April 10, 2023

Family Planning During Residency

Michelle Shnayder-Adams, MD, MPH

Michelle Shnayder-Adams, MD, MPHWith such a long career path, many resident physicians embark on the parenthood journey during residency. While there may never seem to be a “good” time to expand your family, having a child during residency presents a unique set of circumstances. Throughout this article, I hope to highlight some of the benefits and challenges of childrearing during training and describe my experience having a son as a fifth-year interventional radiology resident.

In 2022, the Accreditation Council for Graduate Medical Education (ACGME) revised institutional requirements to begin offering a minimum of six weeks of parental leave during training. Some residency programs provide even more time. I was lucky to work at a supportive institution that allowed a total of 12 paid weeks off for delivering mothers to recover and bond with their babies. These mandated leaves are not universal for physicians working in private practice and must be negotiated in a contract.

Another advantage to starting a family during residency is that it is easier to find people to cover your shifts during leave or for emergent childcare needs. Flexible coverage can be difficult in smaller practices as there are fewer physicians to call on.

As much as one may try to “family plan,” it’s important to remember that getting pregnant can take a while. Night shifts and the stress of residency do not improve one’s chances. As an interventional radiology resident, I calculated down to the month the optimal time to get pregnant, so I could avoid radiation exposure. I was fortunate my plan worked out, but many of my colleagues have struggled with fertility, and this is a factor many do not anticipate.

The time I had with my son during leave was precious, but there were challenges returning to work that I had not expected. After not reading for several months, my reintroduction to diagnostic radiology was working the nightshift for a week. As you can imagine, that week was stressful, and my interpretation speed was very slow. With time, I started to feel more confident in my radiology skills but being patient with myself was crucial.

Also, as a female resident, it is important to realize that if you avoid call and nights during your second or third trimester, you will likely have to make them up upon your return. Although sleep deprivation with an infant is expected, I found that the increased call burden furthered my sleep debt. No matter the degree of sleep deprivation, however, there has been no greater challenge upon returning to work as missing time away from my son. As hard as it may be, I try to remember that our time apart makes the time spent together that much more special.

Breastfeeding during training presents additional obstacles. Without a dedicated office, it can be tough to find convenient and private places in the hospital to pump. ACGME requires programs to provide nearby, clean and private lactation facilities with refrigeration capabilities for safe patient care. Before each rotation, I would make sure to talk to past residents about their pumping experiences to identify nearby call rooms or lactation pods.

Lastly, it is normal to fear damage to one’s reputation for taking time away from work to pump. It seems the culture is shifting to make pumping at work less taboo; however, for those who are still concerned, wearable breast pumps (although expensive and do not work for everyone) can drastically decrease time away from work.

Nobody said parenthood would be easy — especially during residency — but in my experience, one smile from your child makes it all worth it.