Words of Advice
We asked physicians to share their thoughts and advice family planning to medical trainees.
When did you choose to have children and why?
“Mid-career” – Anonymous
“As staff – no interruption in training” – Anonymous
“In fellowship - that’s a couple years after I met my partner” – Anonymous
“During residency - when I realized I could probably manage both (ish).” – Cis-female, resident in 5 year surgical program
“Chose to delay children until residency complete” - Anonymous
“Residency” – Anonymous
“Ideally as a senior resident or fellow, no kids yet” - General surgery R3, heterosexual, cis-woman
"As a fellow (PGY 8). I didn’t have the money or a clear plan on where I was going to live the next 3-5 years until that point." - Male, 35 years old, Latino, heterosexual, research/clinical fellow in critical care medicine, PGY 9
"PGY5, I was ready and in a stable relationship. Scared of waiting too long and having fertility issues. Wanted to have first pregnancy around my family and friends, before going away on fellowship." - Pauline (she/her), clinical fellow in pediatric hematology and oncology (3 years of ped residency, 3 years of ped hem-onc subspecialty, mother of 3.5 year old twins. Heterosexual relationship.
"Last year of residency. Seemed to make sense in terms of flexibility and hours" - Anonymous
"I have not had kids yet. Might have them after finishing my Fellowship, or might not." - Cardiology - 8 years of postgraduate training - 0 children, hetero, female. 31 years old.
"In residency, given the benefits and leave time available" - OB/Gyne, PGY4, female, 1 child, heterosexual
"First couple of years of being a staff physician - that was just how the timing worked out and when my husband and I felt we were ready." - Anonymous
"End of 2nd year FM residency, before starting enhanced skills residency. It was after I wrote my CFPC exam, but still while I had resident benefits." - Female family physician, 2nd year of practice, 3 children (2 in residency, 1 as staff)
"During residency" - Anonymous
"Decided to have children during my SSTP years given clinical years being too challenging from a timing and ergonomic perspective and operative exposures to X-Ray." - Sneha Raju, Vascular Surgery Resident, PGY3, 1 child
"Right at the end of residency as waited until residency was over after watching a colleague try to complete her residency while pregnant - too many barriers (colleague completed her residency in a wheelchair as was unable to walk - this was 1988)" - Jocelyn Charles
"Staff/Faculty because I wanted to finish training before so I would have more control over my schedule and work-life balance." - Anonymous
"Senior Residency, our family decided we did not want to wait longer which would have been past fellowship." - PGY5 General Surgery, 1 child, male, heterosexual
"End of residency, mid-way through PhD, end of fellowship. It wasn't related to timing with medical career for my first, but it was for my second and third child - I decided not to try getting pregnant during my first year of PhD, and then fellowship to be really focused on the work." - Pediatrics, sub-specialty fellow with a PhD, 3 children, female, cis-het
"After residency, due to financial constraints and time available." - PGY2, family medicine, cis-male, homosexual
"Over 35. Married late partly as I kept relocating for med school, residency and then fellowship." - Anonymous
"Medical school then residency. Because I was 31 when I started med school so not possible to wait until I was done." - Anonymous
"2 kids/1 loss in 1st 5 yrs of practice." - Subspecialist, now 45, had kids at 32 and 35, 6 month Mat leaves, cis/hetero female, REI - 7 years postgraduate training
What advice would you like to share with medical trainees regarding family planning?
“Consider earlier” – Anonymous
“PARO and OMA support available” – Anonymous
“There's no time like yesterday” – Anonymous
“Plan early. Find evidence-based guidelines. Ask peers about their experience.” – Cis-female, resident in 5 year surgical program
“1. Find a partner early in medical school or junior residency (if you don't already have one!)
