Saturday, November 24, 2012

Weekly Whine: Don't be a doctor if....

I had another whine scheduled for today, but in light of that delightful Thanksgiving discussion, I decided to write something else that's been on my mind.

I made a post about covering holidays and stated the opinion that I thought parents of young children should have priority for holidays. It got one or two comments, as you can see. Truthfully, I'm not passionate either way. I don't usually care much about taking holidays off because my husband has a very flexible job, so I try my best to be flexible to help others who actually need it for whatever reason. However, I felt it would be more entertaining for you (and me) if I took a side and you got to argue with me (or yell at me, in some cases).

One thing I found particularly interesting is that in refuting my statements, multiple people commented, "If you aren't willing to work holidays, you shouldn't become a doctor."

In all honesty, that's an excellent point. What kind of idiot would become a doctor if they don't want to work on weekends/holidays/etc?

Here's the thing:

Many people *raises hand* are 22 years old and single when they start medical school, with zero obligations beyond getting yourself clothed and fed. And maybe you've even heard that medicine is a good career for a mother because it pays well and you can work part-time. As a little fresh-faced med student, it's difficult to even contemplate what it will be like in the future when (if!) you get married and have children. All you know is that you can manage it all now.

Then it's ten years later. Everyone expects you to put your job before your kids, even though you love your kids more than anything. And when you take maternity leave people give you dirty looks. When you return, they say in a snarky voice, "Did you have a nice vacation?" And you can't take any actual vacation for another year and have to make up missed calls, even though your baby is still waking up twice every night and you're so tired, you could just die. And when people visit your house, they make disparaging comments about how cluttered it is because you don't have time to clean. And people on a blog will write over a hundred comments, furious at your sense of entitlement for hoping to get Christmas off when your nanny is gone so that your baby won't have to be cared for by a stranger that day. And how dare you take a day off because your grandmother died, after you left early last week because your kid was vomiting? After all, having children was a choice you made, so don't expect anyone to help you. You are just another unreliable parent, using your kid as an excuse. For Christ's sake, why did you go into medicine if you can't handle the lifestyle?

I consider myself very fortunate in that both my husband and I have a lot of flexibility in our jobs. But that's actually very rare in medicine. I don't think I appreciated when I was 22 years old how much of a challenge it is to work in medicine or to be a mother, both of which are obligations that expect you to give practically all of yourself. If someone had warned me, I probably wouldn't have listened. I would have figured they were trying to scare me or they were just weak.

When I was 22 years old, I truly thought I could do it all. It's only as I got older that I realized that not only couldn't I do it all, I didn't want to. But by that point, it's too late for most of us.

Premeds and med students: Be warned.

In any case, my follow-up question is: why can't medicine be a field that's more friendly to parents? Must it be the case that becoming a physician dooms you to spend 20 Thanksgivings in a row away from your family (as one commenter stated). And that we should be furious with people who don't want to do this? Maybe instead of being angry at a mom who just wants to spend a holiday with her baby (how dare she??), we should be working toward ways for doctors who want a normal lifestyle to have one. Perhaps hiring per diems to cover holidays or calls in exchange for a slight dip in salary? I don't know. But I believe there is a solution, and it isn't going to be achieved by calling parents selfish because they want to spend time with their kids.

Fifty years ago, they said to exhausted residents who were working three days in a row, "This is how it is. Deal with it." Now we realize how crazy that was, and we let residents work normal human hours. Will the medicine attending lifestyle similarly change in the future, and will we look back with disbelief on people who mocked physicians for daring to want to spend Christmas with their families?

87 comments:

  1. Bah. No one sane would/should argue parents don't have a right to spend time with their kids regardless of their career choice. It's when you say non-parents should be flexible around parents, that I think it's a pile of bollocks. EVERYONE has different lives and needs, and I don't see why we should give parents special treatment over say, a carer for an elderly or disabled person, or people whose families are visiting from other countries over the holidays. It's just insensitive to those who have different - but equally VALID - needs over the holidays. But I get that you're a parent and you're speaking from your perspective, but you need to look at others' too.

    Maybe it's just the States, with its privatised health care system. Over here in the UK, people are usually quite flexible with holidays, rotas and working hours. :-) Convert to the National Health Service! :-)

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    1. I actually said multiple times in the 100+ comments on my other post (not that I expect anyone to read that) that a person caring for an elderly or disabled family member should ALSO get priority. Basically, it would be nice if anyone with the huge obligation of sole care for another human being should get a little extra leeway. They don't need to be a parent.

      But what I'm trying to get at in this post is not that everyone should share holidays equally, but that everyone who wants the holidays off should be able to get them, regardless of what they plan to use it for. The current practice of *expecting* doctors to miss all the holiday should change. Is that so ridiculous?

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    2. Nope, it's not ridiculous. Finally we agree on something! :P But I still think you can't say one person 'deserves' leeway more than the other. That fun trip could make a difference between burnout and working efficiently. People are so complex that I worry when people make sweeping declarations like that. But as a general human nature thing, it of course makes perfect sense to be kind to others. It's like this PostSecret says: http://i572.photobucket.com/albums/ss162/courtney3o6/PostSecret/battle.jpg :)

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    3. True, although the more burdens you take on, the more prone you are to burnout.

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  2. I agree with what Sunrise says.

    But you're right about one thing: a lot of the agony doctors put themselves through is not out of necessity. Rather there is a culture that says that it has to be a particular way. A lot of jobs (firefighter, CEO, etc.) really DO require special abilities. In the case of a firefighter, you really DO need to be able to carry a 200 lb person on your back. A CEO really DOES have to be willing to work 24 hours a day in order to keep his/her company afloat if that is what is necessary.

    Is it really *necessary* that doctors work 80 hours a week in order to be good doctors? In my opinion at least, it is not, at least not in most specialties (you maybe could argue that it is for certain surgical specialties, but even then I think culture drives the hideous hours more than anything).

    And I hear you about "wanting it all" and then having things change. Heck, I still wanted "it all" when I was 30, and part of me still does! Do I regret going to med school given that I now have a family and my desires are somewhat different? No, though I can definitely see why some people might. I would never have been satisfied with the research project manager "career" that I was doing before med school. Being the boss / primary decision maker / having authority at my job was really important to me.

    So here I am, with no regrets (yet).

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    1. Well, there is a necessity of providing medical care on holidays and weekends. But maybe in the future all that care will be provided by moonlighters. Maybe doctors won't earn quite as much but will have a more human lifestyle. I would accept that exchange.

