Mom Realizes she Can't Hack Med School & Raising Children at the same time

[ploughboy]

Am I the only one who is interpreting this as her saying that she is actually going to finish the MD?? Sounds like she is being smart and keeping the door open, but that she doesn't plan on persuing residency training or a career as a physician beyond medical school. Thus I'm not sure why so many people are claiming that she is making such a rash decision?

 

Ya, I know she's planning to finish the MD. The thing is, she can't have it both ways.

 

Either she is truly "giving up on [her] dream of practising medicine"..." bow[ing] out freely" because she doesn't "see a residency -- any residency -- as a feasible option". and is "opting out of a career in medicine." ...

 

... or she's going to wind up taking a year or two off between her MD and her residency or other career.

 

Like lots of other people have done.

 

With less drama.

 

 

I wanna drop out of med school almost daily, and I'm not even a clincial clerk yet -- let alone a clerk with a two-year-old and another on the way. I can't imagine how hard that must be! Had this article been written in a year or two from now, with the perspective of "I took a break, finished my MD, decided I didn't want to do residency and am now pursuing a non-clinical career" I'd have nothing but sympathy for her and her well-considered decision.

 

What's rash -- and I'm one of the ones who used that word -- is that from my point of view she's apparently jumped from hating clerkship to very publically swearing off practicing medicine forever. Do not pass Go. Do not collect $200.

 

It's her life and her decision, so more power to her. I just suspect that it's a decision being made in the heat of her very busy and frazzled life, without sufficient (to use Dr. O'Reilly's word) perspective.

 

pb

 

 

 

PS - There's probably a bit of transferrence going on here on my part. A friend of mine (not in meds) tends to see a lot of things in black and white, with no shades of gray, and this reminded me of him. There tends to be a lot of drama in his life

 

PPS - Doubtless there are people reading this thread who know Ms Adam personally. I feel a little awkward commenting about her this way. But on the other hand she's the one who put her situation into the public sphere by writing for the Sun.

[wanttobedoc]

First let me be clear: I think the woman in question should heed the advice given her and take a year off as an LOA before actually quitting; she sounds completely overwhelmed and stressed and that is no way to make a solid decision.

However, I'm sorry Jochi and others, but I think you're just plain ignorant in this case. There is NO WAY one will know how they will feel when they have a child. And there is NO WAY one will know how they will feel when they have a second, either, despite experience with the first. There is also NO WAY anyone can know how they will feel in clerkship no matter how much information about it they have before going in, and there is NO WAY anyone can know ahead of time how they will feel about both at the same time until they do it. Further, to make sweeping generalizations about how females will be viewed based on one deciding she can't go forward right now is just ridiculous and illogical.

No, currently medicine is not a family-friendly educational process or career. However, there is NO reason why it can't be.....it is the way it is currently is based on historical beliefs, values, and assumptions which are all very male-dominated. As long as females and younger males new to the profession continue to buy in to these antiquated notions, the status quo will be upheld. Maybe this student is blaming the medical system because she has to defend herself somehow from all the criticism and judgement of others. There are other demanding professions besides medicine that have made changes, and are continuing to make changes, that are more family-friendly. But as long as uninformed, biased or judgmental people keep entering the profession and promoting these values, it won't. I'm sorry to see such attitudes amongst people on this board.

Do we judge every young man who drops out because his father is ill or his gf left him and he can't focus on school? Do we tell the student who dropped out because her mom was undergoing chemo for the second time that she shouldn't have started med school knowing her mom's cancer might relapse?

None of us can know ahead of time what life is going to throw at us and how we are going to deal with it when it does happen. We need to stop being so judgemental.

 

Thanks for posting this Mitch...

I could not have said it better myself. I do wish however that this woman did not choose to publically "out" herself...

I am not really sure of the purpose of this. For me, the timing could not be worse...I don't need to be reading stuff like this when I'm about to start the same path this August....

Thankfully, I have great role models and an awesome support system. I think this, will make all the difference (I hope)

[JewelLeigh]

I have a feeling she chose to do this so publicly because she is hoping it will have an impact - not for her personally (though as pb points it, it is sure to jeopardize her chances for a residency match in the future) but for women/mothers in medicine in general. I would imagine she chose to publicize her story to get the word out into the general public as to how unfriendly medical training can be for those with families and to hopefully effect change for future students in her position.

