Maternity Leave

[tellmemore2020]

The culture of America in general, and medicine in particular, is one that values individual work ethic. You come from a nation where you can't work too long, you have minimal chances at anything other than GP, and you take near-indefinite "junior registrar" positions. Sadly, as a consequence of your nation's "don't work too hard" mentality, your entire health system is in free fall, and something like 25% of your physicians are imported from eastern Europe and barely speak English.

I'm not saying this to criticize you; I'm just pointing out that you likely don't really have the context to understand what this debate is all about. This is exemplified by your frequent references to "what pregnancy is like." Even those here who are arguing furiously that programs should accommodate maternity leave at the expense of other residents haven't argued that pregnant residents shouldn't have to work; it's clear you don't really get what we're discussing.

You should probably stay out of things that you don't understand.

I think she is offering a very valuable perspective. Some of us from the states would like to see these cultural moores take a turn as we feel that disadvantages tip the scale.

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[giantswing]

No, I am not an ob gyn resident!!! Our training in the UK is very different to yours. Our first 2 years consist of 6 different jobs, one of those happened to be a gynae job for me. I am in a far more competitive specialty.

Dude, you just said your training is different, plus you're in an entirely different country, so how in all that is holy do you have the right or the experience to comment on our call burden!?

 

[bambi]

The culture of America in general, and medicine in particular, is one that values individual work ethic. You come from a nation where you can't work too long, you have minimal chances at anything other than GP, and you take near-indefinite "junior registrar" positions. Sadly, as a consequence of your nation's "don't work too hard" mentality, your entire health system is in free fall, and something like 25% of your physicians are imported from eastern Europe and barely speak English.

I'm not saying this to criticize you; I'm just pointing out that you likely don't really have the context to understand what this debate is all about. This is exemplified by your frequent references to "what pregnancy is like." Even those here who are arguing furiously that programs should accommodate maternity leave at the expense of other residents haven't argued that pregnant residents shouldn't have to work; it's clear you don't really get what we're discussing.

You should probably stay out of things that you don't understand.

Minimal chances at anything other than GP? We have all the same specialties you do. In fact I think we have one extra! Though to get into the tougher ones it is far more competitive for us than it is for you because of numbers essentially. "Near indefinite registrar positions"? You have no idea what you are talking about. 25% can't speak English properly? Again, no idea. I can assure you we work hard. Our hours are different in terms of number but also in terms of productivity, at least in my experience, partly because some things about our system suck. We do all kinds of crap that your PAs etc do. So on top of the actual doctor work for any given specialty we have extra stuff! I say this again, having experience that most people here don't.

Seriously unless you have been pregnant, do not comment on it, you have no idea what you are talking about. I have never said pregnant women shouldn't have to work! Can you actually read?? I have said that expecting them to work extra shifts than they otherwise normally would, during pregnancy, is not really ideal. As I said I have had bad experiences and admit that perhaps I am more concerned with pregnancy risks than others but you are the one talking about things you don't understand.

 

[bambi]

Dude, you just said your training is different, plus you're in an entirely different country, so how in all that is holy do you have the right or the experience to comment on our call burden!?

Free speech? I am actually supporting what the majority of you are saying! I don't think it's fair that others should be forced to do additional work or did you just miss that???

 

[rokshana]

There are plenty of articles actually, I was forced to research it at one point.

Have you ever been pregnant? Some things people simply should not be commenting on unless they have because you have no idea what you are talking about.

like you talking about US residency training an what is appropriate and inappropriate?

and whether you have been pregnant is irrelevant to the issue (though mine is 24, graduated from an Ivy and works for the World Bank, thank you very much), just because you had a oops baby and were exhausted all the time, doesn't mean every one experiences the same type of pregnancy...and some of us are very capable of working our jobs and being pregnant and for you to say it is inappropriate for a woman resident to have to do her job when pregnant because its too much effort si just as misogynistic as some good ole boy saying women can't make for good doctor, soldier, construction workers...

and IF someone feels that for the safety of their pregnancy they need to take time off...that's fine too...but they should NOT feel entitled to have others do their work.

 

[colbgw02]

So who, again, is advocating that anyone do "extra" work? I must keep missing it.

 

[rokshana]

like you talking about US residency training an what is appropriate and inappropriate?

There are plenty of articles actually, I was forced to research it at one point.