      You were older and more experienced when you started med school, so presumably you had more of an idea what you were getting into. Although I always recount the story of the 35 year old intern on my team when I was a sub-I who broke down sobbing, saying that she desperately missed her son and had made a dire mistake by going to med school. That's why I say that even people who ought to know better really have no idea sometimes.

      I got the double whammy, because I had no idea how much work medicine was AND I had no idea how much work being a mother was.

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    2. Yeah, I do think being older helped. At least I'd had a job before and I knew how bad things could be from that perspective. The 35 year old intern you describe might very well have known in her head what she was getting into, but may not have appreciated how it would be for her. I fully expect that will be me at some point or other during residency -- because residency is hard for everyone even if you are prepared for it! Hopefully I will have the foresight not to do it in front of some judgmental little 28 year old brat who thinks it means I shouldn't have become a doctor.

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    3. Uh, thanks a lot :/

      I guess if you don't want judgmental little brats to think that, it probably is better not to sit in a public lounge, sobbing it over and over.

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    4. Yep, that's what I said.

      (And you are being judgmental.)

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    5. I'm honestly confused. What's the judgment I'm making?

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    6. Judgmental is probably the wrong word.

      I guess what I'm saying is that just because someone cries or complains that their life is horrible and they wished they hadn't become a doctor -- while they are in residency -- doesn't necessarily mean that it WAS a bad decision, or that things won't be better later. I actually think those feelings are quite common.

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    7. Of course, I wasn't there, and I don't know this person. I am just imagining.

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    8. You're right, of course. I guess the point I'm trying to make is that many people (including myself) are surprised at what the doctor lifestyle is really like... even sometimes older, less naive people. You don't hear of, like, accountants breaking down sobbing they made a horrible mistake. I hope that intern found peace with it, but I have no idea.

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    9. Your point about jobs requiring special abilities is interesting. It's certainly true for certain positions, but I wonder if certain jobs create artificial requirements for certain abilities.

      As you said, it's true that being a firefighter requires a certain amount of physical strength. What requirement(s) does being a doctor have over being a nurse or a physician assistant? We'd like to claim that knowledge and intelligence are differentiators, but I'm very skeptical of claims about both. The only thing separating physicians from some of the other healthcare worker positions that isn't debatable is legal rules dictating that the other workers can't do what the physician does. We now have PA's and NP's in primary care pushing for the rights to practice on their own, without being under a physician; what if we find that they can do just as good a job as PCPs?

      So we create an artificial differentiator. It isn't just knowledge and intelligence, which aren't exclusive to physicians; now you must also go all-in. You must dedicate your life to your work, and you must be willing to work long hours with little sleep on top of it. Now you don't just need knowledge and intelligence, but extreme dedication (and some physical endurance).

      From what I know of medical history, that isn't the reason for the physicians' current working environment , but I wonder if it's a reason for the perpetuation of it.

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    10. I will probably catch flak for saying this, but in my observation, there are very real differences in skill set between NPs and doctors. Certainly some NPs are as good as or better than some drs, but on average I don't think that is the case. I think there have been studies demonstrating that patients cared for by NPs in certain settings (eg. CRNAs) have worse outcomes than patients cared for by physicians. It's not my area of research, so I'm not sure how large the differences were, and the outcome differential between NPs and physicians likely differs across specialty.

      So, though there may be real (and possibly addressable) differences in skill sets between NPs and drs, it is probably easier (and more PC) to just demand more physical toughness from doctors. You may be right that this is where some of the culture comes from. Or it may be that NPs will up their ante and start working longer and harder in order to earn cred in the medical establishment too.

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  3. My DH is a doctor. Sorry people but if you think you KNOW what medicine is (those starting it and those not in it) you do not. My husband is smart, well researched and didn't take his decision to become a doctor lightly. He was even older when he entered (did a masters). 25 year old can usually make pretty informed decisions.
    It all changes once you are in it. No one talks about what it is really like. AND now that a baby is on the way, things change again.

    I think it is crazy for someone to say "you should have known" sometimes you simply cannot.

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  4. Here's the thing...my family is a little older, my son is 15, my husband is a scientist. If we want to have Christmas on December 22nd, well, then that's what we do...that's what we did last year because I had to work on Christmas Day. And why did I have to work on Christmas Day? Because I told a new mom I would pick up her shift for her so she could spend the day with her kid.

    I'm all for giving the day up If you're able, but it has to be MY choice to do that. You have to give people freedom to be nice, and saying that new parents SHOULD get priority is like forcing me to make a decision that I might have otherwise made all on my own. If I had been forced to work Christmas, I wouldn't have felt charitable or like I was being a good person. I would have felt discriminated against.

    I do also feel that there is some element of "this is the profession you chose, and these are the things that go with it." Especially listening to my friends in retail whine about having to work on Black Friday...I work in a hospital, not only did I have to work Black Friday but I had to help send someone to hospice and wipe bodily fluids...however...I was fine with it. These are my choices, and that's what makes me ok with them.

    Giving preferential treatment to new parents only widens the gap between those with and those without (or those with older kids). Personally, I think we should be coming together to make these decisions, as a team. Then again, I work in nursing, so, maybe it's different when you become a doctor.

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    1. In some ways, it's good to make it a choice and not make it forced. But here's something that I saw happen a LOT in residency: some people were jerks who never ever were willing to switch calls. So who got asked when someone wanted to make a switch? The nice people. So people like you are ALWAYS going to be asked, and because you feel guilty saying no, you're always going to miss out on the holidays. But if people are given what they *need* to begin with, the nice people won't be disproportionately imposed upon.

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    2. But that's just life. Even nice people have to draw boundaries for themselves or else they will get walked all over. It's not the job of the rest of the world to do it for them.

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    3. I appreciate you trying to play devil's advocate here Fizzy, but I think it's pretty hard to find fault in Vingleburt's logic. I have made a (very hard) decision to wait on starting a family. Holidays, call, vacations, and rotation locations (which is where I am in my career) should not be affected by family status. I imagine I'll work every Christmas and Thanksgiving for the rest of my life, but that's my decision, my good deed, my sacrifice and/or my financial incentive.

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  5. I think it's in part due to a point you have brought up before - people are surprised to find out doctors are humans too. People are surprised you can't do it all, that you need breaks and vacations, can get sick, and want to spend time with your family. Those are mere human needs, and you, as a doctor, are required to be entirely selfless and invincible.

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  6. I used to resent people (mostly women) who would go into medicine intending it to be a part-time job so that they could take care of their kids. Then I realized what 'part-time' in medicine really meant and think that I will probably be in that position someday.