 

Wanttobedoc - yeah, it's a tough thing to hear when you're starting your own path in medicine - but at the same time, welcome to the reality of the career you are choosing to pursue. Anyone who pretends it is all going to be hunky dory and no problem no matter what one's life circumstances are, is a surefire way to invite trouble. Head in with more knowledge and thus more preparation for how brutally tough it's going to be and you'll be in a way better spot when the tough times begin. As to the great role models and awesome support system - definitely fantastic that you have them and likely will be necessary for your sanity at many points throughout medical training! (Speaking from first hand experience - last night did my 4th call in 10 days....blech!)

 

On another note though...I believe medicine is an amazing career. The intimate role you play in people's lives is absolutely incredible - it's an honour and priviledge that I still can't believe I get to experience. It's still worth the (many) sacrifices in my opinion

[RuralDoc]

I want to correct this woman in that part time residencies are offered, particularly in family medicine. If you look at the CARMs descriptions, several universities mention a part time program being available. I think Mac and TO FM come to mind. They tell you to contact the program director for further details, and give examples of parents wanting to raise kids, athletes, musicians etc.

 

Second, if she wants to consider a second career, I suggest teaching. It is the ideal job for a parent! My parents are teachers and I have always had it as my back up plan. You have a total of about 3 months off/year, always have the same holidays/times as your kids, and get to see kids at the same age year after year. You have great benefits and a pension. My mom is a substitute teacher for primary kids and my dad teaches disadvantaged teens at an "alternative" learning centre. Both extremely rewarding and challenging jobs. Plus, lots of wonderful childhood memories of 2 month summer vacations together. Teachers were the second most satisfied with their jobs in a recent Canadian poll, and doctors were not in the top twenty. Would I quit residency now to become a teacher? No, but on tough days I often think about it!

[Ian Wong]

One thing that I still deeply remember about medical school is that it is an incredible roller-coaster of emotions.

 

I consider myself a really emotionally stable individual, and yet med school brings out such variability in your feelings and emotional states that is truly surprising. You literally go through huge swings in your feelings, such that one day you can be totally positive about medicine and what you are doing, all the way to being completely in the toilet about your career and life in general.

 

Med school, particularly third year clerkships, is a year that shows you just exactly how much sacrifice is needed to become a physician. At UBC, many rotations had you on q4 call, taking hits the entire time.

 

For those of you who haven't rolled around on the wards, that means that on an average workweek, if you started out at 7 am on Monday and were on call, that you are working the entire night, and if you are lucky, get to go home around 1 pm on Tuesday, some 30 hours later.

 

Then you pass out in a coma and try to recover so that you are able to get back into the hospital at 7 am on Wednesday. Wednesday and Thursday you go perhaps 7 am to 5-6 pm, which are regular days. Friday is another on call night, so you work another 30 hours, and if you are lucky crawl out of the hospital at around 1 pm on Saturday.

 

Then you get to fall into a coma for the rest of Saturday, and wake up on Sunday for your one weekend day off to catch up on life itself, before coming back into the hospital on Monday at 7 am.

 

This would be pretty typical for Internal Medicine call. From Monday to Saturday, you have worked two 30 hours shifts, and have been in the hospital for a total of 80 hours in 6 days.

 

Now, if you are on surgery, you might be starting at 6 am, and leaving the hospital at 6 pm on both your non-call and your post-call days. That kicks you up to two 36 hour shifts, and a total of 96 hours in the hospital in 6 days.

 

Do that for 2 months in a row, and you can see how painful things can add up. Some programs try to put you on heavy call for two weekends, in order to give you two call-free weekends, which means that you might be on call on Friday and Sunday, or on call on Saturday (either way will totally destroy those weekends for you), in order to keep you out of the hospital the other two weekends.

 

That however means that you be working for 2 weeks straight without a day off to catch up on sleep deprivation or any other life activities (ie. family, friends, laundry, dishes, exercise, hobbies, etc)...

 

Keeping that schedule really sucked, and I had as easy of a time as it would be possible, including having no kids or a spouse to answer to, and living in campus housing without needing to maintain anything (ie. no need for household chores like mowing lawns, trimming hedges, or being responsible for repairs). To this day, I still marvel at how the married people, particularly those with kids, were able to go through all that.

 

Med school, and clerkships can also be a pretty lonely experience. Your non-medicine friends have no idea what you are going through. Your family, unless they have a physician background, typically have no insight into what you are doing.

 

Most of the other hospital staff, like nurses, PT/OT, dieticians, are surprised to find out that two or three of their shifts go through before one of yours does.

 

I would agree with the other posters that a leave of absence could be beneficial. A year away from medicine to recollect and refocus allows you time to consider all options. I'm sure this UBC med student has already considered that.

 

I guess the take-home message is that med school, and clerkships in particular can be incredibly demanding, particularly so for people who are already juggling several other life committments.

