Written by: Courtney Premer-Barragan, MD, PhD (NUEM ‘25) Edited by: Saabir Kaskar, MD (NUEM ‘23)
Expert Commentary by: Ivonne H. Schulman, MD
As I am sitting here, pondering how to adequately share my experiences of becoming a brand-new mom and intern, what better time than when I’m recovering from family “Sienna-itis” as we like to call it ("Sienna-itis” being the many fevers, coughs, and colds she has brought our way). The adage goes, get lots of sleep, rest, and hydration to fight sickness, and wow, does that sound great! However, when you have a child crying inconsolably because they have a 104.5* fever, and simultaneously you have fever, body aches, and feel miserable, your child comes first. You suppress all your aches and ignore your need to recover deferring to motherly instincts that demand your baby feel safe and loved. This is a slightly harsh metaphor of what it’s like to be an intern with a new baby. There is no such thing as rest and recovery. I am responsible for another human. Finally, a day off the MICU. Want to lounge around all day? Watch TV and relax? Nope! Just got off a night shift. Want to sleep all day to recover? Nope. Hey, I don’t work until 2pm, let me sleep in. Nope. It’s a constant rollercoaster that none of my co-interns can relate to, and that makes it even more challenging. But would I do it all over again? Look at this face. Yes! She makes everything worth it. So how did I get here and what have I learned along the way?
Let’s start where it all started, medical school…
I decided during medical school that I was ready to start a family. Previous lengthy graduate school years enhanced the sense of growing older and moving past my prime reproductive years. Looking at the literature, a career in medicine and motherhood seemed daunting. “Pregnant trainees and those contemplating pregnancy often report stress related to faculty and coworker attitudes, rigid and intense educational requirements, long work hours, unpredictable work demands, altered schedules, guilt over colleagues’ increased workloads, and concern for maternal–fetal well-being.” 2 I scoured the internet to find support groups or at least supportive views showing that you can equally be an attentive mom and thrive in your medical residency, albeit this view was scant. Literally every article mentioned medical trainees felt sentiments of guilt, vulnerability, overworked, judged, and feelings of inadequacy1-6. I ultimately decided that I wanted a family, and medicine and family shouldn’t be mutually exclusive. So, I was pregnant at the end of my 3rd year. I did the all-important EM rotation in my 2nd trimester of pregnancy, took Step 2 in my 3rd trimester, did all my residency interviews feeling like I was about to pop (7-8 months pregnant), and matched at my dream program.
On to residency….
The transition to residency, while embracing my new reality as a mom, was tough. You’re stepping into a new role in your life, learning to be a new doctor, and then compounding that with trying to figure out how to take care of another human. Sleep deprivation. Guilt. FOMO. Sadness. Happiness. Isolation. Joy. Every day seemed like a new feeling. As I watched my co-residents all go out together, enjoying fun times when off shift, forging close bonds, I was increasingly feeling sad and isolated, as it was often impossible for me to join. This was heightened by having no family in Chicago as a support network. But then, full stop! There’s the utter feeling of fulfillment. Coming home to Sienna with her blazing smile and her unconditional love is sheer bliss. Lying next to her as she crawls, stands, and slobbers all over me is pure joy. Hearing her laugh permeate the room. Watching her dance with no care in the world. Her self-clap when she takes a new step. So many priceless moments. Again, it’s a rollercoaster of emotions, lots of highs and lots of lows, lots of feeling like the most loved person in the world while also feeling completely isolated. I’m sharing my experiences with all its vulnerabilities to add another perspective to the scant literature and lack of advice to hopefully help fill in the void.
Some lessons I learned along the journey…
1. There’s never going to be a perfect time.
I was so thankful to have a mentor who ingrained in my brain, “never wait for the right time to have kids, because you always find an excuse.” But I’m about to do residency interviews. I can’t show the program I’m pregnant. But I’m just starting my intern year. It’s a huge challenge and draining, and it’s crazy to add a child into the mix. But I’m a senior resident running the department. Let me wait a couple more years until my career is established. Although I’m a new Attending, I need to start my career strong. I’m applying for a promotion. Now is not the right time. But here’s the thing: you name the time, and there will ALWAYS be an excuse. Understanding that there will NEVER be a right time and learning how to make your time the right time, is fundamental.
