Time off between PGY1 and PGY2

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  • #84286
    snssns
    Participant

    Here is the story:
    I went to med school on a military scholarship. I decided I wanted to do PM&R. PM&R requires you to do an internship in Internal Medicine or Surgery prior to entering their program. I chose int med.

    Half way through my 4th yr of med school, the military told me I had to do my internship with them, which was fine. But, they also said they did not need PM&R physicians. So….I had two options:

    1. either do general practice for 4 yrs after internship to pay off my commitment to them and then go do a civilian PM&R residency

    2. or change to a specialty the military was offering.

    I decided I really wanted to stick with PM&R. I completed my internship in internal medicine. Worked as a general practice physician for 4 yrs. Now I am out of the military and free to apply to civilian programs.

    I recently had a baby and would like to stay home with the baby for a year or two before going back to residency. I am worried programs will look down on this.

    Does anyone have any similar experience? Do you think this will make me a less desirable candidate for a residency slot? Any advice?

    Part of my reason for wanting to stay home is lack of quality day care for the hours I would need while a resident. My husband works very long hours also. Our child would probably need a care giver from 6:30am to 7 or 8pm. Which means I would have to wake her up before she was really ready and I would only get to see her for about one hour before she went to bed.

    Thanks.

    PS: How do you even apply to residency these days? When I was in school, it was still on paper. Apparently now it is all electronic. I called my old dean’s office and they said I had to contact the department I was applying for. I called the PM&R dept and they said I had to do it through the dean’s office. I never could get an answer.

    #84288
    psychpsych
    Participant

    Hi! I took off a year between internship and PGY II to be home with my son. It was a great choice for me. I actually felt refreshed and ready to return when I started residency, which was a big contrast to many of my co-residents who were already burned out from internship.

    The flip side was that although my son was in daycare about 50 hrs a week (typically 730-530 when my husband would pick him up), my husband had the flexibility to pick him up and feed him dinner and play with him. My goal was just to get home by 7pm for bedtime if I wasn’t on call. That made me feel more willing to do this with such a little baby. If your husband is not going to have a flexible schedule so neither of you will be home before 7 or 8, I think that would be REALLY tough because neither of you will see the little one much at least during the week. If you have a family member who can provide child care that might work out because at least there will be someone continuous for the baby to connect with. I just imagine it being a huge switch for baby going from having you full time to having no family member except on weekends. Does your husband have any flexibility at all???

    #84290
    snssns
    Participant

    Unfortunately my husband does not. His job is just as bad as being a resident. He is in the business world, not medicine. He works from about 7am – 8 or 9pm, occas even later. This is one of the big reasons I am staying with the baby now. Daycare just wasn’t working out with both of us working.

    If he works a few more yrs while I am at home, we might be able to build our savings up enough for him to stay home (or work part-time) when I go back to residency. Our child would be 3 or 4 by then and could attend preschool. Then he could take her to school, pick her up and be available if she got sick or anything else.

    I just saw a similar topic to this on POL about a woman whose children are now ready to start school and she is applying to residency. A program director responded to her post and said that in his experience, the drop out rate of women in her situation is 100% so that he doesn’t even interview them anymore and will not consider them for a residency slot. I am beginning to worry that this time off is the end of my career.

    #84291
    EemaMDEemaMD
    Participant

    What is POL? And who is that jerk that won’t consider a woman for a residency slot because her kids are ready to start school?

    Arrrrggggghhhh!!!! 😡 That type of Neaderthal thinking makes me furious!!!!

    I am an MS4, medical spouse (surgery) and mom of two boys – one in 4th grade and one in pre-K. I had really hoped that that sort of narrow-minded thinking was a thing of the past. And programs wonder why they can’t fill spots! The days of all-male, single, straight thru undergrad then med school are over.

    I firmly believe that the extra struggles I have gone through to get to this place have made me a better physician and a better mother.

    I am going through ERAS right now, hoping to apply for a position in OB/Gyn. That is the electronic residency application service – and is typically headed by the dean’s office or the academic affairs office. If you are a graduate already, I am not sure what the protocol is, but look at their website: http://services.aamc.org/eras

    I’m concerned that your husband works “residency” type hours already. I know PM&R is more “benign” than many residencies, but you both need to think through all the scenarios. And I don’t know that putting your residency on hold until sometime in the future when your husband’s hours might get better is the best answer. How does he feel about possible cutting down his hours? Why can’t he do it now? And if he has to wait a few years, what makes him think he will be able to cut them down later? Who will pick up your child in case of illness? Who will stay home with the feverish child? In case the center is closed or the sitter is ill?

    Obviously I’m not telling you to give up on your residency, your child or your husband. But I guess I am hoping there is a little more flexibility available on his end to support you in your dream of being a physiatrist.