 

It's a bit of a sad commentary on medicine that we spend so much effort in looking for well-rounded individuals, and then place them into a curriculum that makes that sort of lifestyle unsustainable. It's actually a little surprising how few people end up dropping out, given the above.

 

Ian

[Julie]

Wow, what a scary post! Definitely doesn't make me look forward to 3rd yr!

 

So stupid question...

 

When you're on call, are you actually in the hospital working all the time? I guess it just makes me wonder why they would say you're "on call" if really it's just like a regular shift. Do you not ever get anytime to relax or sleep at all during those 30+ hr shifts? I mean I can see sometimes you wouldn't, but is that typical?

[JewelLeigh]

Wow, what a scary post! Definitely doesn't make me look forward to 3rd yr!

 

So stupid question...

 

When you're on call, are you actually in the hospital working all the time? I guess it just makes me wonder why they would say you're "on call" if really it's just like a regular shift. Do you not ever get anytime to relax or sleep at all during those 30+ hr shifts? I mean I can see sometimes you wouldn't, but is that typical?

On call is definitely not like a regular shift. For most services (general surgery, general medicine, pediatrics and ob/gyn), Ian's post definitely describes the norm. I am personally happy if I get to sleep for a total of 4 hours during these 30 hour shifts! Even if you do get a break, most call shifts are "in house" meaning that you have to stay in the hospital whether you're needed or not. Even if you aren't called (uncommon), you still never sleep well in the uncomfortable, cold call rooms with your pager sitting next to your head, ready to go off any moment. Not to mention that you've not left the building for 30 hours - talk about a downer!

 

Also, when on call over the weekend, you have to spend several hours rounding on your patients in the mornings...which, as Ian said, means you go for 2 weeks straight (or 3 if you are unlucky enough to have two weekends in a row) where you round every single day....yikes!

 

There are a few services (such as Psychiatry) where the call shifts are "home call." In these cases, you still often have to stay late at the end of your regular day and are not uncommonly called in for consults or floor issues. You also still have to round on inpatients on the weekends. Finally, if you have wrapped up a "home call" shift...you don't get the post-call "head home at noon" bonus that you do for in-house call.

 

For residents, the call is often worse from what I have seen, especially for the juniors. They get all the calls we clerks do, but also a whole bunch of simple floor calls that wake them up in a steady stream all night long...Eg. "Mr. John Doe has a potassium of 3.4, what do you want to do?" "Mrs. Jane Doe is still anemic, do we need to transfuse her?" "Mr. John Smith has died, can you come pronounce him?" Etc., etc., etc....

 

On top of all of this...you also have to find some time to study for exams...

[Kyleh]

On call is definitely not like a regular shift. For most services (general surgery, general medicine, pediatrics and ob/gyn), Ian's post definitely describes the norm. I am personally happy if I get to sleep for a total of 4 hours during these 30 hour shifts! Even if you do get a break, most call shifts are "in house" meaning that you have to stay in the hospital whether you're needed or not. Even if you aren't called (uncommon), you still never sleep well in the uncomfortable, cold call rooms with your pager sitting next to your head, ready to go off any moment. Not to mention that you've not left the building for 30 hours - talk about a downer!

 

Also, when on call over the weekend, you have to spend several hours rounding on your patients in the mornings...which, as Ian said, means you go for 2 weeks straight (or 3 if you are unlucky enough to have two weekends in a row) where you round every single day....yikes!

 

There are a few services (such as Psychiatry) where the call shifts are "home call." In these cases, you still often have to stay late at the end of your regular day and are not uncommonly called in for consults or floor issues. You also still have to round on inpatients on the weekends. Finally, if you have wrapped up a "home call" shift...you don't get the post-call "head home at noon" bonus that you do for in-house call.

 

For residents, the call is often worse from what I have seen, especially for the juniors. They get all the calls we clerks do, but also a whole bunch of simple floor calls that wake them up in a steady stream all night long...Eg. "Mr. John Doe has a potassium of 3.4, what do you want to do?" "Mrs. Jane Doe is still anemic, do we need to transfuse her?" "Mr. John Smith has died, can you come pronounce him?" Etc., etc., etc....

 

On top of all of this...you also have to find some time to study for exams...

 

In reference to JL's last point...

 

How do you find time to study??

 

Also, how do you adapt to study when you are tired?

 

Is it just determination?

[Julie]

tks for the reply, JL. It does sound crazy hard, but I'm relieved to read you at least get an few hrs of sleep during those 30+ hr shifts... Sometimes it's amazing what a couple of hrs will do! Wow, it'll sure be an adventure though! I guess I better appreciate my pre-clerkship years!