    Now, I just resent the women like one of my attendings' wife, who went to medical school just so she could use medicine as a back-up to being a mother. She did her internship so she could get licensed, and then dropped medicine to be a SATM. I realize things happen sometimes and people are forced into that position for one reason or another, but it irks me when people enter medical school with the intention of using it as a backup. It's not really the type of career that's appropriate to use as a back-up.

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    1. Are you sure that's why she went to med school? Maybe she realized after the fact that she couldn't handle it?

      Honestly, I feel sorry for people like that. Med school and internship are a huge time and financial commitment, and it seems like you must really hate it to go through all that and then leave.

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  7. I think you make a good point about being willing to take a lower salary in order to get holidays or other time off. During one of the computer industry booms, a friend of mine was making amazing money, and complaining about having to work 80+ hours a week. But the folks in the industry wouldn't have been willing to work 40 hours for half that amazing salary.

    I'm wondering about the way you talk about doctors vs those who would fill in. Wouldn't they also be doctors? Just doctors who've made a choice to do locums work for (probably) less money overall (if they don't have benefits)?

    Finally, you are right on the mark when you say that people can't be expected to know what the future holds, how they'll feel later, etc. How can anyone who hasn't done it know what it's like to do Navy Seals training, medical residency, etc. Those things aren't part of the experience of most people, and reading about it can't be the same. Parenting probably fits in there somewhere, too.
    ~J

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    1. I guess the people who would fill in would be doctors or perhaps PA/NPs. Actually, this could be a great opportunity for mothers who want to stay home with their kids but still want to keep their skills intact by working holidays or occasional weekends when their spouse is around. Or else young people who don't have kids and are trying to save up money for later. I just feel like it shouldn't necessarily be an essential part of practically every physician job.

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    2. Wouldn't it be awesome if you got time and a half as a resident for taking the shifts nobody else wanted? I'll bet that would cut down on the bitterness and resentment!

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  8. Not as many bored people today it seems. I didn't want to pile on the T'giving tirades, but just can't resist adding my two cents.

    Fizzy, you are (maybe should be) making a larger point that applies to any occupation: How to have a reasonable life yet still meet expectations of the field. I've been on both sides. I work in a field that is 95 percent male. The only women in the office were generally the administrative staff and the younger ones were frequently absent for child-related reasons. But no big deal. They were rarely mission-critical. And they were NOT climbing the corporate ladder.

    My mostly male coworkers NEVER took time off, came in late, or expected any special treatment because of "family" (read: small children) issues. Presumably the burden fell on their wives. (OK, I'm sure here and there some guy was forced to pitch in, but if he valued his career, he would be smart enough not to reveal it. He would get a cold, or in a car accident, or whatever would not cause eyebrows to raise rather than admit he needed to be a Dad.) Because those of us killing ourselves to meet management's expectations deeply resented employees with child-care responsibility, people who had to leave at a precise time (or daycare would dump their kids on the street) or leave early to take a sick kid out of school, or didn't come in at all because the babysitter didn't arrive. There was a huge downside for people who put their families first: they would never advance, never get big bonuses or fat raises, never amount to anything within the company. Because that's the culture: You give it your all no matter what that is or you might as well leave. (And even giving it your all doesn't guarantee success.) It's not just medicine that makes ridiculous demands of people.

    But here's the thing: Later in life I became the caretaker for my Alz mother. And I started to understand what people with small children dealt with: Unreliable aides (babysitters), medical emergencies, hours a day that I couldn't afford spent on her needs. As I became less reliable, less able to put in 80 hours each week, I saw the resentment build up among my coworkers, saw my value to the company diminish. And had to leave the job.

    I am working a part-time job from home right now, making not enough to support me and my mother, but until she dies, it's what I have to do. I haven't had a vacation or even a full day off in probably 5 years. It comes with the territory so I'm not bitching, just saying.

    The entire society and culture need to change. People need to be able to have a little of what they need, whether a holiday off or flexibility to deal with unreliable baby sitters. Employers COULD do this, but they can't be bothered as long as there are eager replacements (probably young and without children/elderly parents) in the wings. There is certainly no dearth of candidates in my profession, thus no incentive for management to change the culture. I guess there are still more doctors than jobs. Because only great necessity will force management to change the culture.

    Just IMHO you understand.

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    1. Thanks so much for your thoughtful comment. As you pointed out, it is so frustrating and awful to be seen as unreliable for things that are outside of your control. In actuality, you are taking on much more responsibility than your coworkers, but nobody sees it that way.

      Unfortunately (or fortunately), there is a physician shortage, especially in primary care, so this could go either way: allow doctors to make more demands because they are more scarce, or stretch those remaining doctors thin because there are fewer of them. I definitely think the physician lifestyle is better than it was 50 years ago, so hopefully things will continue to move in that direction as more women enter the field and make it clear that the flexibility is not negotiable. Yes, work your ass off if you want the big bucks, but otherwise, you can still be a doctor without missing out on the rest of your life.

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  9. You know, back during my residency days I was single and I had a couple of female co-residents who took maternity leave. I didn't mind it because I always figured if I ever got married and my wife got pregnant, my wife would be extended the same courtesy.

    I had a couple of male classmates who always got upset about these things, but what can you do? As far as holidays go, I see your point about it as well. Realistically, it's not like Christmas meant that much to me as a mid twenty something single guy.

    That said, there's always the potential for abuse. While some mothers were fantastic co-residents, very reliable and willing to help out with only the rare childcare issue... there was one resident who was constantly late or leaving early and always dumped work on others using their child as an excuse. She also took two maternity leaves during our residency and didn't make up the time. I think everyone was just happy to get rid of her.

    I am married now, my wife is also an attending, and she did get pregnant. I got the sense from my wife that she had a few co-workers that got a little irritated as well with her (this despite the fact that she's an attending at a medical school and the residents do the bulk of the work, as in any academic program). I told her she should tell them to go to hell.

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    1. I find the most understanding people are the husbands. Even more so than other mothers.

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  10. There are a lot of careers where people don't care that you have kids. Fizzy, while you're trying to make a point, it's not just medicine that does this.

    Plus, you can choose to work part-time or take no calls or do a specialty where things aren't so busy, LIKE YOU. Isn't THAT what you did??

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    1. Are you in medicine? 9-5 with no call or weekend isn't always possible to manage. I was fortunate.

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    2. hahaha ok sure. And you CAN choose a speciality that is majority lab based and some patient care like my DH. THEN you can be forced to do 3 years in addition to med school of general training. In addition, you can even be forced to do things like derm which have no call....but of course be forced to fly in on IM, because why not? you are free labour. It is not so cut and dry. Even a well informed choice of 'good' hours don't work out right away...or at all sometimes. Not to mention, I have heard of no other career that makes you MAKE UP any time you take off for parental leave. Yes folks, any parental leave he takes must be made up and put him behind in his job path. So even though where we live he is entitled by law to leave, he is in reality, punished for taking any.