    Linda

    #84293
    elisemomof3elisemomof3
    Participant

    Grrrrr. I am so annoyed to hear about that stupid male director…Could we all enter the 21st century please?

    On the subject at hand, I thought I’d mention that a lot of moms who want to have a regular schedule during residency choose Pathology b/c the residency is pretty much 9-5 with no call. The residency is 5 years though, so if you want to gain stability but be in residency a little longer than some of the other residencies, this is the one for you.

    Yours,
    elise

    #84295
    snssns
    Participant

    To EemaMD: POL is Physicians Online. It is a great site for physicians only. They have news, email, tons of bulletin boards to discuss clinical issues and non-clinical issues. Registration is free. Their site is http://www.pol.net

    Reading my previous post again, I realize that I didn’t make it very clear that the woman applying to residency had taken some time off between graduating from med school and applying to a Family Practice residency so that she could be with her kids. The program director was saying that he doesn’t accept applicants that took an extended time off. This doesn’t make him any less of a Neaderthal, I just wanted to make sure I made that clarification.

    On the issue of my husbands hours, his job is an all or none thing. He works in the headquarters of a large company. He is hoping to stick it out for a few more yrs to build up some savings. Then he would feel better about switching to some type of field that has shorter, more flexible hours (less pay).

    He has been doing this for almost 20 yrs. It is his identity, it is what he knows. I think it will be hard for him to give it up and switch to being Mr Mom while I am in residency. He is willing to try it though. He feels that since I was willing to give up some time to be with our child, he can too.

    He has been very appreciative of my staying home. He never made me feel like I had to stay home or I had to go back to work. He let me decide. He obviously prefers our baby to be with me rather than daycare. He knows he doesn’t have to worry about her if she is with me.

    It sure is nice being able to bounce these issues off of other women in medicine to see what they think!

    #84296
    EemaMDEemaMD
    Participant

    Oops… didn’t mean to be anywhere near as harsh as my previous post sounded. My bad…

    I’ve hit a few snags in the road on my way through medical school – it was a lot harder with children than I ever thought it would be – and my husband, while verbally supportive has dropped the ball on several occasions. The latest in our little journey is the fact that he is buying into his practice here, and I am not getting warm fuzzies from our OB residency program. He is just choosing to ignore any possibility that I might match elsewhere and will not make a commitment to follow me (after I have followed him for 10 yrs, changed med schools, etc.) if that happens. What is sad is that this has become the status quo of our marriage. What I cannot deal with is the thought of being away from my children for four years. I’m scared that if I match elsewhere that he will try to keep the children from joining me. I really don’t care too much what he does himself. Ouch.

    So needless to say I am terrified about the whole match process. I am scared that no OB program will want me – that I will get zero interviews. I am scared that I will match here and scared that I will match someplace else. Ah, the proverbial rock and the hard place. Pity the rock is sitting in my stomach, creating an ulcer. Anyone have a PPI?

    Ugh.

    Linda

    #84298
    psychpsych
    Participant

    Can I just say how much I appreciate the level of honesty on this website??!!

    I think the issue of having a supportive partner is huge if you want to do combine motherhood and medicine. Or having an in-house or practically in-house family member. The families I know where both parents are residents or very busy 60-100 hr/wk professionals rely on either parents or a live-in nanny to make it manageable at all. Do you have options to have an incredibly involved grandparent? Otherwise I think you’d have to have a very flexible live-in helper. Au pair wouldn’t work because they aren’t allowed to work that many hours. You’d just have to pay through the nose for the nanny.

    It sounds like the bigger issues here are husbands who say they are supportive but aren’t actually putting their money where their mouth is. VERY tough situation. I think it’s so common though. And the moms end up covering all the loose ends. One of my friends is now divorced from her busy physician husband. She made it through residency with two preteens but it was (and is) pretty tough. Maybe the first step to making the residency decisions is to get away with your husband (I’m assuming he wouldn’t consider couples therapy as it would ideally be a weekly commitment plus homework, but maybe that’t not true) and really look at your marriage and what your goals for your family are. If you are part of a faith community, there may be a marriage retreat program available to you — I’m more familiar with Christian groups such as Marriage Encounter in the Catholic church, or the Marriage Enrichment Weekends sponsored by the Christian Medical & Dental Associations. Does anybody know of other marriage retreats that might be available?

    #84299
    snssns
    Participant

    To psych, We don’t have any family in town available for childcare. Our house won’t really accommodate live-in help. We tried the live-out nanny and were very disappointed. Our first nanny was great but was only available for the summer because she was a schoolteacher. After that we interviewed a lot of candidates through two agencies and put our own ad in the paper. We weren’t happy with anyone we interviewed. Ended up using the “least bad” one.