[JewelLeigh]

Crazy hard, but crazy rewarding! Definitely an adventure as you describe it.. I still love it and am proud of the small part I get to play throughout the many hours I work at it!

[Paule]

I think everyone's missing the point of Ms. Adam's article.

 

The important point is: Who loses as a result of her quitting?

 

Canadian society. Humanity. Bang! WE've just lost a doctor. Why? Because we have an antiquated system. This system was created decades ago, for the purpose of making doctors out of young men from well-to-do families.

 

And the on-call thing is part of that. Just stop for a second and ask yourself: What the hell is it for?

 

In fact, it was created long ago, based on a notion that doctors needed to learn under sleep-deprived situations, so that they would perform well under similar circumstances, further on in their career.

 

This notion has been completely disproven. Yes, it has, and by clinical research. There is no proven benefit from learning under sleep deprivation. You can't "practice" functioning without sleep. Performance without sleep does not diminish at a slower rate for those who have performed a task without sleep previously.

 

So this idea has no value. It was probably based on a Protestant prejudice that puts a positive moral value on Hard Work and suffering.

 

So we have a damaging practice here, this on-call system, but we just keep using it. Doctors are supposed to be scientists. We're not supposed to apply disproven theories to the way we treat others. We don't prescribe thalidomide for pregnant women anymore, for instance, because it's damaging. Why do we keep this frankly damaging practice, when clearly, it's losing doctors for us (Canadian society?) and harming patients who receive sleepy, substandard care.

 

There are more women entering medicine than men now. But they find themselves in a system that is still tilted in favour of young men. Young men don't have eggs that get old. The responsibility of raising children still falls disproportionately more on women than it does on men.

 

But the main point of Ms. Adams' essay is, WE have all lost a doctor. And for what? What benefit do we receive from running the system this way?

[LFTs]

...And the on-call thing is part of that. Just stop for a second and ask yourself: What the hell is it for? ... What benefit do we receive from running the system this way?

 

I have to disagree re: call is there simply because we can't think of a better system and that it is a remanant of some old way of thinking.

 

I'd say that if you've ever been on call, you'll quickly realize that this is where a lot of learning gets done. If you're covering the ward alone overnight as a medical student/junior resident with, say, only one other senior resident in house and themselves covering other parts/services within the hospital, you learn how to approach issues pretty quickly. Compare this to the during the day when you have multiple residents, fellows, and staff around. So from a practical standpoint, it's not useless.

[Devari]

I think everyone's missing the point of Ms. Adam's article.

 

The important point is: Who loses as a result of her quitting?

 

Canadian society. Humanity. Bang! WE've just lost a doctor. Why? Because we have an antiquated system.

 

That's one way to look at it. Alternatively, you can look at it from another perspective and consider that we've just gained a comitted mother who will devote the necessary time and energy towards raising her children. That's going to provide a direct and substantial benefit to society that may ultimately be far more important then simply having another practicing doctor.

 

This system was created decades ago, for the purpose of making doctors out of young men from well-to-do families.

 

It may be easier to get into (and to pay for) medical school if you're wealthy, but the process of medical education isn't designed to favor wealthy men. Medicine is simply a demanding career and any demanding career is going to make it more difficult to raise children properly regardless of whether you're male or female.

 

And the on-call thing is part of that. Just stop for a second and ask yourself: What the hell is it for?

 

In fact, it was created long ago, based on a notion that doctors needed to learn under sleep-deprived situations, so that they would perform well under similar circumstances, further on in their career.

 

This notion has been completely disproven. Yes, it has, and by clinical research. There is no proven benefit from learning under sleep deprivation. You can't "practice" functioning without sleep. Performance without sleep does not diminish at a slower rate for those who have performed a task without sleep previously.

 

So this idea has no value. It was probably based on a Protestant prejudice that puts a positive moral value on Hard Work and suffering.

 

Sorry, but are you seriously trying to blame the origin of long on-call hours on religion? That doesn't even make any sense. If anything, a religious-derived work ethic would promote more of a balance rather than working excessively long hours. A religious-themed work ethic would also consider the need to provide a sufficient quality of care which would logically preclude providing medical treatement when excessively fatigued.

 

So we have a damaging practice here, this on-call system, but we just keep using it. Doctors are supposed to be scientists. We're not supposed to apply disproven theories to the way we treat others. We don't prescribe thalidomide for pregnant women anymore, for instance, because it's damaging. Why do we keep this frankly damaging practice, when clearly, it's losing doctors for us (Canadian society?) and harming patients who receive sleepy, substandard care.