Have you ever been pregnant? Some things people simply should not be commenting on unless they have because you have no idea what you are talking about.

cite your sources...

kinda going to believe the poster that is actually an ob on this...yours is an n=1....gotta feeling the ob guy has a higher sample size

 

[bambi]

like you talking about US residency training an what is appropriate and inappropriate?

Again, actually read what I have said, I am supporting what most people here have said. Some of you are so naive that you are simply incapable of seeing anything outside of your screwed up little bubbles. This is actually a very common thing on this board, because many of you spend your entire adult lives in one place, or a couple of very similar places you simply have no understanding of what things can and are like elsewhere or what they should be like. You are victims of your own system. If you actually saw what things were like elsewhere and had a proper understanding of it maybe you would do something to change the things you all moan about, you are your own worst enemy in many cases. In the UK, if we don't like something, we change it, we don't just accept the "it was like this in my day so you have to do it too" mentality. Your system sucks, that is essentially all I have said and this thread would never have been started if people didn't agree with that.

 

[bambi]

So who, again, is advocating that anyone do "extra" work? I must keep missing it.

Unless I am misunderstanding what front loading on calls means I don't know what you are missing? I might be, it's not terminology we use in the UK. Multiple people have said here that pregnant women should do this which to me means doing more on calls when pregnant than they otherwise normally would during that time frame.

 

[bambi]

cite your sources...

kinda going to believe the poster that is actually an ob on this...yours is an n=1....gotta feeling the ob guy has a higher sample size

I have personally seen it and done a literature review!!

 

[rokshana]

Having a child in residency is also not the choice some people here make it out to be. Of course in general it is but if you are doing a long residency you may not be fertile anymore at the end of it, you don't have to be as old as you might think to have fertility issues. I did a 4 month gynae job that ended up being mostly a fertility job and in every clinic the majority of patients were in their early 30s, had no health problems and couldn't get pregnant, despite getting pregnant with no problems in their 20s.

I think it's incredibly sexist and generally out of line to suggest anyone avoid a certain specialty because they have kids, particularly in the US actually. You are limited in terms of leave so other than about 10 months (per kid) you can function the way anyone else does, how much impact do you really think those 10 months have on a 30+ year career. In the UK it is a little more of a reasonable argument because people can take excessive leave, be part time pretty much forever etc so it can impact someones career much more..

evidently, unlike the UK, we do not train for upwards to 20 years to be in training during the entirety of our fertile periods...IM and FM are 3 years, even the longest or longest training is may be 9- 10 years (bless all of you that are actually a PGY 8 or 9...PGY 5 has been long enough for me!) so even IF you decided to wait til after training, you still have a few fertile years even if its just on the other side of 35.

 

[rokshana]

I have personally seen it and done a literature review!!

so...post a link...even just one article ...easy enough to do if you have the source.

 

[bambi]

evidently, unlike the UK, we do not train for upwards to 20 years to be in training during the entirety of our fertile periods...IM and FM are 3 years, even the longest or longest training is may be 9- 10 years (bless all of you that are actually a PGY 8 or 9...PGY 5 has been long enough for me!) so even IF you decided to wait til after training, you still have a few fertile years even if its just on the other side of 35.

Again, clearly you haven't read everything that I have said. Fine, it's a long thread. Some of you really have very little understanding of how difficult it can be to get pregnant. We also don't train for upwards of 20 years but the way, even if you include med school and a PhD in that.

 

[rokshana]

Unless I am misunderstanding what front loading on calls means I don't know what you are missing? I might be, it's not terminology we use in the UK. Multiple people have said here that pregnant women should do this which to me means doing more on calls when pregnant than they otherwise normally would during that time frame.

no "front loading" means that you do your harder, more intensive rotations early (i.e.before pregnancy or before leave) than later when one would be pregnant and could keep you from doing the rotation....our residency training is scheduled on a yearly basis...these would be rotations that the resident would have to do anyway...if she does them early in the year..front loading her schedule , then she gets them out of the way ...its not extra...

 

[colbgw02]

Unless I am misunderstanding what front loading on calls means I don't know what you are missing? I might be, it's not terminology we use in the UK. Multiple people have said here that pregnant women should do this which to me means doing more on calls when pregnant than they otherwise normally would during that time frame.