2. Discuss whether children is a priority with your partner early in the relationship
3. Understand that having children in residency is busy and potentially limits pursuing graduate degrees within residency due to financial obligations (can't survive in major cities on a resident salary for >5 years)
4. Find a partner with a flexible job with reasonable hours or choose a residency with your parents near by." - Anonymous
“You will catch up with others, you’ll get there at your own pace. If you’re ready for a family, don’t get blinded by fear of getting behind on work and residency, go for it.” – Pauline (she/her), heterosexual, mother of 3.5 year old twins, clinical fellow in Pediatric Hematology and Oncology (3 years of peds residency, 3 years of ped hem-onc subspecialty)
"The "appropriate time" is very individualized. Choose wisely and according to your beliefs, and desires. I don't think it is an easy task. Medical school, residency and fellowship ARE ALREADY HARD ON YOUR OWN. There are colleagues that are training and have children, there are others like me, that have also been training with no family, and that´s also fine. If you want that, go for it. if you don't, choose safe contraception" - 31 year old female, heterosexual, 0 children, Cardiology - 8 years of postgraduate training
"Engage in conversations with your mentors about this topic." - Female, heterosexual, 1 child, OBGYN, PGY4
"The profession you decide to pursue will have an impact on your family planning. If that is important to you, consider the length of training, as well as the demands of training (specifically call requirements and the intensity of calls)." - Anonymous
"There is no perfect time. Start when you feel ready to have children." - Female, 3 children (2 in residency, 1 as staff), Family physician, 2nd year of practice
"Its difficult and takes significant financial reserve." - Anonymous
"Talk to as many people in a similar situation before embarking on this journey!" - Sneha Raju, 1 child, Vascular Surgery PGY3
"Be kind to your fellow parents and potential parents." - Anonymous
"Don't delay if you really want to start a family. Find a physician mentor who has successfully balanced medicine and family. Together with your partner discuss how you will share child raising responsibilities. Surround yourself with a supportive team of friends and family." - Jocelyn Charles
"The best advice I got from a colleague is 'there is never a good time to have children therefore it is always a good time to have children'." - Anonymous
"There is no good time, do not delay for some far off milestone as things won't necessarily get easier." - PGY5 General Surgery, 1 child, male, heterosexual
"Don't put off having a family for your career if having a family is important to you." - Anonymous
"If it feels like the right time for your family, do it. It will never be the right time as far as career timing. You also have no idea how fertile you are so better to get started if you want to." - OBGYN PGY4, 1 child, female, heterosexual
"There is no good time! If you want to plan a family, start early; get help too." - Female, east Indian, 2 children, staff for 10 years, heterosexual
"Never a good time to have kids but it is so worth it. Choose a spouse who will also help equally with the home and childcare if you plan to go back to work." - Anonymous
"Don't think too much of planning vis a vis your medical career. Listen to your inner voice. If it's telling you that it is the right time for you as a person, it probably is. Having a child is difficult, postpartum is difficult. Reach out!" - Pediatrics, sub-specialty fellow with a PhD, three children, female, cis-het
"You need to be somewhat flexible, which is hard." - Anonymous
"If you know you want kids start as early as possible. Residency is a great time because of the guaranteed time off/benefits!" - Anonymous
"There is no perfect time. There are different challenges at various stages." - 50+ female, married, 3 children, Family physician
"Pick when it works for you in your own life to have kids, which is different for everyone depending on whether you have a partner, etc. If you are in a position to have children and want to, don’t wait because of your career." - Dr. Sharon Domb, Family Medicine, in practice x 27 years, 2 kids (ages 25 and 22), female, heterosexual
"Just do whatever works best for you and your family. Drop the guilt!" - Psychiatry staff, heterosexual female, 3 kids
"Find a mentor you trust and ask them all the questions." - Alyssa (straight female), FM, 5+y in practice. 1 toddler at home and 1 on the way with supportive partner and fam
"Do not delay childbearing." - Subspecialist, now 45, had kids at 32 and 35, 6 month mat leaves, cis/hetero female, REI, 7 years post-grad training
"Plan your personal life/family planning and desire and timing of having children with as much detail as you do for your training and career. There is no ideal time to start a family but there is a “best before” time. Fertility markedly declines with age. If single, consider Egg freezing (not first choice) to mitigate against future disappointment." - Anonymous
"Think of residency as a real job, don’t wait for a staff position to consider yourself “stable” or established in your career and ready to start life. Residency is the most protected you can be from the consequences of taking time off to have children, so don’t let that be the thing holding you up. Make family planning decisions based on what’s right for your personal timeline; work will always work itself out, even if it is hard or awkward or uncomfortable for some time. It will be worth it." - Anonymous
Newfoundland does not pay for out of province residents who require egg freezing as they are exempt from getting NL MCP! - Anonymous
What were some things you wish you knew before engaging in family planning?