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  11. I'mjustagirlintheworldNovember 24, 2012 at 10:13 AM

    Wow. So many of these comments just make me wish I was a guy...I think that mothers in medicine should get priority on holidays/etc; I agree with Fizzy...because if the culture continues like it is, mothers and mothers-to-be will eventually just get "phased out" of medicine. And that is a bad thing - we need doctors who come from diverse walks of life and are able to sympathize with all kinds of patients.

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  12. Admittedly, I'm a childless 22-year-old and plan to stay that way (and I'm going for an academic career). I think a lot of it has to do with my family dynamics, but I'd be the type to volunteer to work the holidays because I don't want to be home with my family.

    The sad thing is that the parents seem to care more about celebrating the holiday on that specific day than the kids. Tell the kids, say, Thanksgiving is early or late. So what? They still get it. Christmas early? Most kids think that's the greatest thing ever!

    Celebrating the holiday on the exact day of (except for possibly Halloween) is really not as essential as a lot of people make it out to be. Most kids, especially when they're young, WILL NOT CARE. I work with at-risk kids daily and have since I was 14. Now I work with foster kids, who don't care what day it is as long as they get to celebrate with Mommy or Daddy /sometime/, whether it's a week before or a week after.

    So no, I don't think priority should be given to parents on holiday. I think putting the shifts on rotate and having it so that each person takes a certain # of holiday shifts a year (and can trade if they want) and then alternate the next year would be fair, with possibly the option to take less/more holidays the more you've worked.

    Just be happy you're able to celebrate with your kids with you, whether it's a day before or three days later or whatever. Not everyone has that option. Be grateful for what you have. ;) Isn't that the theme of Thanksgiving anyways?

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    1. For some families, celebrating the holidays involves the extended family or religious celebration. Convincing a Church or 30 Aunts, Uncles, Cousins, and Grandparents to move their Thanksgiving can be a little hard.

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    2. And you can't move what day your kids are off from school.

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    3. @Chia - single people have the same problems as well. So thats not a reason to give parents priority.

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  13. Alternately, if you value having family holidays, don't marry a doctor. Or maybe that's if you value having sanity. And really, why can't fathers get priority in holidays or in the ability to zip off to take care of emergencies?

    As the wife to a General Surgery resident and mother to a 15 month old, it's rough. There's the normal frustrations of trying to balance my job with making sure the house is taken care of and the fridge is full, coupled with chasing a toddler.

    Then, when the holidays hit, there's an extra level of complication, coupled with us living far away from friends and family. Do the kid and I hang around the house for the holidays, hoping that my husband will be able to spend a few minutes with us, or do we abandon him and head "home"? In a year, or so, will my daughter be upset that a family holiday doesn't involve our whole family?

    Let's just say that I'm counting the days to the end of residency and trying not to think about the fact that we're still a month off from the halfway point.

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    1. Wow, sorry Chia - that's a real bummer. Just wanted to sympathize with you for a minute... hang in there!

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  14. Fizzy

    Eventhough being a doctor of medicine will give people way less family time, I think there are a lot of issues here in the Unites States. I am from different country and where I come from, mothers get 6 months maternity leave with full pay and if they want they can get extra 6 months without the pay (this is for govermental workers, private companies just depends but still way more family time there than US). Unites states is way more developed than my country in many ways but in terms of family/vacation time and mothers need seems like you guys are way behind compare the rest of the world (I have many friends living in different parts of the world). In the States somehow taking time off to be with family is look down upon.

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    1. Yeah, just another thing this country is way behind on compared with all other first world nations.

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  15. There is a solution - move to Europe !!! There is something called the European Working Time Directive there that limits doctors in training to a maximum 48-hour week, averaged over a six month period.

    That will probably give you LOTS OF TIME !!! ha ha ha...

    (but of course, Medicine is Geographical and moving to Europe means writing pesky exams and starting residency all over again...but again, maybe this is why medical training in the US needs more reform - choosing to help people in hospitals should not mean that you shouldn't have a life)

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  16. The way I understood your initial post is that people with children should be given preference regarding time off for holidays. While I do understand that people with children have scheduling issues that those that do not have children have, why should those of us that do not have children or those of us that have chosen to not have children be required to make accommodations? I don't have children and I never wanted any. My husband and I like to backpack. Sure we could backpack at other times but why should we accommodate folks that have chosen to have children? It is one thing to be asked to give up a holiday but it is quite another to give preference to people with children -- in essence it is penalizing those that do not have children.

    I have to admit that I would be EXTREMELY angry if I was passed up for vacation time just because I do not have children and have to give it to someone that has children. Someone's scheduling issues is not my problem.

    Fortunately I have never worked at a place where people with children are given preference with respect to time off. I am willing to accommodate and help out but it is quite another for an employer to give preference to people with children over those of us who do not have children. I am not in health care however, people want the holidays off especially those with children. My employer grants holiday time off on a rotating basis and people with children are not given preference.

    I have given up my time to accommodate a single mother. You brought Christianity into the discussion. The Bible teaches a cheerful giver, not one that is forced. I freely gave up my allotted holiday time versus having my employer take away my choice and gave preference to people with children.

    Fortunately I believe it would be illegal to give preference simply because one had children while those who have not yet had kids or those that have chosen to not have kids are not given the same treatment with respect to time off for holidays. "Preference" implies that it is an employer based decision for it is the employer that ultimately decides who and how many may take off on any given holiday.

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    1. OK, so you decided not to have kids because you like backpacking and maybe enjoy being able to come home and relax every night. A working physician mom spends probably 50-60 hours a week at work, then goes home to diaper, bathe, feed, and cloth her children, unlikely to have a second of time to herself, then has the absolute gall to hope to have some flexibility around the holidays so she doesn't have to scramble to find childcare. She shouldn't be given preference but instead have to beg you to postpone your backpacking trip so that she doesn't have to call everyone she knows to find someone to watch her kids. Is that what you're saying?

      Keep in mind that educated people having children benefits society, and that even though children are wonderful in many ways, they are an enormous responsibility and a lot of work. Every time someone inconveniences you with their "choice" to have kids, think about who will be your physician in 30 years from now. Would you be better off if all educated working people decided to stop having and raising kids because nobody was willing to make any allowances for them? Is that what you'd prefer? If it isn't, then maybe it's time to start making changes in the workplace to keep that from happening, and one of those changes is creating a more flexible working environment.