I think maybe you are misunderstanding.

In U.S. residency programs, a given trainee has a certain amount of "call" he or she is expected to take. That call can take many forms, but for our purposes, we'll use it as a general term to refer to after-hours work.

When people say pregnant residents should do more call when pregnant, they are suggesting that said person may prefer to "front load" this after-hours work before giving birth, so that there is less of it left over to deal with after returning from maternity leave. As discussed earlier, this is an option, and I have yet to see or hear of anyone suggesting that adding this workload onto a pregnant resident is obligatory.

The sum total of work performed remains the same, so the idea that anyone is doing "extra" work is misguided. What much of this thread has been about is residents neglecting to make up the call that they previously missed due to pregnancy, which actually does result in extra work for others.

 

[bambi]

so...post a link...even just one article ...easy enough to do if you have the source.

http://www.ncbi.nlm.nih.gov/pubmed/25607399

 

[rokshana]

Again, clearly you haven't read everything that I have said. Fine, it's a long thread. Some of you really have very little understanding of how difficult it can be to get pregnant. We also don't train for upwards of 20 years but the way, even if you include med school and a PhD in that.

oh i have read your threads...you evidently are in this UBER competitive field that the rest of us are just not remotely worthy to reach for and consequently that must make you smarter than the rest of us...so much smarter that you can comment EXPERTLY on the training methods in a another country that you are not REMOTELY knowledgable about. AND you have such an expert opinion about the rigors of pregnancy and the detrimental effect that working as a resident has on a pregnancy that it is life threatening to a fetus...all because you stayed at a Holiday Inn and did some sort of fertility job there....for a WHOLE FOUR MONTHS!!!

does that about cover it?

 

[bambi]

The front loading thing still sounds like doing more or more stressful things during pregnancy? It's late here, maybe I'm not really paying attention. Prior to getting pregnant like one of you said, fine, no problem, but during pregnancy, even if it is just the tougher rotations rather than doing additional calls to make up for ones that will be missed later is not ideal. I'm not questioning that the sum total is the same, just that the total directly either side of the birth is expected to be more. There seems to be nothing you can do about it though so I'm not sure the point in the continued discussion. As I said it sucks for everyone.

 

[giantswing]

Free speech? I am actually supporting what the majority of you are saying! I don't think it's fair that others should be forced to do additional work or did you just miss that???

Thats the point, because of the way our call is set up, when someone leaves, it's additional work for those left, on an already insanely heavy work schedule.

That's why people get upset over here, it turns an 80 hour week into a 110 hour week (just an example). So when someone says, bend over b****es, I'm having a baby and you all have to cover my absence because i'm doing something noble by proving i had sex at one point, the people left at work get pissed.

 

[bambi]

oh i have read your threads...you evidently are in this UBER competitive field that the rest of us are just not remotely worthy to reach for and consequently that must make you smarter than the rest of us...so much smarter that you can comment EXPERTLY on the training methods in a another country that you are not REMOTELY knowledgable about. AND you have such an expert opinion about the rigors of pregnancy and the detrimental effect that working as a resident has on a pregnancy that it is life threatening to a fetus...all because you stayed at a Holiday Inn and did some sort of fertility job there....for a WHOLE FOUR MONTHS!!!

does that about cover it?

I cannot help it that it is more competitive for us to get into certain specialties and I have chosen a competitive one, that's just a fact. Sorry if your ego has an issue with that. I have spent a great deal of time in the US, in hospital, working, seeing exactly what it is like, how much time have you spent in medicine in the UK, or anywhere else? My fertility experience was part of my postgraduate training, part of a nationally approved curriculum thanks. You are behaving like a child.

 

[Smurfette]

Wow, this thread headed where I'd hope it wouldn't.