“1. Have family near by wherever you are going to live 2. You will have to tell work/training program "no" to prioritize family - do so strategically. 3. Have a rainy day fund when you start talking about have kids - in case you run into fertility issues which are costly.” – Anonymous
“Impact of kids during training vs staff (financial), hearing from residents with kids (from the birthing people themselves, not male/supporting partner).” – Cis-woman, heterosexual, General Surgery R3
“As I am not Canadian, I didn’t know it was going to be so difficult to get a spot in a day care. Plus, it is almost unaffordable which pushed my partner to stay at home with our kid.” – Anonymous
“How unrealistic it is to plan for studying, researching, working from home with newborn (or newborn twins in my case!).” – Pauline (she/her), heterosexual, mother of 3.5 year old twins, clinical fellow in Pediatric Hematology and Oncology (3 years of ped residency, 3 years of ped hem-onc subspecialty)
“Egg freezing advice would have been great. I have had one child but am too late to have a good chance of having more - if I’d frozen eggs, I’d have more possibilities” – Anonymous
“I have been planning for NOT to have a family so far, and I have succeeded. I had appropriate access to contraception, and I am grateful for not having unplanned children at this point of my career. I could probably plan to have a family in the future, however this is yet uncertain.” – 31 year old female, heterosexual, 0 children, Cardiology - 8 years of postgraduate training
“How senior residents experienced time on leave and their experience with transition back to work” – Female, 1 child, OBGYN PGY4
“How long it would take.” – Anonymous
“I wish I knew about egg freezing earlier. And I wish I had more Roundtable-type talks with people in my field who juggled family planning and career transitions, including honest things like talking about how much childcare costs, single parenting by choice, etc.” – 34-year-old cis-female, heterosexual, PGY6
“It's worth it and returning to work is not as hard as I thought it would be.” – Female, heterosexual, 1 child, OBGYN PGY4
“Getting pregnant might not happen when you want it. We are used to planning anything/everything and this is the one thing that you might not be able to control. Parental leave should be parental leave - it's not a vacation. Don't feel obliged to work - if you don't want to.” – Cis-female, heterosexual, 3 children, Pediatrics, sub-specialty fellow with a PhD
“To get a salaried job so that you can get a paid mat leave. Don't open up your own practice honestly until you're done having kids.” – Anonymous
“Challenges of balancing childcare and work. Ultimately chose to work part -time to balance these” – 50-year old female, married, 3 children, Family Physician
“I felt more disconnected from my resident classmates after having kids, as I wasn’t as available for get-togethers or review courses that required travel.” – Female, heterosexual, 3 children, Psychiatry Staff
“I think on some level I knew this but I had to experience it to get it - how much my priorities and attention shifted after kids. Also my constant fatigue” – Alyssa (straight female), 1 toddler at home and 1 on the way with supportive partner and family, Family Medicine, 5+ years in practice
“There is no subspecialist coverage.” – 45 year old cis-female, heterosexual, had kids at 32 and 35, 6 month maternity leaves, subspecialist REI - 7 years postgraduate training
“That two kids are significantly harder than one. And that you need to work for 600 hrs to qualify for any paid parental leave as a resident, but 22 weeks total to get the standard amount, otherwise the EI only portion is pro rated.” – Anonymous
“I was lucky and didn’t have much trouble getting pregnant, but I think if we were ready as a family, I might have wanted to have more kids in residency - especially the latter years which are less busy but you still have the security of being employed” – Anonymous
What were some barriers you faced when you were planning your family?
“Time off for parental leave.” – Anonymous
“Finding a spouse, long-distance parenting during training.” – Cis-woman, heterosexual, General Surgery R3
“Feeling like there was not enough time. Fearing pregnancy complications due to high demands on my schedule.” – Cis-female, resident in 5-year surgical program
“Fertility. We are lucky however - wife is fully employed with both grandparents near by” – Anonymous
“Childcare, physical toll of pregnancy with call, sustaining relationships while a resident” – Cis-woman, heterosexual, General Surgery R3
“Money. Time off from training.” – 35 year old, male, Latino, heterosexual, research/clinical fellow in Critical Care medicine, PGY 9
“The timing with Royal College Exams was the most complicated issue. In first trimester your risk nausea/fatigue, in third the risk of premature birth/contractions/not being comfortable seating for long time… and then post partum comes the fatigue/concentration issues/breastfeeding… The night calls were also very hard with the pregnancy, even though they stopped at 20 weeks (Twin pregnancy). Knowing I had to do a fellowship but not knowing where and not much time to organize daycare/housing.” – Pauline (she/her), mother of 3.5 year-old twins. Heterosexual relationship, clinical fellow in Pediatric Hematology and Oncology (3 years of peds residency, 3 years of ped hem-onc subspecialty)
“There were barriers every step of the way since starting medical school. No time to date, stress from medical school, financial stress during residency and fellowship, exams... Once I found a partner and got married, there were additional stress of buying a home with student debt, which was very difficult.” – Male, heterosexual, no children, clinical fellow
“I did not meet my partner until later in my life/career.” – 34 year old, cis-female, heterosexual, PGY6
“Childcare, costs, fellowship.” – Female, heterosexual, 1 child, OB/GYN PGY4