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    2. (In health sciences but not medicine)
      I do think that there should be changes to help both parents but it seems like you are penalizing people who do not have children. Do childless people like to celebrate holidays with their family less than people with children? If you think yes, then children/non-children people will never see eye to eye. We may not have children but we do have parents, siblings, grandmothers, nieces, nephews and other relatives, and we may not see them too often. To be forced to work every holiday seems unfair just because we do not have children. It sucks to think that I may never spend Christmas with my family until I have a child.

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    3. "To be forced to work every holiday seems unfair just because we do not have children"

      I'm pretty sure I never suggested anything like that...

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    4. I am sorry that I misinterpreted your post. I honestly did not mean to put words in your mouth.
      But you said that parents of young children should have priority for holidays. That led to my assumption that if they take priority and get those holidays off, childless people will have to be the ones to work them (because who else is left?)

      I also think that if there is some policy (whether official or unofficial) that gives priority parents of "young children" there will be bickering even among people with children, unless there is some rule that the person with youngest child gets priority or something. Although I guess there will always be bitching over vacations no matter what you do (in pretty much any job).

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    5. I wrote in my original post:

      "I wasn't trying to say that a parent should get every holiday off and a non-parent should work every holiday... but if everyone gets, say, three holidays off and the parent says they really need Christmas off due to childcare issues, that should receive preference."

      I still do think that's reasonable. That way everyone gets the same number of holidays and it can still vary year to year, but parents of kids young enough that they can't be left alone have a little extra flexibility.

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    6. But even though it sounds reasonable, childless people will still probably never have Christmas off.
      They may have other holidays but EVERYONE, with or without children, will want Christmas (or any desirable holiday off) unless they do not celebrate it. So unless a site has a lot of Jews/Muslims/other religion/militant atheists who refuse to celebrate the secular aspects, the majority of people will want Christmas off. Even if there is not a childcare issue and a parent can find a babysitter, parents will want to see their children open presents every year and they will want Christmas off every year. (Even to work Christmas day and celebrate it at home a few days early, a kid may have to be older before parents would want to move the holiday.) So even if we get 3 holidays, the childless ones will still be the ones working Christmas since the parents will take priority. Parents will always use the sentimental reasons for requesting that date off. For the same sentimental reasons, childless people want to celebrate with our own families. It sucks that I may or may not get Christmas/Thanksgiving off but a parent always will.

      Unless I am misinterpreting your statement and you are saying that if childcare is possible, parents should be put in rotation for holidays. However, I can see some people lying in that instance. After all, no one is going to check all your babysitters so make sure that you really don't have any childcare.
      Or people will say that "my 12/13 year old can't be left home alone so I can't work" and people will bicker if the not-quite-so-young child should get preference ("I can get a babysitter but I want to see my 5 year old open presents on CHRISTMAS DAY. How can I explain to my young child that we have to celebrate Christmas on December 23? Your 12/13 year old can stay home alone.")

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    7. I guess there isn't much you can do about people being liars, although I'd hope they wouldn't do that. I mean, under the situation that people are advocating where you have to ask someone else to switch with you, a parent can always come up to you with some crazy sob story and guilt you into switching so as not to feel like a horrible person.

      I suppose the whole thing predicates on parents acting ethically in exchange for the extra flexibility.

      Personally, while I have small children and we "celebrate" Christmas, I don't feel particularly attached to getting Christmas off. I absolutely wouldn't mind doing the presents a few days early if someone else wanted the holiday more than I did, children or no children. And before I had kids, I used to request Christmas specifically because I had no use for it more than any other holiday.

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    8. (Plus the thought of traveling at Christmastime makes me want to vomit.)

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    9. Eh, i have to travel. I currently live over 12 hours away from my family so school breaks scheduled around holidays are the only time I can see them. It's not that bad, although I drive. I imagine an airport would be a lot worse.

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    10. Although I am childless (because my partner and I have decided to defer children until I finish residency), I highly value having major holidays off as these are the only times I get to see my partner, parents, and extended family (many of whom travel from distant locales). I can't make this happen any other time of year, so if I work both Christmas and Thanksgiving I don't get to see most of my family members that year. Has nothing to do with the leisurely backpacking trips you imagine I like to take.

      Perhaps employers could/should provide an on-site or local childcare option to parents required to work a holiday.

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    11. Medicine is not the only profession where hours are crazy and require shift work. My sister in law, a single mother, is a police officer. She does not get priority as vacation time is based on seniority. Also schools do not let out only on Christmas and Thanksgiving day but they let out for several days on Thanksgiving and a couple of weeks on Christmas making childcare somewhat of a nightmare for some. The belief that those of us without children can see family or friends anytime while true, is not the same as seeing family on special holidays. It is a different atmosphere and asking us to continually lose out on that special time because we don't have children is not fair. My hubby and I spent Thanksgiving with family. I can assure you that the time we spent with the whole family is not the same as seeing family when we are not all together. My sister in law worked that day so we held off the meal until she was able to join us.

      I seriously doubt that the physician shortage is due to childcare issues. Of all the reasons I have read about and heard regarding physician shortage such as Medicare cuts, lower pay for PCP, and a whole host of other valid reasons, I have never seen any statistics or read that one of the reasons we have a physician shortage in this country is childcare issues. If childcare were the case, we would suffer shortage in many other professions due to childcare.

      Why doesn't the employer provide childcare? The firm that I work for does provide childcare in emergency cases so that the employees can work. Many parents could not work if their child is sick with a cold because childcare centers won't take a sick child so the parent has to stay home. The childcare that the firm provides for emergency uses is utilized during holiday time. The employee pays a share based on their ability to pay (salary based) and the firm covers the rest. It sure is a better solution than asking childless folks to give up family time or vacation time to do other things.

      And yes, I agree with you that educated people having children is good for society. While I do not mind helping out, it is not my responsibility to perpetually give up my holiday time so that those with children do not have to deal with childcare issues. If it is good for society, then our society should provide the tools to help much like many companies do to aid their employees with childcare issues. As I said, I work for one. If it is good for society, the burden should not be placed on the few that do not have children.

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    12. Articles such as this one talk about how women working parttime (largely due to childcare issues) contribute to the shortage of physicians:

      http://www.nytimes.com/2011/06/12/opinion/12sibert.html?pagewanted=all&_r=0

      Childless people pay through their tax dollars for public schools and other services for children because it's judged to benefit society. So there is some precedent for this.