 

I agree that working excessively long hours is a retarded way for medical students and doctors to work because it doesn't provide the proper quality of medical care. But unfortunately the only thing that really has any potential to change this would be lawsuit-related issues that lead to strictly enforceable regulations for reasonable working hours. Unless something like this happens there's really no way to prevent the routine sleep-depravation and the substandard medical care that occurs as a result.

 

There are more women entering medicine than men now. But they find themselves in a system that is still tilted in favour of young men. Young men don't have eggs that get old.

 

Most women graduate from medical school while they are still in their mid to late twenties. At this age they're still quite young from a reproductive standpoint and really don't need to worry about fertility issues.

 

The responsibility of raising children still falls disproportionately more on women than it does on men.

 

I'd agree with you during the baby's first year or so since the mother will need to be around for breastfeeding (unless she uses a breast milk pump so someone else can bottle-feed the baby). But there's not necessarily any reason why men can't share equally with the child-rearing in other respects. If a woman finds herself with a partner who doesn't want to do this that really isn't a problem with medical school. It's a problem with the CHOICE of haing children while in medical school along with the CHOICE of a partner who requires her to bear the majority of the child-raising burden.

 

But the main point of Ms. Adams' essay is, WE have all lost a doctor. And for what? What benefit do we receive from running the system this way?

 

Again, as others have pointed out already this situation is simply a case of someone's personal CHOICES. She CHOSE to get pregnant, CHOSE to enter medical school and then CHOSE to get pregnant AGAIN. After finding the workload too demanding she is now CHOOSING to abandon a career as a doctor. She also CHOSE to ignore the possibility of finding a way to allow her to finish a residency (which would require only 2 years for a GP) so she would at least be capapble of working part-time as a doctor when her children get older and her child-raising demands decrease. The "system" didn't make any of these choices for her nor did it "force" her into the situation she finds herself in.

 

The reality here is that raising children properly is extremely demanding and time-consuming. Medicine is a career that is also very demanding and time-consuiming. Practicing medicine and raising children will therefore directly conflict with each other by competing for this time and energy. Expecting a medical career to be somehow designed to accomidate raising children simply isn't realistic. If someone CHOOSES to try this then they would have to be retarded to try to blame the medical education system for not allowing them sufficient time to raise their children simultaneously. It would be like expecting medical school to somehow allow you to work another full-time job and then complaining because you can't fit in the additional 40 hours a week required for the additional career.

[The Law]

Expecting a medical career to be somehow designed to accomidate raising children simply isn't realistic. If someone CHOOSES to try this then they would have to be retarded to try to blame the medical education system for not allowing them sufficient time to raise their children simultaneously. It would be like expecting medical school to somehow allow you to work another full-time job and then complaining because you can't fit in the additional 40 hours a week required for the additional career.

 

Why is this not realistic? Surely there must be ways to improve the family friendly nature of the career. Sure it's demanding, but steps may be taken to improve the 'family friendly' nature of the job. There is no way that with all the creative, innovative minds out there - that nobody can think of ways to improve this career. I too find 30 hour shifts a little bit ridiculous, what kind of patient care would someone who's getting your assistance while you are that exhausted going to have anyway? It shouldn't be completely impossible for someone to at least be able to manage a family (of course with help from others) while pursuing a career in medicine.

[Devari]

Why is this not realistic? Surely there must be ways to improve the family friendly nature of the career. Sure it's demanding, but steps may be taken to improve the 'family friendly' nature of the job. There is no way that with all the creative, innovative minds out there - that nobody can think of ways to improve this career. I too find 30 hour shifts a little bit ridiculous, what kind of patient care would someone who's getting your assistance while you are that exhausted going to have anyway? It shouldn't be completely impossible for someone to at least be able to manage a family (of course with help from others) while pursuing a career in medicine.

 

It's not a matter of making medicine into a more "family friendly" career. It's simply an issue of the amount of time and energy that need to be devoted to medical training or to any other demanding career. The same problems would arise by trying to take a full undergraduate course load or to work as a graduate student at the same time as raising children. There simply wouldn't be enough time to do both of them properly. You can't be in two places at once and by definition a full-time educational program or job isn't going to provide sufficient spare time to devote to another another full-time job such as raising a child.

