this will translate into residents working a single block of night float that is about a month long instead of taking overnight call throughout the year.

[TulipsAndSunscreen]

3.) How possible would it be for me as a resident to have enough flexibility in my schedule to drop what I'm doing and go help my family with an immediate need?

This is so sweet. I think you owe it to him to answer honestly that it's just not possible...

[diggitydot]

1.) What medical specialties would best allow me to spend time with and take care of my family? Worst?

I would think derm, FM, and EM would all allow for scheduling flexibility.

2.) It seems like work conditions during medical residency are largely based on who you are working for. If so, what should I consider when searching for a medical residency. What steps can I take to make a good choice for my family?

Attend all the dinners and 2nd look stuff. You'll get an idea of how family friendly a program is by how many events are scheduled to include kids and spouses.

3.) How possible would it be for me as a resident to have enough flexibility in my schedule to drop what I'm doing and go help my family with an immediate need?

Have their spouse talk with a resident's spouse at the dinners/2nd look about this subject. They'll know and be less inclined to BS.

Our experience in residency was that people would cover for residents if there was some sort of significant emergency. Several peeps have had spouses or kids admitted into the hospital and the resident was told to leave, go to them, that their stuff would be covered by someone and not to worry about work until the crisis was over.

Part of the flexibility is the other people being willing to step in and help out.

4.) More restrictions have been placed on resident duty hours recently. How well do institutions follow duty hours guidelines? Do you expect duty hours to change in four years? If so, how?

DH's program is SUPER tight about the restrictions and will read a resident the riot act if they don't accurately self report.

Truly, I have no idea how duty hours will change, but if they keep trying to lower them they're going to have to extend the length of residency programs. Keep that in mind when selecting a specialty.

[moonlight]

Jen I'm worried for this guy. He sounds like he is having lots of second thoughts. Were these his ONLY questions for you or did you just post the ones about family issues?

[diggitydot]

Jen I'm worried for this guy. He sounds like he is having lots of second thoughts. Were these his ONLY questions for you or did you just post the ones about family issues?

I wouldn't be worried about him having second thoughts. I think these are all valid concerns, some of which DH thought about at that point, too.

[TulipsAndSunscreen]

I think it totally depends on what he does within his chosen specialty. I know, for example, that some people say EM is a better lifestyle specialty but I know that several of our members are EM spouses that work a TON of hours with responsibilities across multiple hospitals/systems.

He can probably aim for a better lifestyle by choosing a less competitive residency in any specialty but I feel like he's looking for flexibility that's really not there in medicine.

[GreyhoundsRUs]

Jen I'm worried for this guy. He sounds like he is having lots of second thoughts. Were these his ONLY questions for you or did you just post the ones about family issues?

I agree with you 100% He sounds like he wants to have the best of both worlds - the benefits of being a doctor (whatever they seem to be for him) and a great family life. He asked me some questions on the phone a few months ago - pretty much the same stuff. It's the wording that's bothersome, I guess. Those 4 questions were the only ones that he emailed me.

[Vanquisher]

1. Best: ROAD and PM&R. I would say probably ER too. And little pursued gem PM&R is probably the best.

Worst: Ortho

2. Good luck with that. Wolves in sheep's clothing.

3. No.

4. There are duty hours restrictions? As an attending, DH works 80-100 hours per week.

[niener]

3.) How possible would it be for me as a resident to have enough flexibility in my schedule to drop what I'm doing and go help my family with an immediate need?

This is the only question I could see the honest answer to not being something he'd want to hear. It's up to him if that's a make or break issue. (ETA: The answer is not )

My advice overall is just talk to people. Talk to the resident spouses at programs you're interested in. There are definitely family friendly ones out there but it will involve a bit of investigation on his part.

The other thing I don't quite get -- he's interested in orthopaedics but not surgery? I'm not sure what that means exactly, but it sounds like he needs to stay the hell away from surgery.

[moonlight]

I agree with you 100% He sounds like he wants to have the best of both worlds - the benefits of being a doctor (whatever they seem to be for him) and a great family life. He asked me some questions on the phone a few months ago - pretty much the same stuff. It's the wording that's bothersome, I guess. Those 4 questions were the only ones that he emailed me.

He should try and look for smaller community programs with the shortest number of residency years required. I don't say that to dish on small community programs. I think the training there is excellent in fact. This comes from a tiny amount of exposure to those types of teaching programs while DH was MS4. For the most part we could avoid those locations but on a couple elective rotations he ended up at a community based program and the schedule was LITE. Residents typically left for the day by 4pm if not a tad sooner. They came in around 8am and call was a breeze because there was so many residents to spread it out between. The residents only worked at one hospital and not a big complex of hospitals- also making for less work time.

If he doesn't get in and really does want to get into med school somewhere, please let me know and I have a small mountain of advice when it comes to more family friendly off shore options.

[peggyfromwastate]

How old is he? And how old are his kids? Dh has talked 2 people OUT of pursuing med school-- both already were in the med field, had stable jobs, we're in their 30s, and had more than 3 kids. They wanted it all--- dh (and our kids) have learned the hard way that you can't have it all really.

It's not the day to day stuff that kills me really... It's the conferences, the away rotations, the courses, etc. dh spent over 14 months away during med school alone. And during residency he's been away for blocks of 4 months here and there too. Add in stress of exams, the dad never being "present" mentally, and physical exhaustion... It's not about duty hours really. All the upshot will be of limiting duty hours is extending residencies.

And all in all, the kids and I are fine. Damaged a bit, but fine. Dh has missed out on so much though. Practically missed the three middle kids' entire childhood really-- he's been in med school and residency since the twins were 2 and ds7 was born when dh was a MS1. He has only been with us for 2/10 of the twins birthdays bc he's almost always on an away rotation or course or something like that. It's a significant sacrifice--- and really the Dawktor is the one who loses the most.

[mommax3]

He shouldn't choose OB/Gyn, and might be better off pursuing a career as a nurse/nurse practitioner. Good luck to him!

[moonlight]

1. Best: ROAD and PM&R. I would say probably ER too. And little pursued gem PM&R is probably the best.

Worst: Ortho

2. Good luck with that. Wolves in sheep's clothing.

3. No.

4. There are duty hours restrictions? As an attending, DH works 80-100 hours per week.

Have you ever noticed every time a PM&R spouse joins on here they Never stick around or post more than 8 times? Just saying...

[Vanquisher]

I don't even recall a PM&R spouse.