Rx for medicine and parenthood

Medicine is tough. Parenting is tough. Not surprisingly, the two combined, say parentphysicians, is really tough. Dr. Nadia Alam, an Ontario family physician, anesthetist and former OMA president, would know. She is a parent of four. “Long hours, changing work locations, changing schedules, high-pressure work environments, steep learning curves, exhaustion, excitement and burnout all pose significant challenges to finding childcare and raising kids,” said Dr. Alam. “Throw in school, playdates, extracurricular activities, birthday parties and so on—it’s hard. There’s no way around it. It’s just hard.” For many physicians, making the decision to become a parent in the first place can be really hard, too. “Training to become a physician is long and rigorous, and occurs during the optimal reproductive window for women physicians,” said Dr. Andrea Simpson, a parent, obstetrician and minimally invasive gynecologic surgeon at St. Michael’s Hospital in Toronto. “But physicians should have children whenever they want to. A delay of childbearing is associated with increased risk of infertility and adverse pregnancy outcomes,” added Dr. Simpson, who in 2021 published, “The Inconvenience of motherhood during a medical career,” with Drs. Maria Cusimano and Nancy Baxter, in the Canadian Medical Association Journal. Planning ahead is key The Resident Doctors of Canada (RDoC) website outlines available resources, supports and advice for residents and doctors in practice who want to start and raise a family. Among the key advice? Plan ahead. That means, for example, notifying your residency program director and post-graduate medical office early; notifying the Canadian Medical Protective Association if you are taking maternity/parental leave to pause your coverage; and looking into available maternity and parental benefits from employment insurance (EI), as well as provincial residency contracts that might provide additional financial support. Note that this fall, the government is re-evaluating the number of weeks offered for maternity and parental leave, so there may be changes around EI. Also, physicians should be aware that each province and program have unique standards for the number of gestational weeks at which a pregnant physician is no longer required to fulfill extended shifts and on-call duty. Most importantly, experts—and those who have lived through it—strongly advise planning ahead for childcare. Securing childcare The process of securing childcare can take upwards of a year, and for many, obtaining reliable childcare is the most nerve-wracking part of the transition back to work. This is especially true for physicians who lack family support in the community where they are working or training. Options for childcare include: daycares, day homes, foreign nannies, au pairs, local nannies, and nanny-on-call companies. Particularly for physicians who are considering putting their child in daycare or hiring a foreign nanny, says the RDoC, they should put their name on wait lists or get connected with a hiring agency as soon as possible. Day homes as opposed to daycares may offer more flexibility with unconventional physician hours (but also need to be vetted to ensure they are accredited). The RDoC lists websites for nanny services and other options. “A career in medicine is demanding and often inflexible, so ensuring more flexible childcare options is essential,” said Dr. Simpson. It takes a village Whether its family, friends or colleagues, develop a support network when you are raising your family, advise Drs. Simpson and Alam. “I had my daughter during my fellowship training in minimally invasive gynecologic surgery,” said Dr. Simpson. “I was fortunate to have mentors and colleagues who were supportive when I told them I would be taking parental leave. However, the inflexible training hours were a challenge when I returned with a child in daycare. Days when my child was sent home sick were often covered by my spouse, who is not a physician. I imagine this would be even more difficult for single parents, and when both parents are physicians.” Dr. Alam said she feels lucky her parents and in-laws helped a lot with childcare, especially for sleepovers during call shifts. “However, as time went on, the grandparents couldn’t help out. So finding alternate childcare for call shifts—it was brutal. I didn’t have a nanny, however, I had a great babysitter who lived a couple of houses down the street.” Even then, she said, getting childcare for when she locumed “up in Moose Factory, or Cochrane, or really anywhere outside of Halton Hills was beyond difficult. My husband stepped in. I faced the same challenge when I became involved with health system advocacy and becoming OMA president. . . . It took a village, and without it, I wouldn’t have been able to pursue the opportunities I have.” Dr. Alam, who says she once got a Mother’s Day card from her son saying, “Mom’s favourite thing: Work,” advises parents to establish what is important to them. “Manage your expectations. Decide what’s most important and what’s less important as you sort out your schedule and your kids’ schedules,” she said. “For example, I chose to forego enrolling my kids in tons of extra-curricular activities so I would have time with them. I know that I’m not going to be able to do everything for my kids that my mom (who stayed home) was able to do, and I’ve made my peace with it.” Dr. Alam also believes in being real with kids, and letting them know that accomplishing your goals while raising a family is challenging. “I don’t hide that my work and life is hard. I tell my kids when I can’t afford something . . . when my day has been tough, what makes me cry, when I’ve made a mistake, when I’ve come home hurt and exhausted,” she said. “I want them to see how I deal with the hard things so that they can learn how to deal with the hard things in their lives. . . . I want them to see all that—so that they can be more than I am.” More resources Other physician organizations besides RDoC offer resources and support for doctor-parents. The CMA provides resources on their wellness hub “to help physicians and their families manage and overcome the challenges that arise throughout a career in medicine and build better relationships.” Resident Doctors of BC has a comprehensive collection of resources for parenting before, during and after leave. Mothersinmedicine.com, a group blog written by physician-mothers, explores the challenges and joys of tending to patients and children. Despite the challenges, Dr. Simpson advises would-be parents to just do it. “There is no perfect time to have children. If having children is a part of personal fulfillment for you, don’t delay this aspect of your life to wait for a ’perfect’ time with respect to your career. Being a doctor-parent is hard. But personal fulfillment is as important as fulfillment in your career.

Rx for medicine and parenthood

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