 

I find it amusing that so many people are saying "Wow, take a look at this, we're losing a doctor because it's hard to raise children and go to medical school at the same time! How can we fix this?" The answer is that you can't "fix it" because nothing is broken. It's simply a case of trying to fit too many things into a 24 hour day. The problem is the person's unrealistic expectations, not the fact that medical school requires a full-time commitment. The fact that some people can manage to raise a child while in medical school doesn't mean that it is either easy or realistic. Trying to combine medical education with raising a child means that it is unavoidable that each of these tasks are going to suffer to some degree as a result, and some people are simply unwilling to make the necessary compromises.

[JewelLeigh]

I have to disagree re: call is there simply because we can't think of a better system and that it is a remanant of some old way of thinking.

 

I'd say that if you've ever been on call, you'll quickly realize that this is where a lot of learning gets done. If you're covering the ward alone overnight as a medical student/junior resident with, say, only one other senior resident in house and themselves covering other parts/services within the hospital, you learn how to approach issues pretty quickly. Compare this to the during the day when you have multiple residents, fellows, and staff around. So from a practical standpoint, it's not useless.

I completely agree! I have definitely learned much more per hour during my time on call compared to regular workday hours.

 

Not to mention, current doctors are being trained clinically at about 60+ hours per week. If we reduce that to say, 40 hours per week, we would have to increase the number of years of training. This is the only way graduating students/residents would gain the same amount of clinical experience that is expected/needed for competency at the end of training. Med school and residency are long enough already in my opinion!

 

Med schools and residency programs are becoming more and more family friendly from what I have experienced and heard about from the past. I have seen several instances at my medical school where the university has gone above and beyond to accommodate the needs of students who are parents....mat leaves, changing call schedules, etc. It doesn't change the fact that medicine is both a demanding education and career, but it certainly helps.

[Julie]

The same problems would arise by trying to take a full undergraduate course load or to work as a graduate student at the same time as raising children. There simply wouldn't be enough time to do both of them properly.

 

Ok, I think everyone knows raising a family while working or being a full time student is quite a challenge. That's not the point of this discussion. I think there's much difference between the amount of work required to do an undergrad or go to grad school, and the amount of hours during clerkship. They're saying it's 80+ hrs per week. So it's more like working 2 full-time jobs and having kids. To me, that's not the same problem.

 

Clerkship is the way it is and it may be necessary to keep the hours as they are. However, I think maybe it could change somewhat to accomodate a new way of life where both parents usually work full-time. I'm not saying clerkship should be like a 40 hrs a week, 9 to 5 job, but maybe the hours could be cut just a tad? I mean, what if the 30 hrs were to be reduced to 24? I don't know, I haven't been through it yet. Maybe once I will have, I'll think it's perfect the way it is. But I do think it's good to ask the question. If we're to be the future of the medical profession, then someday we might actually have a say in this, and it's our responsibility to wonder if the system could be improved in some way.

[D-Rock]

I guess one thing about this article that gets me is how she doesn't really give Family Med a fair shake, implying that residencies take 5 years.

 

An issue that should be considered is the equity between men and women. It seems that more men have children while in medical school than women, and the men often graduate on time and say it was a trying but rewarding experience. Women give the impression that it's more difficult.

 

So, The Question: Should we be trying to make parenting equally realistic for men and women, or should we allow the biological differences between men and women to continue to make raising a child in med school more difficult for women?

[D-Rock]

Another reason why the long hours in a hospital are necessary: you do need to see a lot of things, and if you're not there, you can't see/learn it. Sorry, I don't buy the argument that you can learn it from a book. Just look at the sorry example for science undergraduates who've had their labs cut as an example of how well book learning works.

[Poolboy]

This has made me re-think having another kid in a couple of years. I already have a six month old, and in my third year we would have a three year old and a six month old if we have a second - it sounds like that would be crazy busy.

 

But are fourth year and residencies just as busy? Am I going to be waiting six years to have the next kid to make sure things are a little more settled down - I didn't want to have two kids who are so far apart in ages.

 

I'm the father so I think it will be a lot easier than if I was the mother, but it's still a lot of responsibility.

[Ian Wong]

Part of the problem is that med school (particularly third year), is busy enough that it can take your entire day if you let it.

 

Having a spouse and a young child could similarly consume all your waking hours.

 

How then, do you reconcile both? I think the reality is that it takes a lot of compromise, and a ton of hard work, with no guarantee that you will perform as well at either task, than if you just could concentrate on one or the other.

 

Having a second child during the Med 3 clerkships would be rough. Med 4 is significantly lighter than Med 3. As the low man on the totem pole, your R1 year will suck. Beyond that, the amount of pain in residency will be directly proportional to the specialty that you enter.