2. This goes against the common convention but talk about family life/being pregnant/wanting to get pregnant in interviews, during residency, or whatever stage of your career you are at.
I received very mixed advice regarding this point while going through residency interviews. Some attendings were shocked that I wanted to be so open about my pregnancy. Some were like, “heck yes!” Is there still bias against women in medicine having children? 100%! With this in mind, I wanted to find a program that I knew would support an arduous journey I was about to embark upon. I was appalled by a couple of residency interviews and how they responded to me being pregnant. And boy, was I thankful they transparently showed their colors. I can’t imagine if I would have kept my pregnancy a secret and then have been stuck in an unsupportive environment. Thankfully, most of my interactions were very positive and gave me hope that medicine and babies can mix. When I matched at Northwestern and they sent Sienna a little snow hat, I instantly knew my family would be supported. All my fear and anxiety surrounding being the intern with the baby dissipated.
3. Support is everything (family, co-residents, friends).
Lean on EVERYONE for help, because man, do you need it! My mother moved here for the first month of residency, and that support was everything. Don’t be shy to ask for help. Unless you also have a baby, you can’t imagine how incredibly difficult it is to be an intern and a mom. Let yourself be vulnerable and relish in all the support. If someone offers to help watch the baby, heck yes! If someone offers to bring you groceries because they know you’re struggling with every task, let them bring you the groceries.
4. It’s okay to take mini breaks to survive long rounds.
As women, we put a lot of pressure on ourselves to not show any weakness. That pressure is only heightened when pregnant, trying to show that we are just as strong as everyone else. But guess what? It’s not a sign of weakness to take that little break on 4 hours of grueling rounds because your back is breaking. Grab that hospital orange juice if you’re feeling light-headed or weak. Run to the bathroom multiple times if that’s what’s calling. I was so thankful that I did my internal medicine rotation with my best friend who consistently reminded me that I needed to take care of myself, and I’ll still look like a rockstar medical student, even if I silently disappear for a minute here or a couple minutes there. At the end of the day, while we think the attending and co-medical students/co-residents are judging us for doing those little things, get over it! They’re not! So, take care of you and you’ll still shine.
5. Advocate for your breastfeeding journey.
Let me reinforce this vital tenant: advocate for yourself and your baby. I cannot stress that statement enough. If you are breastfeeding and therefore pumping at work, don’t be embarrassed/shy to take those pumping breaks. And, for the love of everything, don’t feel like a burden for taking those 20-minute breaks while your co-residents are working. You are balancing being a mother and a physician. No one else can possibly fathom the overtime amount of work you are doing both at work and at home. (Pro tip: if pumping multiple times per shift, put all the parts in the fridge so you don’t have to clean everything between each pump session. It saves sooo much time!)
6. Embrace the emotions.
You’re going to have the happiest of days. You’re going to have the darkest of days. AND THAT’S OKAY! Talk about when you’re feeling sad. But also share those glorious happy moments. Celebrate all the wins that make it so incredibly worth it. It’s really important to normalize all your feelings.
7. Most importantly…. Take care of you!
In case all the above did not sufficiently convey that balancing residency and parenthood can be quite exhausting, and make it so easy to forget about yourself, it’s vital to remember you need time to decompress and recharge. Go on that hour run by yourself. Get your nails done. Go on a date. Take a long bath. When you have a list of things that need to get done on your day off, look at that list, and think, “is this really the priority? Will life fall apart if I clear my mind at the gym instead of doing 20 Rosh Review questions and cleaning the bathroom?” To be a good mother, an engaged resident, and a good wife, you need to also take care of you. Period.
References
1. Attieh, E., Maalouf, S., Chalfoun, C., Abdayem, P., Nemr, E., & Kesrouani, A. (2018). Impact of female gender and perspectives of pregnancy on admission in residency programs. Reproductive Health, 15(1), 1-5.
