When I was in college circa 2010, I was doing research and visited with a surgeon to explore my interest in a career in medicine and surgery. He told me that as a woman, I had a decision to make between being a mom and being a surgeon. I was shocked that I was getting this response, seemingly in the “modern days of medicine.”
Fast forward about 15 years, and mission accomplished: I am a mom to a toddler, and I'm also a plastic surgeon in my first year of practice with a dream job and a dialed-in work-life balance. There were a few hurdles that I had to overcome and some strategic planning that was involved.
Despite the difficulty of balancing a rigorous career in surgery and motherhood, I decided to take this on as soon as I found the right partner. For me, this happened to be at the end of my residency training and the start of my fellowship. It is important to note that there is no right time, and sometimes this leads to individuals kicking the can down the road for too long. My view is that if you can check off most of the topics listed below, with #1 being a required prerequisite, then you should be OK (I am certain the dogmatic senior surgeon who advised me against motherhood and a career in surgery would blow a gasket hearing this advice).
Interestingly enough, starting the parenting journey while you are in training, residency, or medical school has many advantages. In training, you have a larger built-in support network. Although it may not feel this way, you are not always critical to the team since there is redundancy, and there is less cost to your career trajectory despite your education taking a short hit.
To the surgeon who warned me (and other women) against becoming a mother and a surgeon: do not underestimate the love, hard work, and resilience of smart moms. We do better than alright.
Here's my take on balancing matrescence and being a surgeon and how to build the foundation that will make this life project a success.
#1 Find a Supportive Partner
The most instrumental part of this working well, in my experience, is having a partner who understands that I am responsible for taking care of people’s health and that emergencies do crop up. He followed my lead on the timing of conception and trusted me when we toured a daycare on the same day I was interviewing for my job (six months before the due date). I was very intentional about app dating and having important conversations with my partner early in the process. We covered the book, 8 Dates: Essential Conversations for a Lifetime of Love, in our first year of dating. This way, we could have deep conversations about our life dreams—mine to be an owner of a private practice and his to have a family.
#2 Find a Supportive Job
One reason I was drawn to join my current practice (a small, physician-owned group) was that the two existing partners, one male and one female, each have three kids and prioritize family time away from the office rather than operating more days each week. With the high rate of burnout in healthcare, this standard for work-life balance is critical to me. I work four days a week and operate 1-2 days a week, and I started with six weeks of vacation. This is huge. That means on my weekday off, I can go to Costco (the best store that ever was) and load up on organic goodies, then lunch with my friends as an adult sans kid. That helps keep my sanity and life balance.
More information here:
The Gender Role Reversal: Being the High Earner of My Family as a Woman
How to Get What You Deserve as a High-Earning Woman
#3 Once Pregnant, Find Childcare
Once you're pregnant as a physician, it's crucial to start looking into childcare—I'd recommend sooner rather than later (20 weeks or before). There are a few general options for childcare:
- Family (if you’re lucky)
- Nanny
- Daycare
It is incredibly difficult to get into a good daycare during the infant stage (12 months or younger). Nannies are plentiful, yet it is difficult to assess their quality and reliability. Visit daycares (if you can) and pay the $100 deposit to several. It will be worth it when the baby arrives.
For us, a few things informed our decision to go with a standard (“corporate”) daycare with long hours and good quality care rather than an in-home daycare.
- On average, daycare is associated with better cognitive outcomes.
- There is more early childhood illness in daycare kids, although less illness in elementary school.
- Daycare does not affect maternal attachment; parenting does.
Our perspective was that if a hired nanny was sick, on vacation, or decided to quit, we would be hosed. Daycare does not shut down unless there is a snowstorm. And a sick baby is a sick baby; many nannies do not want to take care of a febrile baby, and certainly that’s a no-go in daycare.
Budget for daycare ranges from $1,500-$4,000 per month, depending on the cost of living in your area.