 

I would agree with the other posters that call is invaluable in your training. Things that are very straightforward when you are rounding with your team become much more complicated when you are in the elevator by yourself heading up to see a patient by yourself. It is during these moments that you develop your own style, as well as your mental checklist for all the things that you need to evaluate a patient in order to solve their chief complaint.

 

The first time that you forget to check your obtunded patient's med list, and your senior resident uses narcan to wake up the patient will be the last time that you neglect to check for the patient's recently administered medications. As you see more and more patients, you refine your style, to the point where you feel prepared to handle whatever the next page will bring you, whether that be a new admission in the ER, a floor call from a nurse, or a crumping patient on the verge of coding.

 

The more times you do anything, the better you get at it. You see a lot of patients while you are on call, and more acutely feel the responsibility of it, because literally at night, it is you and the patient. You are entrusted with a HUGE level of responsibility.

 

The analogue for a non-patient care specialty like radiology, is that a CT scan or MRI is WAY, WAY easier to read when you've got a few buddies in the reading room that you can consult if you feel stuck. When you are there by yourself, and the surgeons are waving around scalpels based on your interpretation, it's a whole different world, and often those cases are the ones that are the most memorable, and go the longest towards making you into a competant physician.

 

Ian

[Devari]

Ok, I think everyone knows raising a family while working or being a full time student is quite a challenge. That's not the point of this discussion. I think there's much difference between the amount of work required to do an undergrad or go to grad school, and the amount of hours during clerkship. They're saying it's 80+ hrs per week. So it's more like working 2 full-time jobs and having kids. To me, that's not the same problem.

 

Suggesting that undergrad or graduate studies somehow doesn't require as much of a “full-time” commitment as medical school simply isn't true. As both an undergraduate student and a graduate student I’ve never found myself with enough spare time left over that it would somehow be feasible to try raising a kid. Undergrad, graduate school, and medical school all have different types of challenges and commitments but each of these requires the majority of your time and energy in order to do well. The pressures are different in each case but each of them is a full-time program. Undergrad has the pressures of needing to perform at a high level in virtually all of your courses (since it only takes one low mark to significantly lower an entire year's GPA) in addition to maintaining extracurricular activities. Graduate school has a certain degree of flexibility in terms of the work schedule but scientific research is exceptionally time consuming, inherently unpredictable and needs to be far more self-directed and self-taught than any other discipline. Medical school probably has the largest amount of material to learn although this is mitigated significantly by the fact that most schools use a pass/fail system and medical education is designed to ensure that virtually everyone will successfully complete their training, which means that the material doesn't need to be mastered to the same degree that it would be in other disciplines. None of these situations are going to leave enough "spare time" to raise a kid. It really isn’t an issue that is specific to medical school.

 

Clerkship is the way it is and it may be necessary to keep the hours as they are. However, I think maybe it could change somewhat to accomodate a new way of life where both parents usually work full-time. I'm not saying clerkship should be like a 40 hrs a week, 9 to 5 job, but maybe the hours could be cut just a tad? I mean, what if the 30 hrs were to be reduced to 24? I don't know, I haven't been through it yet. Maybe once I will have, I'll think it's perfect the way it is. But I do think it's good to ask the question. If we're to be the future of the medical profession, then someday we might actually have a say in this, and it's our responsibility to wonder if the system could be improved in some way.

 

I agree that the hours that are worked by doctors and medical students need to be carefully considered because there's a critical balance between trying to spend as much time learning as possible and being well-rested enough to actually learn effectively. The suggestion that is sometimes made that "if medical students spent less time working their education would take longer" isn't really valid because at some point someone becomes too fatigued to learn effectively and the sleep-deprivation actually becomes counter-productive. In addition there’s also the problem of not being able to provide a proper standard of medical care when excessively fatigued. As I mentioned above, however, I don’t really see this changing unless legal issues force the medical system to use more reasonable working hours.

[ploughboy]

Q: What's the worst thing about one-in-two call?

 

A: You miss half the good cases...

 

[Paule]

That's one way to look at it. Alternatively, you can look at it from another perspective and consider that we've just gained a comitted mother who will devote the necessary time and energy towards raising her children. That's going to provide a direct and substantial benefit to society that may ultimately be far more important then simply having another practicing doctor.

 

The problem with this argument is that it implies that this woman was not a committed mother BEFORE she decided to leave school. Furthermore, I feel that, for instance, my son BENEFITS from my going to med school because it is what I need to be satisfied with life and because I want him to see me pursue my goals despite any barriers.

 

It may be easier to get into (and to pay for) medical school if you're wealthy, but the process of medical education isn't designed to favor wealthy men. Medicine is simply a demanding career and any demanding career is going to make it more difficult to raise children properly regardless of whether you're male or female.