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    13. Good article. This article discusses the long hours that physicians face and their desire to spend more time with their families. Unfortunately this problem is not limited to physicians. I can't tell you how many professional women I know that have switched to part time or quit work so they could spend time with their children. As one young corporate lawyer stated to me regarding her decision to work part time, "I didn't have a baby so someone else could raise him." She was in a financial position to hire a nanny to come to her home rather than dropping off her baby at a day care center. She left a very high paying position. She is now a stay at home mom. She picks up contract work for the firm she left, covering depositions, some court appearances, etc. There are many like her.

      Again while your article was a good one, it had nothing to do with physicians scrambling to find someone to cover for them during holidays which is what your post was about. You cited this as a societal issue, fewer doctors not good for society, educated people having children good for society, etc. Again, I stand by my statement that physician shortage is not due to holiday coverage issues. I was responding to that issue only and not long hours that physicians face. The article cited that female physicians are more prone to choosing specialties that are more conducive to spending time with their families rather than their male counterparts.

      Your solution, however, is to take a segment of society, those without children, and place the burden on them to cure society's need for holiday coverage. If holiday coverage is a problem that affects society as a whole, which is what you were arguing, then the solution should not be placed on the shoulders on a smaller segment of society but rather, society should address this holiday coverage issue. The article that you cited came up with a solution that many corporations have already addressed, on-site childcare. Actually, I am surprised that hospitals do not have that benefit for their employees. It would benefit both the employees and the hospital.

      Lastly, and as I mentioned previously, your solution that childless people bear the brunt of holiday coverage because they can see family any day is unfair. Childless people want to spend holidays with their families as much as families with children. As I am sure you know, spending holidays with family is a special time and not the same as paying a visit any day of the year. With many families living across the country, it may be the only time that a whole family gets together in one place. Even so, depriving childless people the joy of Christmas, Thanksgiving or any other holiday just because they do not have children is a burden that should be shared by the whole of society rather than a small segment of society. If it is an issue that affects all of society, the solution should be the burden of all of society, not a segment that you have decided does not need to spend time with family because they can see family any other time. I can only imagine the added insult to a woman that is trying to conceive but is unable and then to be told that because she does not have children, she is required to work on a holiday so that those with children do not face childcare issues.

      Despite this argument that you raised, it is a moot point. I cannot imagine any employer putting themselves at risk by sending out a new holiday vacation schedule stating that all employees with children will get preferential treatment during holidays and if there are any slots left over, it will be given to childless employees. If your hospital or wherever you work were to implement your idea, they will likely be lining the pockets of lawyers defending childless employees.

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    14. I agree with the childless people not being thrown under the bus for those with kids. Children are important, of course, but to assume that childless people are devoid of loved ones who need them or that they are dying to see is cruel. Parents already take far more time off for their kids and childless people take up the slack. Childless people are still people... they deserve breaks and family time as much as parents do.

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  17. It is fascinating that everyone got So angry and uptight about this question, myself very much included. It sure sounds like we're all really scared and anxious about something in it. I think it's about being cared about as individuals, in our workplaces, and even more so, about getting our own needs met. So hard to think about it rationally with all those worries hanging around.

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    1. Well, at least you didn't accuse me of being selfish and entitled and never willing to take personal responsibility. Even though I made clear from the beginning that I never asked for any of these things for myself, since I am not religious and have a husband who can handle childcare on holidays. It's hard to have a conversation when people start with the name-calling.

      I really appreciate it when people can state their arguments rationally without letting anger color their language. If someone responds in that way, it's hard not to respond similarly, and then things really degenerate.

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  18. I am a physician, and I am childless (and plan to stay that way). I think it's probably a losing proposition to convince us that we should give up our holidays, or let our colleagues with children have priority for holidays off, or that we should somehow feel guilty about the fact that we don't want to make that sacrifice. I don't mind occasionally accommodating a colleague with a family emergency (of any kind, not just relating to child care), and have in fact "volunteered" to work this Christmas day. If I CAN help out, I will. But I definitely would object to a blanket policy around preferential treatment for those colleagues with children being forced on me that would obligate me to work more holidays than I already do. It's unfair.

    As much as you seem to object to the idea of having children being a choice -- I'm not sure I see it any other way, particularly for a highly educated, professional group such as physicians. While I agree that it's fair to say that, as a 22 year-old, you should know exactly what each of your life decisions for the next 10-15 years will entail, I still think that making certain choices carry certain clear sacrifices. Those who have children have chosen to start a family, much as I have chosen NOT to have children, and have somehow managed to... not have children! With that choice come certain responsibilities and certain sacrifices, which are I assume balanced by the inherent joys of parenthood, which I will never be in a position to experience. The truth is that no one can 'have it all' (whatever that means). However, I think we as physicians come fairly close, compared to many other people. Our jobs are gruelling and difficult, and do have their specific downsides, but we also have a decent, stable salary and some degree of job security relatively speaking -- eg it's very unlikely that I'll be laid off because my hospital is 'downsizing'. Ultimately, no job is perfect, but medicine is pretty good, all things considered.

    ER MD

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    1. Don't you feel, however, that there are benefits to society for physicians and educated people to have children?

      First, if the field is completely unyielding to childcare needs, fewer women will enter medicine and there will be gaps in primary care fields that are generally filled by women (if simply the idea of fewer women in medicine alone isn't compelling enough). Also, for little girls, there is no better role model than their mother, so having women in medicine breeds more women in medicine. Further, do we really want all the children in our society to be produced by families with little interest in learning or highly skilled professions? To the extent that intelligence is environmental vs genetic, either way it doesn't bode well for the next generation.

      In summary, looking at the bigger picture, I think there are many compelling reasons to allow more flexibility for parents in medicine.

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    2. I think it's a pretty big leap to go from "not giving priority for holidays off" to "being completely unyielding to childcare needs"-- yours is a bit of a slippery slope argument. I also think its a big leap to say that I am arguing for more children produced by less educated/employed families just because I don't want a policy forcing me to work more holidays than I already do. Again, we're not talking about mat leave here, or flexibility to work part-time -- just whether or not parents get Christmas off to spend with their kids. I doubt that people will make decisions on whether or not to have kids because they may not get certain holidays off. It's a challenge to get child care on holidays, but balancing any job with parenthood is a challenge -- which, again, is presumably balanced by whatever inherent benefits of parenthood.

      ER MD

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    3. Yes, but I wasn't trying to say that you should work more holidays than you already do, simply that if a person with small kids requests a particular holiday in lieu of another holiday because it would make childcare much easier, then they should be given preference for that request. Finding childcare on a major holiday can be a huge nightmare, and though some people seem to be able to manage it, if you don't have lots of friends or family in the area (that was someone's solution), it can be a source of MAJOR stress. I don't think it's too much to ask for people to have some flexibility just so we don't have to put a young mother through that, when she already may be close to the breaking point. I can say through personal experience that when you are balancing small children and a challenging career, you are often one childcare emergency away from shutting yourself in a closet and bawling your eyes out.