#4 Sleep Train Your Baby
Sleep training is controversial. I can tell you that it was very sad and uncomfortable to hear our 6-month-old baby cry for 45 minutes each night for about a week—until she learned to put herself to sleep. Once she learned to fall asleep herself, we felt solid that we had made the right choice for our family. Having a baby in bed from 7pm-6am means that my husband and I can catch up in the evening, I can prep for cases, or go to sleep early. Being well-rested for work and life is so critical to my mood and productivity. We used a great course called Taking Cara Babies.
More information here:
Lessons From Everyday Breadwinning, Six-Figure, Millionaire Moms
You Should Invest Like a 50-Year-Old Woman
#5 Pump at Work If You Choose
I breastfed until my child was almost 1. Using wireless portable pumps makes it easy to do between charting or even in the OR while I am infiltrating tumescence for a patient. I came to discover that the portable pumps are less effective than a medical-grade pump like the Spectra. I also realized that my production went down precipitously while pumping at work, likely since I was charting during my pumping time rather than looking at cute videos of my baby, which is recommended. I had the option to take dedicated breaks, though I declined since I wanted to focus on building my practice. There are lots of trade-offs here, and you'll choose what's right for you.
#6 Make a Plan for When Your Baby Is Sick
Recall #1 on this list—finding that supportive partner. Our baby gets sick, and yours will, too. Someone, or both of you, will have to manage this situation at least once a month. Ninety-five percent of the time, this responsibility falls to my husband, who thankfully does not work in healthcare. He can shift his work day from home to hang out with our snotty, febrile gremlin while I see my consults and surgeries and continue to grow my practice. I am very lucky.
If you are a two-physician household or the other partner has less job flexibility, coming up with a backup plan is critical. Recently, our baby got sick on the day my husband was scheduled to present at a conference. Cue the backup plan. Thankfully, we could call on a friend who has flexibility in their daily schedule (and no kids, yet). Having friends who are not all in medicine or who work high-intensity jobs can certainly be a perk. We can call on them for help and compensate them for their time. They are not “nannies,” but they are wonderful people with common sense.
Other options include daycare services for sick babies, which some hospital systems do provide. This is worth looking into. Being a part of a “doctor mom” group in your area is another great resource for last-minute childcare emergencies. It happens to everyone, and it will happen to you.
#7 Keep Family Time Sacred
Despite my relatively balanced schedule for a young attending surgeon, I have about 3-3.5 hours of awake time with my toddler every working day. Each morning, we prioritize cuddles, reading books, playing, and eating before “school.” I make it a point to leave work on time, even if I have more charting to wrap up. When I started working, I was often behind on charting since I was learning a new EMR. I had fewer patients, but unfortunately, it didn't balance out. I was writing notes in the evenings AFTER bedtime (until I got more efficient). After school, we try to keep phones down (hard!) and spend quality time as a family.
More information here:
The Tale of 2 Books (and How I Broke the Binding on My Unwritten Instruction Manual)
How to Survive Residency as a Single Earner with Kids
#8 Lean into Your Support Network
I am very lucky that my two best friends became moms before me. Neither of them is in medicine or lives in the same state as me, yet since they are both brilliant and high-powered career women, they are my top resource for all things “baby.” They were incredibly helpful in navigating pregnancy ups and downs, especially in the early weeks of having an infant, and sharing stories of our toddlers being too cute to handle. The added bonus was that they not only gave me advice but also a ton of hand-me-downs. Around 95% of my kid’s belongings are from friends, neighbors, or family. This makes things easy on the wallet, and it is so sweet to send photos to friends and have them say, “I remember when my kid wore that!”
Everyone’s journey into parenthood (and surgery) looks different. There are strong and smart female surgeons who succeed as single parents. There are those with not-so-family-friendly jobs who make it work, too. And there are those of us who shrug off the idea that you have to choose between being a mom and being a surgeon. Just as you craft your own surgical career, just know that, with intentionality, you CAN build the work-family life balance that you have dreamed about.
Are you a busy doctor or other high earner who's also a mom? How have you made it work? What kind of sacrifices did you have to make? What other advice do you have?