 

Oh come on. When medical education began is WAS designed to favor wealthy men. Please give me some historical examples of how this was NOT so. I would be happy to give you some of how it was so. Furthermore, no one is arguing that medicine is not a demanding career. The argument here centers on whether or not it is possible to accomodate those, especially women, who have children. Notice in Dr. Susan O'Reilly's response that she also had an eight months old. However, she also had a free creche for students' babies at the university. That is a form of support that makes it easier for a woman in medical school who have children. At UBC, it will take you two years to get your kid into the university child care, it is not free, and it only opens at 8am, the same time that classes begins.

 

Sorry, but are you seriously trying to blame the origin of long on-call hours on religion? That doesn't even make any sense. If anything, a religious-derived work ethic would promote more of a balance rather than working excessively long hours. A religious-themed work ethic would also consider the need to provide a sufficient quality of care which would logically preclude providing medical treatement when excessively fatigued.

 

I am not blaming long on-call hours on religion. That's silly. My point here was simply that as a society largely founded on protestant values, we sometimes value hard work and suffering as being good in and of itself, regardless of whether or not anything comes out of that hard work and suffering. But this is really a whole different topic...

 

I agree that working excessively long hours is a retarded way for medical students and doctors to work because it doesn't provide the proper quality of medical care. But unfortunately the only thing that really has any potential to change this would be lawsuit-related issues that lead to strictly enforceable regulations for reasonable working hours. Unless something like this happens there's really no way to prevent the routine sleep-depravation and the substandard medical care that occurs as a result.

 

That's an awfully defeatist view.

 

Most women graduate from medical school while they are still in their mid to late twenties. At this age they're still quite young from a reproductive standpoint and really don't need to worry about fertility issues.

 

Actually, according to UBC admission stats, the mean age of the entering medical school last year was 24.71, and there are many women who are older than that. So MOST women are not graduating in their mid to late twenties and many do have to worry about fertility issues.

 

 

I'd agree with you during the baby's first year or so since the mother will need to be around for breastfeeding (unless she uses a breast milk pump so someone else can bottle-feed the baby). But there's not necessarily any reason why men can't share equally with the child-rearing in other respects. If a woman finds herself with a partner who doesn't want to do this that really isn't a problem with medical school. It's a problem with the CHOICE of haing children while in medical school along with the CHOICE of a partner who requires her to bear the majority of the child-raising burden.

 

 

 

Again, as others have pointed out already this situation is simply a case of someone's personal CHOICES. She CHOSE to get pregnant, CHOSE to enter medical school and then CHOSE to get pregnant AGAIN. After finding the workload too demanding she is now CHOOSING to abandon a career as a doctor. She also CHOSE to ignore the possibility of finding a way to allow her to finish a residency (which would require only 2 years for a GP) so she would at least be capapble of working part-time as a doctor when her children get older and her child-raising demands decrease. The "system" didn't make any of these choices for her nor did it "force" her into the situation she finds herself in.

 

 

The reality here is that raising children properly is extremely demanding and time-consuming. Medicine is a career that is also very demanding and time-consuiming. Practicing medicine and raising children will therefore directly conflict with each other by competing for this time and energy. Expecting a medical career to be somehow designed to accomidate raising children simply isn't realistic. If someone CHOOSES to try this then they would have to be retarded to try to blame the medical education system for not allowing them sufficient time to raise their children simultaneously. It would be like expecting medical school to somehow allow you to work another full-time job and then complaining because you can't fit in the additional 40 hours a week required for the additional career.

 

 

Well, I just think that you are dead wrong and, obviously, have fundamentally different values than you do. I certainly do not believe that I have to CHOSE between raising my child and practicing medicine, and I fully expect my medical career to accomodate my raising my children AND that it is in their best interest to do so. I am not one to kowtow to the status quo. Luckily for me, the Island Medical Program administration has, so far, indicated that they WILL accomodate my having a child, and the fact that his father is away a lot of the time, in a number of ways.

 

It is good to know, though, that in fighting for my right to have a medical career and have children, I will also have to deal with the narrowmindedness of other students.

[ducky]

I know that I won't be in med school until I'm 24 going on 25 (assuming I get in). My mind is constantly plagued by questions of whether I can handle a family and medical training at the same time. I doubt I'd have children during med school, but it'd be more and more likely during residency. There are times even now I wonder why I'd put myself through so much stress and for what? For my children to not know me? How on earth would you afford day care when you're in debt and netting 30-40K a year in your first few years? If there are numerous options for females in the medical profession they're not clear enough to quell my fears.