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  19. I'm a med student (MS4), about to go into psychiatry.

    There is no way in hell anyone's about to tell me (past residency, of course) when I can and can't work. That's why I'm going into private practice or a group of some sort. If I want to work 85 hours a week, that's my business; if I want to work 30 hours a week, that's also my business. What matters is that I will be providing excellent care to my patients, and in my field that requires taking care of myself as well (due to the nature of psychiatry as a two-way street between patient and doctor). I'll have kids if I want, and I'll have hobbies if I want.

    It upsets me me that people are expected to choose one very important aspect of their lives over another (children vs work, work vs hobbies, etc), but then after thinking about it, I realize the following:
    Who expects us to make these decisions? A lot of the time, it's people who have made that decision and can't face the guilt that they gave up something important to them, or can't face the possibility that perhaps they can't get that thing they gave up back anymore. It's easier to accept that "it's just the way it is" than to go back and try to make amends or face your estranged children or family.

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    1. Sole private practice has its benefits but also its own set of challenges. To some extent, you're at the mercy of your patients. But the plus is that nobody tells you what to do and you get to work when you want. It's not clear to me how people in sole private practice handle things if they have a baby and want to go on maternity leave... just curious if this is something you've looked into?

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    2. Solo practices has pros and cons. We shut down my office for the holiday week (pro), but we'll get paged throughout for non urgent matters (cons). With maternity coverage you can either get someone to fill in for you which works depending on your type of practice, or have a short one, start back part limited time and because it's solo practice bring the baby to work for the first several months. Solo means you set the rules and you need to set the boundaries as well. Downside, if you aren't careful, patients get mad and your income drops. Overall though it works better for moms. Some specialties just don't work this way though.

      I think you bring up, and not the first time (This of course privately makes me wonder about how you are doing) about issues of burn-out. We can't do it all. It's ridiculous to try. We can just do the best job we can. At the end of the day our kids and families are really the only ones that matter. Working with patients facing their own mortality, no one ever wishes that they made more money or worked harder. Everyone just wants more time with their kids. It's a good take home message about what is in the big picture, more important.

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  20. Wow, after reading comments to this post and your...er...popular previous post, I'm starting to believe that there are an awful number of insensitive people reading your blog. 0.o All you're asking is for people to be more understanding and considerate, not that they bend over backwards 24/7 to accommodate everyone's needs.

    I'm a little premed, inexperienced about the ways of medicine, but I'm surprised (and a little saddened) by how much the public demand of physicians. I want to meet all their expectations and "save" everyone I treat and give everyone perfect health and never make a mistake and never have to be responsible for someone's death. I desperately want to and I work desperately hard every day to do so one day. But that's just not possible.

    I do plan to have children one day. I have already given up some in terms of a personal or social life and I know I will have to give up much, much more. Of course if we choose medicine, the sacrifices are steep, and we should be aware of this and well-prepared. At the same time, does that make the reality of sacrificing any less difficult?

    Doctors are trying. Be understanding. Doctors are taught to be understanding of their patients, but patients are rarely so of their doctor. (And doctors can be surprisingly callous towards one other).

    I really enjoy your blog, by the way. It's funny, thoughtful, and actually gives me quite a bit of hope for my future. Thanks. :] Happy belated Thanksgiving.

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    1. I know... I thought the things I was saying were very reasonable. In no way was I ever suggesting that childless people give up all their holiday or even ANY of their holidays.

      I think the issues are that:

      1) Some parents who have had to struggle with finding childcare for their kids have the attitude of "well, I did it, so you should too" no matter how awful it was. I don't think that's the right attitude to have, although it's a common one in medicine.

      2) People with kids often DO abuse the system, and it tends to leave a residue of bitterness. When you've been constantly covering for parents who cut out early to pick up their kids and are always calling in sick, I can understand getting angry that these entitled parents want one more thing.

      Ideally, we should allow flexibility to people who need it (for whatever reason), but not at the expense of everyone else.

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  22. Sorry to be off topic .

    I have come to dislike the person I have become .
    I am irritated and impatient a lot of the the times.

    I was someone who was under the great illusions of becoming this compassionate caring Doctor ready with a smile but then this stress and constant demands from patients and family and the society has really taken its toll .

    As doctors we are under so much pressure to fit into particular stereotypes and constantly live up to never ending expectations .

    I have this niece who was telling me the other day that she wanted to be a surgeon just like Christina Yang of Grey's Anatomy. Its sad that people base their decisions based on glamorized shows which doesn't tell the grimy real life details and the million other sacrifices one has to make .

    I really wish that students with rosy glasses planning for Med school really give it serious thought before enrolling contemplate the sacrifices involved and if only absolutely sure ,proceed with it.

    As a mother of twins and a new baby girl it just makes things worse when you feel guilty that you can't be for them unlike almost a lot of other Mothers both working( in other jobs) as well as SAHM's.

    So far I have had bad luck with Nannies and it always runs in the back of my mind whether I am doing the right thing to entrust my kids with a stranger when I, the Mother should be the one to be with them.

    I had felt a lot of times to just quit but then I have come so far in the game that it feels a little intimidating to start over a new career .I feel that a lot of it HAS to be blamed on this irrational system which drives us to madness expects us to juggle taking care of kids, family and patients and in the process loose the 'Me ' time as well .

    It has been years since I have taken out my easel and done a decent painting and if I do try to ,then i feel guilty that I should be spending time with the kids than doing this .

    Sometimes I do feel much bitter thinking that this is how it is going to be and maybe never would have a quality'Me' time or family time until I retire. I think that as Doctors we are the only ones who comes out worse at the end of the game not the patients who come in when sick and leave when fine , kids who grow up around nannies and grandparents and one day they are gone and a career which has sucked the creative daylights out of you.

    I am sorry for the rant but it feels a little better to get it out there.

    Fizzy you had mentioned 'Ideally, we should allow flexibility to people who need it (for whatever reason), but not at the expense of everyone else.' so what do you think should ideally be done at a got to-pick up- -sick-kid-at -school scenario?

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    1. It's okay. I always appreciate a good rant :) I think everything you have to say is very legit.

      The picking up sick kid scenario is a tricky one and it varies depending on what work you do. When I have to pick up a sick kid, I simply leave and come back in the evening to finish my work, because that's possible for me. If you have a clinic, then it's probably going to involve trying to reschedule patients, and seeing if anyone else has gaps in their schedule. If it's a hospitalist-type scenario, maybe there should be a back-up person who gets paid to be available if needed.

