“As a mom and a doctor, what advice would you give a third-year medical student trying to choose a specialty?” the bright-eyed med student asked me.
Her smile was ear to ear, and I didn’t want to burst her bubble. This is a complicated question to ask and the answers change as life changes. I chose OB/GYN because it was the only specialty I truly fell in love with. For me, there was no other option. I knew that residency was going to be rough. I knew that life after residency would still be hard. As a determined, energetic and idealistic young woman I told myself — this is my destiny!
My husband is a physician as well. For six years following residency, between the two of us, we took about 15 days of call per month. Before kids, we tried to align our call schedules so that we were always on-call the same night. After kids, this became more problematic. I distinctly remember a Christmas Day when we were both on-call without a nanny. I brought my daughter with me to the hospital at 2 a.m. so I could catch a baby, and my husband brought my son to the OR waiting area for an emergency case. Thank goodness for the kind and willing nursing staff over the years.
After baby number three, my husband and I realized that something needed to change. While he contemplated an offer from the hospital for additional trauma call coverage, I had to ask myself whether what we were doing was feasible. The long hours and on-call coverage wore us out and the last thing I wanted to do after a fourteen-hour day was getting on the floor of the living room and play with blocks or make a puzzle. As our children grew, so did their needs.
Granted, most of us physicians learn to loath taking call as we age and our careers progress. But, people don’t get sick, have accidents or give birth during bankers hours. It’s a dirty job, and someone has to do it … round the clock. As physicians, taking call is part of the job, right?
Being on-call just gets harder as we mature in our careers. The sacrifices we make for the honor and duty of practicing medicine increases in depth as our families grow and our children grow up. I’ve seen this play out — in many specialties — over and over again. Typically, it culminates in a demand from the physician to the hospital or partners: “More money or I walk.”
My impression is that these antics are a call for help. Throwing money at a post-call sore back and headache doesn’t recharge the lost REM sleep. You are only as good as the care you take of yourself. There is no price tag on finding rest, balance and happiness in life. Investing time and energy into the love of our life partners and families is priceless. Maybe the answers are in the innovation of health care delivery rather than more money for a call shift … but that’s another article for another time.
I’ve noticed lots of chatter lately about burnout of our physician workforce. I scratch my head as I’m neither a millennial physician nor an “old timer.” I straddle both generations. My impression is that we have it better now than fifteen years ago.
Fifteen years ago there was no such thing as an OB hospitalist program. Fifteen years ago midwives and doctors rarely collaborated in the hospital setting. Fifteen years ago there were no hours restrictions for residency.
Maybe the expectations of the physician workforce are different today.
After almost ten years post-training, I have absolutely no regrets. I survived the grind of medical school, residency, and junior partnership. I would go back and do it again, over and over and over.
I’ll admit to growing tired and weary of taking lots of on-call duties, so I’ve transformed my practice and career. As a result, I’ve opted to make less money to get more sleep. Someday, I may get back in the game — maybe when my kids don’t think I’m cool enough to hang out with any longer.
So, my advice to a med student choosing a specialty is to pick whichever specialty you fancy. But, choose wisely when selecting a practice or job after residency. Better to take less money and find a practice environment that nurtures and values the wellness of both the physician and the patient. Better to have partners that equally share the workload and are always willing to help each other out.
No matter what specialty you chose, you have to ask yourself whether you will be able to find a job and work in an environment that will support you in achieving your goals — whatever they may be — in life.
As my career has evolved, I’ve often stopped to ask my mentors ten years ahead of me what words of advice they may have. Recently, one of the senior physician executives in a large health care organization spent forty-five minutes with me offering his recommendations of the various master’s degrees, leadership training and career paths I could pursue in health care leadership. The following day, he sent me this email message:
“It was great speaking with you. You have already accomplished much in your career and have many exciting opportunities ahead. I hope this isn’t too much advice, but remember to cherish your children. Our firstborn is now a sophomore in college and … I miss him.”
Eve Shvidler is an obstetrician-gynecologist and author of Burning the Short White Coat: A Story of Becoming a Woman Doctor. She blogs at burning the short white coat.
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