July 2009  |  Welcome to Finding Balance eNews

Parenting in Medicine

Summer is here and I hope you are having some fun! I have a few weeks at home (unusual for me) to enjoy with my family.

Upcoming programs & events:
My five day, late summer program, at the Omega Institute, in upstate New York, Aug. 30-Sept 4, 2009. This is a great opportunity to dive in and enjoy yourself. All are welcome. This is not just for those of us in health care. Families and friends are invited!

I am also one of the course directors for The 10th Annual Science and Clinical Application of Integrative Holistic Medicine to be held this year at the Westfields Marriott Washington-Dulles, Chantilly, Virginia. October 4-8, 2009

Parenting in Medicine
Today, my daughter finishes her Montessori certificate training as a teacher and is well on her way to her Masters in Education. My son graduated high school two weeks ago and will be off to college. It is a long time since my wife and I were medical students with a baby, but in many ways, this has been the best part of my life.

This raises a question that I often hear from students and residents. “When is the right time to have a baby in medicine?” While I often come up with a ‘wise’ sounding answer, I am not sure that there is a ‘right’ time.

It is certainly difficult to enter medical school as a parent. The burden on you and your partner is immense. Doing this as a single parent, without significant support is probably ‘crazy-making.’ Paradoxically, being a divorced, co-parent, can make this easier as you have some days to your self. Some students, especially those with previous careers and non-infant children, do this and do it well. Students with a stay at home spouse or solid support can also do this. Having a child during medical school is very difficult to say the least.

A somewhat better time to start a family would be between medical school and post-graduate training, or between your residency and work life. I highly recommend taking the first year off as a parent if you can afford to do so. This gives you the chance to be mom or dad full time.

If you cannot afford to do this, another choice would be to live with a relative. (Grandparents are great for this if they can do it.) This obviously depends on your relationship with them, (and your partner’s too).

One of the great changes in medical training is the part-time residency program. While it will take you longer to finish, this was specifically created to allow new parents or parents-to-be time to enjoy this role. These programs are growing in Pediatrics, OB-GYN and Family Medicine. Roughly 25% of pediatrics programs offer a part time option, but few residents choose it for time and financial reasons, but also because of the “tough it out” mentality of residency training. Obviously, the residency has to be large enough to allow for ‘flex-time’ scheduling, but where implemented, this has been a partial success.

In a study at the University of Saskatchewan it was shown that the least satisfying time to have children was during residency. Medical student parents were slightly more satisfied, and faculty parents were most satisfied in their parenting role. (Cujec 2000) It would seem that the best time to have children is post training, but pre-work. I also recommend, (if affordable,) part time work to start, thus allowing time to enjoy being parents.

There is one statistic that I find extremely disturbing. One of the highest rates of suicide for physicians is amongst young women. Part of this issue is the imbalance of trying to be both a mother and a physician. In the literature this is called “role overload.” This is a difficult balancing act and maybe an impossible one. When these two jobs are being taken on by a perfectionist, it only gets emotionally worse as the perfectionist will feel like a failure at work and at home. Add this to medical school debt and it is a recipe for disaster.

Another lesser, but still negative outcome is ‘spoiling’ your child. When childcare time is restricted, the physician parent may overindulge the child because of separation guilt.

So, if there is no ideal time to have a child, would I recommend it? Yes! However, learning coping skills will be very useful, such as meditation, yoga etc. I suggest that you also make sure to take time for your partner. That relationship will be an essential part of your parenting life, and life in general.

One good guide, for those of you starting out, is a book by Cassandra Veiten, PhD. Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child's First Year. This book is based in mindfulness. The goal is to truly enjoy the time you have with your child, and to better manage the emotional difficulties which arise in motherhood.

Reference:
Bibiana Cujec, Tammy Oancia, Clara Bohm, David Johnson, CMAJ, 2000;162(5):637-40

Just for fun
My music pick for the month is a great songwriter Dave Amadio, from Columbus, Ohio. I suspect that he is not a familiar name to you at all, so I strongly suggest that you check out the song “Holiday” on his web site.

Guaranteed, it will stay in your head. Great summer music for you car or barbeque! I have used it for my DVD slide show of my kids. It’s hard not to smile when hearing this song. The rest of the “Saving Rome” album is a treat.

Happy summer!