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  23. I'm an MS2, and it's a little annoying to me that our faculty, administration, and the general public seem to have this idea that all of us are superhuman. Already: I have worked HARD in premed to get IN to a good medical school, moved FAR away from home and any sort of support system, given up the better part of my twenties (read: skipping vacations, seeing friends, seeing relatives' kids, having time to myself) to study, paid exorbitant amounts of tuition and digging myself deep in debt I will be repaying for at least the next ten years. And I'm not even halfway through med school! I understand that physicians have a social responsibility, and maybe should even be held to a higher standard for that reason, but it is that social responsibility that led me to make all these sacrifices in the first place. It makes me upset that because I feel a calling towards essentially giving my life to public service, I should now also sacrifice either kids or holidays with my family? And if I'm not willing to do that, well, I should have just taken the easy way out and NOT decided to become a doctor? As a fresh-faced 24 year old, I certainly hope that is not what I have to look forward to. I sincerely hope that the system changes for the better and that senior doctors (with or without children) can give me what was not given to them. Correct me if I'm wrong, but I thought medicine was about making people's lives better.

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    1. Anon

      I apologize aforehand for what I am going to say and probably am going to have a lot of hate-dung thrown at me but here goes.

      No it is not going to be better . If at 24 you feel this way then you ought to think a lot more and discuss with your seniors to make sure if this is what your heart is really into .

      Let me tell you this , if you feel that you are okay with the strain of seeing your spouse/partner at random times and barely be able to hold a normal conversation because you are already so shattered from long hours at work and you have kids that you have to leave at the mercy of strangers and who grow up hating you for not being there for recitals and stuff and miss out on holidays and vacations and all the while your good friend who is ,say a college professor gets months off at work , who comes home relaxed spends ample time lounging around with family and has time to cook and just take it slow and get months of vacation spend globetrotting.

      I know I sound bitter but I want to save any one who gets into Medicine without knowing what ensues.

      We have this couple at work , who were both Neurosurgeons and one day she was telling me her story , when they were both Neurosurgeons and she used to see her Husband so rarely that eventually they started drifting apart and were going through a lot of stress and then in order to save the marriage she ended up switching over to Peds

      So please don't see this is a discouragement but rather real life speaking. Be wise and good luck .

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    2. You and I both know that by the time you're a 2nd year medical student you really don't have a choice. You've already forked out enough in loans that it's pretty damn near impossible to back out. I'm sure this advice comes from a good place, but quite frankly anyone who is in medical school is already "in medicine" and short of having a wealthy family that has the money to pay off your loans or a spouse with a very, very good paying job, you're kind of stuck with the decision you made as a naive 21 year old.

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  24. Hi Rosmarie,

    No hate, I appreciate the honesty. I had a rough year last year, and spent a lot of time thinking about this. And I did it all, I talked to my seniors, my faculty, my mentors and they all told me that I should continue if I couldn't see my self doing something else. And at this point, I can't. I'm not trying to be unrealistic about the lifestyle, I know people who sound like your neurosurgeon friend, and have heard their stories: they are all too common. I know that I will choose a specialty partly based on them for sure. I'm sure I have no idea what is coming at me, but it's true I've been warned.

    Right now, I can't see myself doing anything else, and I will take whatever comes with the career I chose, exactly because I chose it. What I was getting at, is that although it will be tough, it doesn't have to be as hard as it was for the generation before mine. I know the system won't change quickly, (another irony in medicine), but I hope I am supported by people who had to do it when it was harder, instead of being told that I need to be stronger, or that I should have chosen something else. That might still be naive, but I think it's something I have to believe.

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  25. Hi,

    I am the third child of two physician parents. My father is a radiologist and my mother is a pediatrician. Yes, they occaisionally had to work holidays- but we all understood that. My father, grandfather, and both of his brothers are also doctors. So Christmas with his family would be held whenever the most people were off.

    The hospital that both parents were affiliated with did one thing that was great for families- they gave each doctor a full Christmas/thanksgiving meal. (Turkey, dressing, gravy, pies) One would pick thanksgiving and one would pick Christmas. Until I was 9, I thought my mother had cooked everything herself. The hospital eventually stopped doing this. But I think it made holidays better for both physicians and their families.

    It could be more parent friendly.

    sconesail

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  26. I remain confused on how your argument of "people shouldn't have to force to scramble for childcare on Holiday" =/= "single people should be forced to work on holidays" in your mind.

    What Holidays are we talking here that do not end up with kids not having school? People are "forced" to "scramble" for childcare on: Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, New Years Day, Memorial Day, Labor Day, July 4th, Martin Luther King Day.

    So, what holidays do single people get?

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    1. Well, maybe you know that your parents will be in town for Labor Day or your nanny is going away for Thanksgiving or your physician husband is working July 4th, so it would make life incredibly easier to be able to work around the people who help watch your kids. Does that not make sense?

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  27. I find it very interesting that everyone seems to regard having children as a personal choice rather than a biological & societal imperative. Very few people decide to have children and think that its going to make their lives easier. Rather, they feel the biological need to contribute to the next generation of society. Frankly I think this urge should be applauded and encouraged wherever possible. Reproduction rates drastically decrease with increased education and I would think that society would want to encourage people who are highly educated, hard working, and social conscious to reproduce.

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  28. A bit off topic but I've gotta rant about this. I'm dismayed by how it is just assumed that ALL entering med students are spoiled rich 22-year-olds who never heard of responsibility before or even the most general "no one under 30 has ever had to do anything" idea. My dear friend, who just turned 27, is going to be an M2 in the fall. She's a non-trad who has a 5-year-old son. Her husband died a few years ago and her job was horrible, so she needed to find a career switch. Want stress? Try being a mom, single and poor on top of working all the time. But you know what? She's grateful for EVERYTHING she gets and every chance she has been given. I feel like the ones who complain the most are the traditional students. It's like they are never happy or thankful! I guess it's because they really never have had bad things happen or a genuinely stressful situation until med school. But there are worse fates in life than being a doctor. Maybe they all need to spend a week as a mother who works as a CNA or a fast food employee. I'm not saying your life or others aren't stressful, of course they are but not everyone is completely starry-eyed and rosy-cheeked when they walk into class the first day. Be thankful for your life and opportunities. Many people fight to be where you are and many kids will never know the security that your children do. There are plenty of younger kids who have to share in the responsibilities of the household by bringing in money or taking care of the younger kids or sick parents. That doesn't seem to be an issue you will have to face, so why so upset?

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