A couple comments:
1. Telling anyone who hasn't experienced pregnancy that they can't weigh on how much a gravid female can work or what reasonable maternity leave is, is offensive. It's not like people are telling you how to physically feel during pregnancy. Note how mothers here on SDN aren't exactly clamoring to jump on this viewpoint. I know women in medicine who took less than their available maternity time, the full time, or extra time. It is a complex issue, as everyone experiences pregnancy differently, everybody has a different home situation (as far as family support, etc.) and differing limitations as far as income, disability, etc. Not all women have significant fatigue or other issues during pregnancy. Some might with one pregnancy and not others. Doctors have all sorts of conditions other than pregnancy that can affect them physically; certainly the amount that these physicians can work or need to take leave can be discussed by those without the same conditions.
2. A person with children should not automatically be entitled to more holiday time, nor should their time outside of the hospital be considered more important than a childless person's. I think that was not really what was meant earlier in this thread, but I have met people who think this way when they first become parents. For those who subscribe to this mode of thinking, what to do once everyone has kids? Someone still has to work. You can't put the same childless person on call for every holiday. That's discrimination. Imagine if you couldn't get a job because you have children and you couldn't or wouldn't work as much as your childless colleagues based on that. You'd be outraged.
3. Culturally, it is hard for Americans to comprehend a European work model and vice versa. Neither is wrong, as both ways have their advantages and disadvantages. In the US, it is hard to comprehend taking a year off work and being able to return to the same job (which would be rare in itself) and without co-workers or employers being resentful. In most cases, that delay to return will result in many extra hoops to resume practice, a lower income, loss of referral base, etc.
4. In residency, there is a certain amount of work that needs to be done in a defined period. No one wants to extend their training. A woman who takes maternity leave has a bit less time to get that work in; she's not working "extra", but the calls and certain rotations may have to be made up and may require others to have to switch their training around (rotations, calls, etc.) to enable the pregnant woman to meet all her requirements. It's not as if pregnant residents automatically have MORE calls than their colleagues; they can't do their calls/hard rotations when they are off so they have to do them either before or after they are off. Generally speaking, in vacation months, residents often have some more frequent calls (if still compliant with regulations) in order to make up for the time they will be off when others will have to pick up a call or two on their behalf. It all evens out in the end, for the most part, if you are considerate and don't assume others will carry your share without some reciprocity of covering calls, etc.

I'd also like to remind everyone to keep it civil since this is obviously a topic that has struck a nerve.

 

[colbgw02]

The front loading thing still sounds like doing more or more stressful things during pregnancy? It's late here, maybe I'm not really paying attention. Prior to getting pregnant like one of you said, fine, no problem, but during pregnancy, even if it is just the tougher rotations rather than doing additional calls to make up for ones that will be missed later is not ideal. I'm not questioning that the sum total is the same, just that the total directly either side of the birth is expected to be more. There seems to be nothing you can do about it though so I'm not sure the point in the continued discussion. As I said it sucks for everyone.

Well, then, I'll refer you back to my earlier statement that this is optional. No one on this thread is saying that residents have to take on a tougher schedule while pregnant, only that the option frequently exists should they prefer it.

 

[bambi]

Thats the point, because of the way our call is set up, when someone leaves, it's additional work for those left, on an already insanely heavy work schedule.

That's why people get upset over here, it turns an 80 hour week into a 110 hour week (just an example). So when someone says, bend over b****es, I'm having a baby and you all have to cover my absence because i'm doing something noble by proving i had sex at one point, the people left at work get pissed.

I get that and have agreed that it's unfair all along.

 

[giantswing]

Again, actually read what I have said, I am supporting what most people here have said. Some of you are so naive that you are simply incapable of seeing anything outside of your screwed up little bubbles. This is actually a very common thing on this board, because many of you spend your entire adult lives in one place, or a couple of very similar places you simply have no understanding of what things can and are like elsewhere or what they should be like. You are victims of your own system. If you actually saw what things were like elsewhere and had a proper understanding of it maybe you would do something to change the things you all moan about, you are your own worst enemy in many cases. In the UK, if we don't like something, we change it, we don't just accept the "it was like this in my day so you have to do it too" mentality. Your system sucks, that is essentially all I have said and this thread would never have been started if people didn't agree with that.

I've lived all over and had a career before going back to med school.

Yes, even if our system sucks, it is the way it is and we have to live in it. But thanks for pointing it out.

 

[rokshana]

The front loading thing still sounds like doing more or more stressful things during pregnancy? It's late here, maybe I'm not really paying attention. Prior to getting pregnant like one of you said, fine, no problem, but during pregnancy, even if it is just the tougher rotations rather than doing additional calls to make up for ones that will be missed later is not ideal. I'm not questioning that the sum total is the same, just that the total directly either side of the birth is expected to be more. There seems to be nothing you can do about it though so I'm not sure the point in the continued discussion. As I said it sucks for everyone.

well, i guess ya'll still think being pregnant is being in "a delicate condition"

 

[bambi]

Well, then, I'll refer you back to my earlier statement that this is optional. No one on this thread is saying that residents have to take on a tougher schedule while pregnant, only that the option frequently exists should they prefer it.