2. Blair, J. E., Mayer, A. P., Caubet, S. L., Norby, S. M., O’Connor, M. I., & Hayes, S. N. (2016). Pregnancy and parental leave during graduate medical education. Academic Medicine, 91(7), 972-978.
3. Finch, S. J. (2003). Pregnancy during residency: a literature review. Academic Medicine, 78(4), 418-428.
4. Peters, G. W., Kuczmarska-Haas, A., Holliday, E. B., & Puckett, L. (2020). Lactation challenges of resident physicians-results of a national survey. BMC pregnancy and childbirth, 20(1), 1-8.
5. Sandler, B. J., Tackett, J. J., Longo, W. E., & Yoo, P. S. (2016). Pregnancy and parenthood among surgery residents: results of the first nationwide survey of general surgery residency program directors. Journal of the American College of Surgeons, 222(6), 1090-1096.
6. Walsh, A., Gold, M., Jensen, P., & Jedrzkiewicz, M. (2005). Motherhood during residency training: challenges and strategies. Canadian Family Physician, 51(7), 990-991.
Expert Commentary
The decision to begin having children during medical school or residency is one that preoccupies many women, even before they decide to pursue a career in medicine. This is in sharp contrast to men, who although now consider work/life balance and parental responsibilities more than before, still benefit from societal gender roles that place the bulk of the parenting and domestic responsibilities on women.
The number of female physicians has continuously increased over the past few decades, with women now comprising just over half of the medical students in the United States (1). Despite increasingly egalitarian societal attitudes toward gender roles, female physicians still struggle to balance a medical career and a family. Female physicians, particularly young ones, are much more likely to reduce their work hours than males, a gap that emerges immediately following medical training.
Moreover, significant gender differences in the time spent on parenting and domestic responsibilities among physicians are still evident (2). There is evidence that traditional gender roles impact female physicians’ medical specialty choices, representation in academic and professional societies, original and invited authorships, leadership positions, compensation, full time vs. part time work status, and promotion and retention in academic medicine. These findings highlight the importance of increasing awareness and expanding social and institutional support for work-family balance for female and male physicians. Until policies and a culture allowing women and men to be both parents and physicians are created, women are less likely to be retained and to advance in medicine. Proposals for solutions include availability and affordability of childcare services, maternity and paternity leave, and advocating, through mentorship, leadership courses, and support groups, for changes in social norms, such as sharing of household and child care responsibilities and creating an environment conducive to work-life
balance for all genders (3).
References
1. AAMC. The Majority of U.S. Medical Students Are Women, New Data Show. Association of American Medical Colleges; www.aamc.org; 2019.
2. Frank E, Zhao Z, Sen S, Guille C. Gender Disparities in Work and Parental Status Among Early Career Physicians. JAMA Netw Open. 2019;2(8):e198340.
3. Dandar VM, Lautenberger DM, Garrison GE. Promising Practices for Understanding and Addressing Salary Equity at U.S. Medical Schools. Association of American Medical Colleges; 2019. Disclosure: The opinions expressed in this paper are those of the author and do not necessarily reflect those of the National Institute of Diabetes, Digestive and Kidney Diseases, the National Institutes of Health, the Department of Health and Human Services, and the government of the United States.
Ivonne H. Schulman, MD
Senior Scientific Advisor for Acute Renal Failure and Renal Pathophysiology
Program Director, Translational and Clinical Studies of Acute Kidney Injury
Division of Kidney, Urologic & Hematologic Diseases (DKUH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institutes of Health (NIH)
University of Miami Miller School of Medicine
How To Cite This Post:
[Peer-Reviewed, Web Publication] Premer-Barragan, C. Kaskar, S. (2024, Jul 29). Becoming a New Mom and New Resident. [NUEM Blog. Expert Commentary by Schulman, I]. Retrieved from http://www.nuemblog.com/blog/new-mom-and-new-resident