    It was helpful with our long work hours but she was usually late (which made my husband late to work). She had visitors over while we were gone. She was generally lazy and watched TV or talked on the phone most of the time. The final thing that made me decide to not try the nanny thing again was that she helped herself to quite a few of our things.

    I think I will feel better if I stay with our child until she is 3 and able to attend a good preschool. At which time, my husband and I can basically switch roles. I will go to residency and he can be the primary care-giver.

    I would start residency today if I knew that my child had good care and that residency hour limits were really going to be enforced. Funny thing is, before I became a mom, I didn’t mind the residency hours so much. My only complaint during internship was being too tired. Priorities sure change when you are blessed with a baby!

    #84301
    snssns
    Participant

    New twist in the plot. My husband wants to have our second baby now instead of after my residency. His suggested plan is to get pregnant before the end of the year so we can have the baby by September 2003. That would give me 9 months with the baby if I entered residency in July 2004.

    He has decided he will quit his job one month before I go to residency. That will give us one month together as a family before I vanish into the hospital. He will then be a stay-at-home dad for the two kids.

    He feels that if we don’t have baby #2 now, we shouldn’t have one at all. He thinks we will be too old when I finish residency. He is now 40 and I am 32.

    I hope it is OK for me to do a little venting here. I worry about him home alone with one child much less two children. I love him but he doesn’t take child safety issues seriously. I have caught him leaving the baby in the bathtub to grab something from the other room and letting her play with his wedding ring and other small choking hazards. A couple of times she has crawled halfway up the stairs by herself before he noticed. The next door neighbor lady told me that one time he was in the front yard with the baby and she ran out into the street. He doesn’t tighten the car seat straps because it makes it too hard to get her in and out of it and is uncomfortable for the baby. He thinks I am overreacting when I get upset about these things.

    He occasionally watches our daughter on Saturdays for a few hours while I go to CME lectures. I have to remind him to feed her. I will get home and find out that he didn’t give her anything to eat. His embarrassed response is “I guess I figure she would ask for something if she was hungry.” I don’t mean to bash him. He does love our baby. He, for some reason, just can’t see that these things are dangerous. He has never been around children before and I guess just has a lot to learn.

    I have some hard thinking to do quickly. Benefits of having the baby now are that I would be able to stay home with him/her for the first 9 months. I can’t do that in residency and might not be able to after residency. And we aren’t getting any younger.

    The down side of having another baby now is that I am still tired from the first one! She is 20 months old now but still doesn’t sleep through the night. She still nurses a lot. I can’t seem to get her to decrease to just a couple of times a day. She has just been a very needy baby from the second she popped out. She had some problems the first 12 months and was also on a very restricted diet for food allergies until she was 18 months old. All of the peds and specialists we saw told us she was a difficult baby but that a second baby would likely not be. If I could have that in a written guarantee, I would have already had the second child!

    Anyway, sorry to ramble on for so long. Just needed to let that out.

    #84303
    MD mother of 2MD mother of 2
    Participant

    I’ve read through nearly all the posted replies. Yes, it’s rough. And a rough choice. But it shouldn’t have to be.

    I married during internship to a 3rd-yr resident. He had to pay-back the military and he needed to move out-of-state. I chose to follow him, but got a residency in a different specialty (for which I am truly grateful!), 175 miles away from his military base. We saw each other on weekends for 1 year. Then they decided to ship him oversees…we’d only been married less than 1.5 yrs (we’d married after having met 6 months earlier)……so for the marriage to stay in tact, I felt it necessary to follow him abroad. I joined him 3-4 months later. During my stay abroad, we decided to start a family. I had one child. Once his obligation was fulfilled, it was my turn to pursue my career and I applied for residency.

    Thus, I had a 3 year hiatus between PGY-II and PGY-III. Unfortuneately, I discovered that I needed to interview for the PGY-III year during the time I was pregnant…on forced bed-rest! Thus I had to write to the programs and enclosed a note from my gynecologist, explaining why I couldn’t make it to interviews. Well, I lost out and they wouldn’t consider me. Luckily, one program was alittle behind in their schedule, and I was able to schedule an interview about 3 months postpartum….and that is where I ended up going for PGY-III and IV.

    It was difficult returning to residency after a 3 year hiatus, but after about 6 months I was back on track.

    With the experience I have gained as a parent, I think it unfair for today’s progressive society to make women have to pick between family and career. Family should always be number one. Those first few years of your child’s life are so important. My son did not start childcare until he was 19 months old…and I wish I had spent more time with him….so after residency I took another year off to spend at home with him while he attended 1/2 day kindergarden (it was the best decision I had ever made) and it was the best year I ever spent with my son. I was very happy that year…possibly the happiest year of my life thus far.

    Now my daughter started childcare at the age of 3 months at a very nice childcare across the street from work (a hospital childcare). I was in the middle of my career (in private practice with a group for 3 years) and didn’t want to disrupt it.