I know but it's just not ideal, that's all I have said. Some people have no problem with pregnancy and could do loads others with bad pregnancies simply couldn't.

 

[bambi]

I've lived all over and had a career before going back to med school.

Yes, even if our system sucks, it is the way it is and we have to live in it. But thanks for pointing it out.

You don't have to live in it, you can change it, we did in the UK. Not overnight obviously but we have.

 

[bambi]

well, i guess ya'll still think being pregnant is being in "a delicate condition"

For some people it is, that's just a fact. Awful things can and do happen to both mother and baby, you went to med school, you know this, you are just arguing for the sake of it. As I have said not long ago I would have done the same but things for me have changed and maybe they will for you one day too.

 

[giantswing]

You don't have to live in it, you can change it, we did in the UK. Not overnight obviously but we have.

Uh ok, that'll keep me warm on long call nights.

 

[colbgw02]

I know but it's just not ideal, that's all I have said. Some people have no problem with pregnancy and could do loads others with bad pregnancies simply couldn't.

Well, for one, that's not all you've said. You've said a great deal more on this particular branch of this topic, which is why I'm posting. If that's 'all' you had said, then my posts would have been superfluous.

And it's only less than ideal for the pregnant resident. The co-residents probably find it imminently fair that the new mother has to make up the work somehow, which - of course - is the entire point of this thread.

 

[bambi]

Uh ok, that'll keep me warm on long call nights.

Why not try and change it? Why have that mentality? I know of people that were denied the afternoon off to go to their own wedding in the UK but as a group we don't stand for that kind of nonsense and have changed the system. Some would say if you aren't prepared to do anything about the problem you have no right to complain. Personally I don't agree with that because there are obviously difficulties with changing things but you are supposed to be smart men and women, you don't have to just always do what you are told with no questioning.

 

[bambi]

Well, for one, that's not all you've said. You've said a great deal more on this particular branch of this topic, which is why I'm posting. If that's 'all' you had said, then my posts would have been superfluous.

And it's only less than ideal for the pregnant resident. The co-residents probably find it imminently fair that the new mother has to make up the work somehow, which - of course - is the entire point of this thread.

Well forgive me for being a medical professional showing some compassion for new mothers, how awful of me. I never even said the pregnant woman shouldn't make it up, just that immediately either side of giving birth might not be the best time. Given how short your training is in general I absolutely think missed time should be made up.

 

[colbgw02]

Well forgive me for being a medical professional showing some compassion for new mothers, how awful of me. I never even said the pregnant woman shouldn't make it up, just that immediately either side of giving birth might not be the best time. Given how short your training is in general I absolutely think missed time should be made up.

You're getting defensive because your posts have been dismantled in a logical manner. I haven't criticized you for showing compassion to new mothers, nor have I advocated a position contrary to such compassion. If you don't like my criticisms, then make better posts.

 

[colbgw02]

Why not try and change it? Why have that mentality? I know of people that were denied the afternoon off to go to their own wedding in the UK but as a group we don't stand for that kind of nonsense and have changed the system. Some would say if you aren't prepared to do anything about the problem you have no right to complain. Personally I don't agree with that because there are obviously difficulties with changing things but you are supposed to be smart men and women, you don't have to just always do what you are told with no questioning.

This approach presumes a cultural and policy supremacy. If you have already decided that maternal concerns are paramount, then engaging in this thread without making a case for why such concerns are - in fact - paramount - is fruitless.

 

[giantswing]

Why not try and change it? Why have that mentality? I know of people that were denied the afternoon off to go to their own wedding in the UK but as a group we don't stand for that kind of nonsense and have changed the system. Some would say if you aren't prepared to do anything about the problem you have no right to complain. Personally I don't agree with that because there are obviously difficulties with changing things but you are supposed to be smart men and women, you don't have to just always do what you are told with no questioning.

Because here you'll be seen as lazy, difficult, and not a team player. Here, you do what you're told. Medicine is a heirarchy.