“School hours - University life; Lower income as a Resident - Fellow; Timing away from your educational activities vs timing away from your family;” – 31 year old, female, heterosexual, Cardiology - 8 years of postgraduate training
“Planning when would be the best time in training (weighing time away from surgical training vs staying in training)." – Female, heterosexual, 1 child, OBGYN PGY4
“Call requirements and the length of training” – Anonymous
“Scheduling around exams, Masters degree, starting as staff.” – Female, 3 children (2 in residency, 1 as staff), Family Physician, 2nd year of practice
“Fertility assistance, time off for doctor's appointments, child care” – Anonymous
“Planning for adequate childcare. Schedules can be unpredictable and most childcare institutions run 7:30 - 5:30/6 pm. Caregivers are another option but expensive and also work 40 hrs/week so need to consider supplementation with family or two caregivers. Adequate time and safe spaces to pump and store breastmilk.” – Sneha Raju, 1 child, Vascular Surgery PGY3
“Didn’t want to let down fellow residents in my program with taking time off. Wanted to write exam with my cohort. Didn’t want to miss fellowship opportunity” – Anonymous
“Time, health, lack of income for mat leave” – Anonymous
“Juggling service requirements with fertility treatments, discrimination against pregnant residents” – Anonymous
“Started new practice at 22 weeks pregnant, maternity leave was only 16 weeks and I had a premie, colleagues upset that I would be away for 16 weeks after just starting a new practice. I came back from mat leave with a 2 month old (corrected) son, lost my day care 2 weeks later and had to give a nebulizer every 4 hours x 24 hours and run a new practice - utter exhaustion and I got quite sick! Things have changed for the better but I think we still have room to improve.” – Jocelyn Charles
“Trouble conceiving because I waited until I was done training; hiding infertility treatments while working full-time; feeling guilty about taking a full maternity leave” – Anonymous
“Competing interests with resident schedule, Royal college exam.” – Male, heterosexual,1 child, General Surgery PGY5
“No funds to cover practice when on leave. As a result, I only took 8 weeks leave with my first child, 4 weeks with my second and 3 weeks with my third.” – Anonymous
“Undergoing fertility treatments currently - inflexible residency scheduling makes it very challenging to attend necessary appointments. Anticipating difficulty taking time off after residency due to lack of parental leave supports.” – Family medicine PGY 2
“Training in an intense specialty and subspecialty, not being sure about partner (residency made dating and relationships very hard), not having enough family support in the city.” – 34 year old cis-female, heterosexual, PGY6
“Concerns regarding how time away from work would impact my skills, concerns regarding extending my training, concerns regarding balancing being a parent with being a medical trainee” – Female, heterosexual, 1 child, OBGYN PGY4
“Infertility, uncertainty about job prospects.” – Female, East Indian, heterosexual, 2 children, staff for 10 years
“Timing; you can't predict when you will get pregnant and have to be mindful of exams" – Anonymous
“Infertility, coverage of clinical work (patients, lab/test results).” – Anonymous
“Time between wanting a child and actually getting pregnant; planning rotations/time off; planning to move countries and what fertility support might look that there. I had fertility issues for my three pregnancies and juggling that on a busy schedule was the WORST barrier.” – Cis-female, heterosexual, 3 children, Pediatrics, sub-specialty fellow with a PhD
“Being in a same sex male couple.” – Cis-male, homosexual, Family Medicine PGY2
“Worry about judgement and impact on training. Very stressful trying to exactly time conception around exams and rotations!.” – Anonymous
“Honestly not many. Very lucky for that.” – Anonymous
“Impact on training - risk of program extension.” – Anonymous
“Program expectations can be hectic with a baby.” – Anonymous
“No real barriers. I was lucky to have graduated when I was young, didn’t get married until I was 26, and didn’t choose to have children prior to when I did. I was worried about telling my boss, but he was ok about it..” – Dr. Sharon Domb, female, heterosexual, 2 children (ages 25 and 22), Family Medicine, in practice x 27 years
“With my first child - thankfully none. My program was very supportive. The timing of my second and third children were somewhat dictated by my own guilt - I wanted to work for long enough between kids to not feel like I was letting my patients or colleagues down.” – Heterosexual female, 3 children, Psychiatry staff
“Pandemic. Money.” – Anonymous
“Age and perceived risk of genetic issues for kids if waiting longer. $$ and debt repayment and very limited funding for mat leave” – Alyssa (straight female), 1 toddler at home and 1 on the way with supportive partner and fam, Family Medicine, 5+ years in practice
“Income loss, practice coverage, child care, reproductive aging.” – 45 year old cis-female, heterosexual, had kids at 32 and 35, 6 month maternity leaves, subspecialist REI - 7 years postgraduate training
“In Newfoundland, there is only a meager paid parental leave through NLMA and it does not last long” – Anonymous
“Planning... Not really any other than mental. My school was supportive. I was not able to travel for electives like my classmates and was not able to apply to programs outside of where my husband lived and worked, but that has more to do with his job than just the kids.” – Anonymous
“Mainly was single till later in life. Hard to focus on career and personal life.” – Anonymous
“I was lucky to have a supportive program. But there was internal guilt of being yet another person on mat leave in a small program” – Anonymous
“None with regards to children. But when deciding to get married, as a current resident, it required jumped a few hoops into order to be able to plan time for the wedding (which was quite expected).” – Family Medicine PGY2