By T.J. Porter, WCI Contributor
Going through medical school and residency can be difficult on their own. If you have a child that needs to be taken care of at the same time, it can feel like a nearly insurmountable task. Though it is by no means easy, many people have managed both being a parent and becoming a doctor. Understanding the different childcare options and how to choose the right one for you can be a big help.
Stats on Childcare
According to an article from the AMA, roughly one in 10 medical students will be parents by the time they earn a medical degree. The Department of Health and Human Services considers childcare affordable if it costs no more than 7% of a family’s income. In 2021, the average first-year resident made $58,860 compared to center-based childcare costs of $5,700-$16,000. That amounts to 9.7%-27.2% of the resident’s salary, making childcare a major concern. That price is a relatively small portion of the more than $300,000 that it costs to raise a child from birth to age 17 in the US.
More information here:
Having Kids in Medical School or Residency – What Should You Do?
Childcare Options for Students and Residents
It’s no secret that childcare is expensive. While you’ll likely get some amount of parental leave, even as a resident, you’ll need to have a plan for who will care for your child—and how you’ll pay for that care—before you come back to work. Don't forget to consider backup plans for each scenario, as it is inevitable you will have a sick child at some point or your childcare provider will be unavailable.
Hospital-Affiliated or Provided Care
An ideal scenario for many medical students and residents is arranging childcare through a hospital-affiliated daycare. Many hospitals even have daycares onsite. Given that the primary market for these onsite daycares includes doctors, residents, and other medical personnel, they are quite used to the difficult and unusual schedules and surprises that come with working in a hospital. Many also offer discounts to employees, helping keep costs low.
Despite the discount, it isn’t always cheap. For example, Roper St. Francis Healthcare in Charleston, South Carolina charges about $200 a week for childcare, which adds up to $10,400 a year.
Stay-at-Home Partner/Spouse
While it won’t be an option for everyone, the least expensive way to handle childcare during residency is by having a stay-at-home partner or spouse. This has the benefit of huge flexibility. Your partner can handle taking care of your child and you don’t need to worry about daycare schedule or other issues.
It also has no immediate financial cost. However, there is the opportunity cost of your spouse leaving their career. That means they won’t earn an income, and it can reduce future earnings potential.
Nearby Family
A similar option to relying on a partner or spouse is to get help from nearby family. If you have parents, grandparents, siblings, or even close friends in your area, you may be able to get childcare help from them. Even if this isn't a daily childcare option, consider talking to nearby family and friends about helping out in emergencies, when you have a sick child, or if your regular childcare provider is unavailable.
Daycare
If your hospital doesn’t provide daycare or other childcare assistance, you could choose to rely on a third-party daycare. Roughly 59% of children attend some form of daycare, so it’s a popular option. There are some major drawbacks to daycares that aren’t affiliated with hospitals. One is that they will likely have set schedules that may not align with the schedule that you have to keep as a resident or student. You’ll need a backup plan to find care when you’re working a night or weekend shift, for example. They can also be very expensive. Care.com reports that the average cost of daycare now sits at $284 per week per child. In some areas, the price is even higher. Daycares in Washington D.C., for example, charge $417 per week, on average.
Nannies and Babysitters
Hiring a nanny or babysitter can offer your child one-on-one care. They also could offer more flexibility than a traditional daycare with set hours. The drawback of hiring a nanny is the cost. The national average cost of a nanny is $736 per week or roughly $18.40 per hour. You might wind up having to pay more given the long hours and odd schedule you work, which can quickly make this price unsustainable. On the other hand, if you have multiple children or if you can split a nanny with another family, it may become price competitive with daycares. If you can get some help from nearby family, a babysitter that you can call on when needed may be a better choice than a full-time nanny.
Au Pairs
A solution to childcare that is becoming more popular in physician families is hiring an au pair. An au pair is a person, typically a young adult, who comes from outside the United States to live for a year or two on a cultural exchange visa. They live with a host family and provide childcare and light housework in exchange for a place to stay during their visit. Hiring an au pair offers a host of benefits, including having a live-in caretaker for your child and giving your child a unique opportunity to learn about a different culture.
The cost of hiring an au pair can vary widely depending on the service you use to find one. You also have to provide them with a stipend of about $200 per week. That can make them price competitive with options like daycare if you have multiple children. The drawbacks of hiring an au pair is that it can be difficult and time-consuming to find one that is a good fit for your family, and some matching services can be quite expensive. You also need to have space in your home for the au pair to live. Remember that an au pair is generally only visiting for a specific period of time so you will need to go through the matching process every year or two.
More information here:
25 Sick Days in 5 Months: How Daycare Germs Are Costing Our Family
Conclusion
Figuring out childcare during medical school and residency is hard. Unless you’re fortunate enough to have nearby family or a partner who can handle childcare, you’ll have to deal with inflexible and expensive solutions like daycare or even more expensive but more flexible options like a nanny or au pair. The best thing to do is to talk to your colleagues who have children and ask them how they handled childcare. They may have valuable insight that can help you find the right solution for your child.
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