While I was in college around 2010, I researched and visited a surgeon to explore my interest in a career in medicine and surgery. He told me that as a woman I had to make a choice between being a mother and becoming a surgeon. I was shocked to get this answer, seemingly in the “modern age of medicine.”
Fast forward about 15 years, and mission accomplished: I’m a mother of a toddler, and I’m also a plastic surgeon in my first year of practice with a dream job and a good work-life balance. There were a few hurdles I had to overcome and some strategic planning involved.
Despite the difficulty of balancing a tough career in surgery and motherhood, I decided to take up this career once I found the right partner. For me, this happened to be the end of my residency training and the beginning of my fellowship. It is important to note that there is no right time, and sometimes this leads to individuals stalling for too long. My opinion is that if you can check off most of the items below, with #1 being a prerequisite, you should be fine (I’m sure the dogmatic senior surgeon who advised me on motherhood and a career in surgery would be spanked if he heard this advice).
Interestingly enough, starting the parenting journey while in college, residency, or medical school has many benefits. During training you have a larger built-in support network. Although it may not feel like it, you are not always critical of the team as there are redundancies and fewer costs to your career path, despite your education taking a short hit.
To the surgeon who warned me (and other women) not to become a mother and a surgeon: don’t underestimate the love, hard work, and resilience of smart moms. We are doing better than good.
Here’s my take on balancing adulthood 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 important part of this, in my experience, is having a partner who understands that I am responsible for looking after people’s health and that emergencies arise. He followed my lead on the timing of conception and trusted me when we toured a daycare center on the same day I interviewed for my job (six months before my due date). I was very conscious about app dating and had important conversations with my partner early in the process. We covered the book, 8 dates: essential conversations for a life full of lovein our first year of dating. This way we were able to have in-depth conversations about our life dreams: mine to own a private practice and his to start a family.
#2 Find a support job
One of the reasons I was attracted to my current practice (a small group of physicians) was that the two existing partners, a husband and a wife, each have three children and prioritize family time outside the office, rather than working more days per week. With the high burnout rate in healthcare, this work-life balance standard is critical to me. I work four days a week and am active 1-2 days a week, and I started with six weeks of vacation. This is huge. That means on my day off I can go to Costco (the best store ever) to stock up on organic treats and then have lunch with my friends as an adult without a kid. That helps maintain my sanity and life balance.
More information here:
The reversal of gender roles: as a woman, being the big earner in my family
How to get what you deserve as a high-earning woman
#3 Once you’re pregnant, find childcare
As a doctor, once you’re pregnant, it’s crucial to start exploring childcare options. I would recommend sooner rather than later (20 weeks or sooner). There are a number of general childcare options:
- Family (if you’re lucky)
- Babysitter
- Daycare center
It is incredibly difficult to get good childcare in the infant stage (12 months or younger). Nannies are plentiful, but it is difficult to assess their quality and reliability. Visit daycare centers (if you can) and pay the $100 deposit to several. It will be worth it when the baby arrives.
For us, a number of things led to our decision to opt for a standard (“corporate”) daycare center with long hours and good quality care instead of a daycare center at home.
- On average, childcare is associated with better cognitive outcomes.
- There is more early childhood illnesses in children in childcarealthough less illness in primary school.
- Childcare does not affect the mother’s attachment; parenting does.
Our perspective was that if a hired sitter was sick, on vacation, or decided to quit, we would be hosed. The childcare center only closes when there is a snowstorm. And a sick baby is a sick baby; Many nannies don’t want to care for a baby with a fever, and that’s definitely a no-no in childcare.
The childcare budget 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 six-month-old baby cry for 45 minutes every night for about a week until she learned to put herself to sleep. Once she learned to fall asleep on her own, we felt confident we had made the right choice for our family. Having a baby in bed from 7 p.m. to 6 a.m. allows my husband and I to catch up in the evening, prepare for illnesses, or go to sleep early. Being well rested for work and life is so crucial to my mood and productivity. We used a great course called Taking Cara babies.
More information here:
Lessons from daily living, six-figure, millionaire mothers
You should invest like a 50-year-old woman
#5 Pump at work if you want
I breastfed until my child was almost 1 year old. The use of wireless portable pumps makes it easy to use between shots or even in the OR while I infiltrate the tumescence in a patient. I found that the portable pumps are less effective than a medical pump like the Spectra. I also realized that my production while pumping at work dropped off quickly, probably because I was charting while pumping instead of watching cute videos of my baby, which is recommended. I had the option to take special breaks, although I declined because I wanted to focus on building my practice. There are a lot of tradeoffs here and you choose what suits you best.
#6 Make a plan for when your baby is sick
Remember number 1 on this list: finding that supportive partner. Our baby gets sick, and so will yours. Someone, or both of you, will have to deal with this situation at least once a month. Ninety-five percent of the time, this responsibility falls to my husband, who fortunately does not work in healthcare. He can shift his workday from home to hang out with our snotty, feverish gremlin while I review my consultations and surgeries and continue to grow my practice. I’m very lucky.
If you have a two-physician household or the other partner has less work flexibility, coming up with a backup plan is critical. Recently our baby got sick on the day my husband was supposed to give a presentation at a conference. Provide the backup plan. Luckily, we were able to rely on a friend who has flexibility in his daily schedule (and no kids yet). Having friends who aren’t all in medical school or in high-intensity jobs can certainly be an advantage. We can call on them for help and compensate them for their time. They are not ‘nannies’, but they are great people with common sense.
Other options include childcare for sick babies, which some hospital systems do provide. This is worth investigating. Becoming part of a “doctor-mom” group in your area is a great resource for last-minute childcare emergencies. It happens to everyone, and it will happen to you too.
#7 Keep family time sacred
Despite my relatively balanced schedule for a young attending surgeon, I am awake with my toddler for about 3-3.5 hours each workday. Every morning we prioritize cuddling, reading books, playing and eating before going to ‘school’. I make it a point to leave work on time, even if I have more cards to finish. When I started working, I was often behind on charting because I was learning a new EHR. I had fewer patients, but unfortunately it didn’t balance out. I wrote notes at night AFTER going to sleep (until I became more efficient). After school we try to keep the phones off (hard!) and spend quality time as a family.
More information here:
The Tale of Two Books (and How I Broke the Bond to My Unwritten Manual)
How to survive a residence permit as a single earner with children
#8 Lean on your support network
I’m lucky that my two best friends became mothers before I did. Neither of them are in medical school or live in the same state as me, but since they are both brilliant and powerful career women, they are my go-to resource for all things “baby.” They were incredibly helpful in navigating the ups and downs of pregnancy, especially in the first few weeks after we had a baby, and shared stories about our toddlers being too cute to handle. The added bonus was that they not only gave me advice, but also a lot of hand-me-downs. About 95% of my child’s belongings come from friends, neighbors or family. This makes it easy on the wallet, and it’s so fun to send photos to friends and have them say, “I remember my kid wearing that!”
Everyone’s journey to parenthood (and surgery) looks different. There are strong and smart female surgeons who succeed as single parents. There are people with not so family friendly jobs who make it work too. And there are those of us who shake off the idea that you have to choose between being a mother or being a surgeon. Just as you craft your own surgical career, know that you CAN intentionally build the work-life balance you’ve dreamed of.
Are you a busy doctor or other high earner who is also a mother? How did you make it work? What sacrifices have you had to make? What other advice do you have?
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