    I now work only 1/2 time…so I have time to help my son (who’s now in high school) with his homework and pick him up from school. And to pick up his sister (who’s in pre-K) in mid-afternoon most times. I’m home to help with homework, talk, cook a decent dinner, etc. I feel like I’m there for my kids majority of the time and they still come first.

    I realize everybody is different and they have different perspectives on motherhood, but I just want to say it is OKAY for a female physician to have the same mothering instincts as any other female. If anything, it make us better doctors!

    MD mother of 2

    #84304
    MD mother of 2MD mother of 2
    Participant

    I just read the last reply before I replied….anyway….

    I’m not too sure about having a baby just before you start residency. Sound like a suicide mission to me, especially when the first child is still quite young.

    The good news is, the second time around (2nd child) will be easier to care for because you’ve already learned everything you need to know with the first. I found raising my second child alot easier than the first…basically I’ve tried not to repeat any of my former mistakes. But my first child is also 10 years older than my second one and helps out ALOT! If I didn’t have him around to help, I imagine I would be alot more stressed out. My husband is a workaholic and never around.

    About your comments regarding your husband….I can somewhat relate. My husband has very little parenting skills. Once I accepted that (it took about 8 years!) and realized I would have to function as a single parent, I was less resentful and things went more smoothly. Yet, at times, I can’t help but feel resentful that I have all the responsibiltiies. Ofcourse, this goes deeper as I have not only the responsibilties of parenting, but also am his business manager for his practice, am primary bread winner, manage the household & it’s finances, and also am chief cook and laundress. Enough about me…

    MD mother of 2

    #84306
    snssns
    Participant

    MD Mother of 2, thanks for your input. I am very interested in your 3 yr break between PGY2 and PGY3.

    In what specialty did you train?

    Was it hard to find a program that would take you after the time off?

    What kind of concerns did the programs express when you interviewed after your break?

    Did you do anything medical during your break to maintain skills or license or to help your resume/applications look better?

    I did my internship in internal medicine, like I said above, and then did 4 years of general practice in the military. I intend to apply to PM&R programs. I am worried they will want me to repeat internship since I took time off. I do not want to repeat internship but I am worried that if I don’t I will be rusty. There was a female MD in the same clinic were I worked that did one year of peds before the military pulled her out saying they had enough peds and needed more GP’s. She did her 4 years as a GP and then returned to her old civilian peds program. They had her do a shorted internship as a refresher and then moved her on to PGY2.

    Any words of wisdom you can offer will be greatly appreciated.
    Thanks.

    #84308
    docnrolldocnroll
    Participant

    Boy… at 32 you are still pretty young and could definitely wait an extra year to have the second one…. sometimes the stress of residency and a child and what your husband thinks he can do to help could be too much and create irreparable damage…. my kids are 3 and1/2 years apart and even that was tough in the early months…

    I took two years off between internship and my residency and worked in an ER full time … no kids. Still found it hard to explain why I had time off. My residency was one that requires almost a year and 1/2 ahead to apply.

    don’t stay out too long… get it over with. Pay extra to have live in or get an au pair and ask your husband to commit to coming home earlier. After 20 years at a company you definitely have some clout…b

    #84309
    snssns
    Participant

    Originally posted by docnroll:
    [b]I took two years off between internship and my residency and worked in an ER full time … no kids. Still found it hard to explain why I had time off. My residency was one that requires almost a year and 1/2 ahead to apply.

    don’t stay out too long… get it over with. Pay extra to have live in or get an au pair and ask your husband to commit to coming home earlier. After 20 years at a company you definitely have some clout…b[/b]

    What kinds of concerns did the residency directors have about your time off?

    Was it hard to find an ER that would hire someone who wasn’t board certified? Did you have to get your own liability insurance or did they cover it for you?

    I have thought about working a couple days a week in a doc-in-the-box type place just to keep up my skills and to show that I did something medical during my time off. I haven’t called any places yet, I figured they only wanted board certified/eligible. I have also considered volunteering at a shelter or somewhere but have heard I have to get my own liability insurance which I am sure would be too expensive.

    My husband hasn’t been at the same company for 20 years. He had to change companies when the military moved me 5 years ago. He has been in the same career field for almost 20 years though. He works in finance. Very long hard hours. His only option would be to quit, which he is strongly considering whether I go to residency or not. He says he would definitely quit when I go back. I think we would have to get him some help though. He goes crazy if he is alone for just an hour or two with our one child. He loves her, he just doesn’t have the patience or the know-how to deal with kids I guess. Maybe if we have the kids in Mother’s Day Out twice a week and have a Mother’s Helper come over on the other days, he can make it.

    Thanks for your input. I welcome any advice.

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