If not ? Then you'll be unemployed with no residency training, no board certification which will leave you unhireable, and 100k x n in debt.

 

[dpmd]

Why not try and change it? Why have that mentality? I know of people that were denied the afternoon off to go to their own wedding in the UK but as a group we don't stand for that kind of nonsense and have changed the system. Some would say if you aren't prepared to do anything about the problem you have no right to complain. Personally I don't agree with that because there are obviously difficulties with changing things but you are supposed to be smart men and women, you don't have to just always do what you are told with no questioning.

There is a push to try to change things relating to maternity leave in general in this country, but the issue is that there is a cost involved with what your system allows. Paying for someone to be at home with their baby while also paying someone to do their job has a cost. If the employer has to eat that cost then they will have an incentive to discriminate against hiring people they see as likely to cause them this cost. If you make the government responsible for the cost then you basically resdistribute the cost to the taxpayers, many of which have no interest in paying for someone else to get to stay home for a year regardless of the reason. It just comes down to a fundamental difference in mentality.

 

[rokshana]

I cannot help it that it is more competitive for us to get into certain specialties and I have chosen a competitive one, that's just a fact. Sorry if your ego has an issue with that. I have spent a great deal of time in the US, in hospital, working, seeing exactly what it is like, how much time have you spent in medicine in the UK, or anywhere else? My fertility experience was part of my postgraduate training, part of a nationally approved curriculum thanks. You are behaving like a child.

zip, zero, nada...but i haven't called your training system sucky either...and you have called ours such multiple times in this thread...and your observerships or clerkships do not really give the full picture (you haven't worked as a resident or an attending in our system since to do that, you would have to actually have done a residency here to do so). Trust me (as some here on sdn will attest) my ego is fine...and its funny you state how "competitive" your specialty is, but you haven't mentioned it...i would imagine that those that have applied to say Derm, NS, Rad Onc would say that their specialties are uber competitive too, i would think more so that there are so many more people to compete with here than in any specialty in the UK.

and watch out pot...you're calling the kettle black...

 

[rokshana]

So on top of the actual doctor work for any given specialty we have extra stuff! I say this again, having experience that most people here don't..

seriously? this tells me you have NO idea about the American Healthcare system and the work that US physicians have to do...

 

[rokshana]

As I have said not long ago I would have done the same but things for me have changed and maybe they will for you one day too.

how condensing of you, but bless your heart, thank you for thinking i'm young enough that I haven't have any experience...

 

[Winged Scapula]

seriously? this tells me you have NO idea about the American Healthcare system and the work that US physicians have to do...

Yeah, I like the part about "your PA does it".

Having worked in the UK, South Africa, Australia and the US I can verify that we do more here and work more hours. So there's that n = 1 here.

 

[FutureInternist]

I think expecting pregnant women to work extra on calls is unreasonable. It is incredibly tiring being pregnant, even a normal schedule is very tough. Stress can cause problems in pregnancy, some of you are seriously expecting women to risk the health of their child? If anyone even suggested to me that I should ever do anything that could potentially hurt my child I would never speak to them again. I have had very bad experiences though so am probably far more touchy/concerned about risks than most people. I also think asking someone with a 6 week old baby at home to work extra on calls is unreasonable, male or female. I'm sure many people to try to arrange pregnancies around lighter schedules but some desperately struggle to get pregnant so can't necessarily do it when it's most convenient. There are obviously time limits on getting pregnant, you absolutely cannot expect anyone to potentially risk never having a baby so as not to interfere with work schedules.

Saying "everyone has a family" doesn't really fly with me. Ask anyone that has a child who they would rather die, their child, or literally anyone else in the world and you can bet no one would say their child. A parent, sibling, or spouse is just not the same. Obviously other people are important, but it's not the same.

To those super hard core people saying you shouldn't have kids in residency or should go into lifestyle specialties, medicine is a calling, it should be your only priority etc when covering for others why aren't you thinking, "great, more work, more time to learn, this is why I went into surgery, to see everything and do as much as I can"? One could argue that those taking leave are actually giving you what you claim to want, every patient is a learning experience.

I am in an incredibly tough surgical specialty and a few years ago would have had a very different response to this thread but being pregnant changes you. Those saying they would simply have an abortion (something I used to say) have no idea how they would really respond if they got pregnant, a hypothetical, and reality are different.

Despite the above, I do think it is unfair that the extra on calls are forced onto others and working outside of the US find it a bit shocking that this is the way your system is set up. In the UK most doctors take several months, if not a year off after delivery, and don't work right up to it, regardless of specialty. Taking a full year is actually preferable in terms of work in many ways so you complete training at the normal time, just a year later. Any time off is added to the end of training but that is just the norm and accepted. The 6 weeks off you get in the US would mean extra training time for us anyway. Beyond the first 2 years, you can only take 2 weeks out for sickness etc without extending your training. For us no one is forced to do extra work to cover, the hospital will simply hire a locum if needed. So getting pregnant actually benefits other people, you give someone a job they otherwise wouldn't have had! I would be very angry about being forced to do extra cover with no compensation, they should at the very least pay you extra.

It was the woman's decision to get pregnant (or keep the baby)
So for her decision to be imposed upon me is unfair.
If I decide to not study as much, hence becoming a burden to the team, where you may have to see more pts since I can't handle my designated load, then would you fell the same way??

A normal sch'd is tough, which is why it is looked down upon when someone deliberately does something to make it tougher. If you want to have a kid, that's great, but the payback system should be utilized so that any & all extra call your colleagues took, because of your decision, is paid back in full

As for children being "higher" on the "Which family member do I want not to die" list....that is entirely a subjective thing (and a very stupid thing to say). Just because you would kill your SO to protect your child, doesn't mean everyone else would. And even if they did, that only applies to people who have children. For those that do not, the SO immediately "climbs a rung" so to speak, so you child becomes just as important as my SO

 

[22031 Alum]

http://www.ncbi.nlm.nih.gov/pubmed/25607399

Depression is a confounder. It's common knowledge that even treated depression is associated with more adverse pregnancy outcomes than pregnancies with no depression. As I said before, find me a study that says that the "stress" of working a job (or even normal grief) is "bad for the baby." And let's try for something a little more robust than a placental histopathology study with an N of 12(!!!) in some Romanian journal. If I'm going to start agreeing to give work excuses to healthy women with uncomplicated pregnancies a dozen times a week, I'm going to need stronger evidence.

 

[Trauma Surgeon]

I have followed this post for some time now and wanted for once do as my chief of surgery tells me; which is I shouldn't get get involved in these kind of discussions since if we express what really is on our minds we will get hammered by the society we live in (Europe). My chief did experience this the hard way, he hired 6 female residents (PGY 1-3) in their early 30s, 5 of them became pregnant basically at same time and wanted their 1 year maternity leave plus no night calls from 6months in pregnancy, which they are entitled to by law, I don't have to tell you what mess that followed where senior attendings in their 50s had to take calls to cover for their absence. Let just say (even he never would admit it) he would probably think twice before hiring females in the future…
I believe for the sake of arguments and for you Americans it is a good idea to let Bambi say her mind since then you can avoid doing the same mistakes we have done during the last decades in Europe (work-hours restrictions, maternity/paternity leave and so on). Obviously you were either not that smart or did not have all facts when you past the Obama care and one of the references on how good it would work was Sweden

 

[Geekchick921]

I start Ob/Gyn residency this summer. I have every intention of having baby #3 around the mid-point of my residency. Hopefully, that pregnancy will be similar to my first two, uncomplicated and not hard on me at all. I worked/went to school right until my deliveries and didn't take any time off after I had Geekling 2 months into MS-1. I plan on front-loading my call schedule however expectant residents in my program typically do. Thankfully, my program seems very family friendly. I'm going to appreciate my coresidents covering for me just a I'll do for them if the need arises.

And then I'll find 5 dollars.

 

[Member 1337]

I'm going to appreciate my coresidents covering for me just a I'll do for them if the need arises.

I think you will be in good shape, especially if you tell your coworkers these plans in advance and work to coordinate your plans with them (as much as is reasonable).

Your PGY group especially will really appreciate your respecting their schedules (on and off work) by giving them a heads up and it will instill trust in your capacity to be responsible with your time and theirs.

 

[Trauma Surgeon]

I start Ob/Gyn residency this summer. I have every intention of having baby #3 around the mid-point of my residency. Hopefully, that pregnancy will be similar to my first two, uncomplicated and not hard on me at all. I worked/went to school right until my deliveries and didn't take any time off after I had Geekling 2 months into MS-1. I plan on front-loading my call schedule however expectant residents in my program typically do. Thankfully, my program seems very family friendly. I'm going to appreciate my coresidents covering for me just a I'll do for them if the need arises.

And then I'll find 5 dollars.

Even though I respect you for your planning ahead, the reality is that NO ONE can plan anything when it comes to pregnancy! What if (God forbid) you don't have a uncomplicated pregnancy this time around?
I have posted this in another post, people are so naive when they think that the hardest part whit children and residency is the pregnancy/postpartum period. Here we talk about a couple of weeks that actually most programs can plan for or at the worst other residents cover for you, even though it would be a hard time for them. The real hard time actually begins after this period. This period does not ever end! Children are a life time commitment. And during this period no planning can be done and this is where most irritation amongst colleagues happen...

 

[captaincrunch]

I'm surprised that more people don't have more sympathy for female residents who have children during training.

To those who say that women shouldn't have children during residency or should pick up extra call during/after pregnancy to make-up for their leave, I would be careful voicing this opinion outside of anonymous internet forums. While you might not like the rules, you do have to follow them. You don't want to be accused to creating a hostile work environment. Furthermore, most women in residency take off far less time than they are permitted. Even though the law may allow generous maternity leave (it varies from state-t0-state and by how long you have worked for an organization), the ACGME is fairly strict and most people do not want to decelerate their training if it can avoided. Most women I know took only two weeks, which is very short.

If someone has a complicated pregnancy, the program has to make reasonable accommodations for the disability. This is separate from maternity leave and falls under disability leave. Avoiding heavy lifting would be a reasonable request; no night-call probably not. In certain circumstances a medical leave may be necessary if a resident can't perform their duties, but this is no different from any other disability a resident might face. It's not desirable, but it does happen. Ideally, if co-workers were asked to pick up extra call, they should be compensated for it. Pretty much any other industry would do this, and it would a long way to mitigate any ill-will felt towards new mothers.

I think it's important to keep some perspective. For example, even if you don't have children, you still pay property taxes to fund your local schools. You may be asked to give up your seat on a bus. And you might have to cover a female co-worker who goes into labor. That's tough, but it's life. But the work of raising a new generation of kids is far greater than covering a shift. Our society has made the decision that it's a worthwhile expense to accommodate pregnant and postpartum women to keep them in the workforce. Without these accommodations, certain fields would be very difficult, if not outright impossible, for women who wants kids. In modern society, asking women to chose between certain fields (let's say neurosurgery) and parenthood is an unnecessary and false choice. I'm in a fairly competitive field and have kids (though I am a man), so I know it's possible. I'm glad I trained at more enlightened programs. And on the scale of things, the US is far less accommodating than our European friends.

It's actually far easier to have children during training, when there is increased coverage, elective months, research blocks, vacation time, sick leave, etc that can be used to lessen the impact on fellow residents. Training programs have a lot of time (9 months, in fact) to arrange the schedule to minimize the impact on others. I was on elective when my children were born, so nobody had to cover me. Having children while in practice with significant call responsibilities is far more difficult. To those who have said they wouldn't want to hire women who want kids, that is exactly why asking about marriage or family planning during an interview is considered to be a discriminatory line of questioning. Don't do it!

 

[Geekchick921]

Even though I respect you for your planning ahead, the reality is that NO ONE can plan anything when it comes to pregnancy! What if (God forbid) you don't have a uncomplicated pregnancy this time around?
I have posted this in another post, people are so naive when they think that the hardest part whit children and residency is the pregnancy/postpartum period. Here we talk about a couple of weeks that actually most programs can plan for or at the worst other residents cover for you, even though it would be a hard time for them. The real hard time actually begins after this period. This period does not ever end! Children are a life time commitment. And during this period no planning can be done and this is where most irritation amongst colleagues happen...

Well, obviously, I can't bank on it, but all I have to go on is my own history. I'll be pushing AMA when I finish residency and the age gap between kid 2 and 3 will be at least twice the age gap between kid 1 and 2 if kid 3 is due when I'm going to aim for. I'm not postponing more than I've already decided to.

I already have 2 children. As far as irritating my colleagues, I guess I'm already screwed. . Thankfully, my husband works from home and is ready and willing to take the brunt of unexpected parenting responsibilities.