Published in The New Physician, March 2005

(sidebar to Babies on Board)

You could say that Dr. Rivka Stein is infinitely comfortable in her own skin. That’s because the Brooklyn pediatrician arrived for her residency interviews packing more than just an unyielding set of expectations. She was also eight months pregnant with her second child. “So [the issue of motherhood] definitely came up as I waddled in there,” says the mother of four.

Stein, an orthodox Jew, says she never questioned her ability to have both a family and a medical career; in her community, the best timing for these things isn’t planned. But Stein did approach her residency search in an open manner and took control of her own situation—something many women are afraid to do, becoming apologists for their families instead.

Stein interviewed at 13 programs in three weeks, each time explaining what she expected from the residency and what they could expect from her. “I brought it up. I said, ‘Listen, I already have a child, and here’s what my husband and I do.’ I presented them all with a complete plan for how we handled child care. I just basically told them, ‘Here’s why it’s not going to inconvenience you.’”

Of course, for many graduates, the evidence of the need for childbearing plans won’t be quite so obvious during residency interviews. An Association of American Medical Colleges survey found that women are about three times more likely than men to be asked about their intention to have children. So what should you do if the topic arises with directors?

First, know your rights. Employers are prohibited by federal law from asking applicants about their family plans, so if you are uncomfortable with such questions, simply say so. However, keep in mind that if you are in the early stages of a pregnancy or soon planning one that could affect your participation in a residency program, it may be best for all involved to discuss it in the interview.

“I’m supervising residents now,” says Stein, who settled on Maimonides Medical Center in Brooklyn, “and when someone goes on maternity leave for six weeks, someone else has to cover. It’s a big headache for the program. You have to be realistic. They have a program to run. Devise a plan for how you will handle your pregnancy well in advance, and share it with interviewers. In the long run, it will make it so much easier for all involved.”

Another option is to consider programs that offer job-sharing residencies, where you split duties with another resident for half the time and half the compensation. While not common across all specialties, the approach is used in some areas. You can check availability of such programs on FREIDA, the American Medical Association’s residency database, online at www.ama-assn.org/vapp/freida/srch.

For the last decade, Dr. Carol Carraccio, director of the pediatric residency program at the University of Maryland School of Medicine, has offered part-time options that aren’t strictly job sharing but offer similar flexibility. “I may actually end up with somebody in my first-year group that’s half-time and somebody in my third-year group that’s half-time,” Carraccio says. “They have different responsibilities, but they are contributing to the whole.”

Directors aren’t likely to offer a part-time or job-sharing option unless residents specifically inquire. Carraccio says that when an applicant shows interest, she attempts to budget the reduced working hours accordingly. A person working only three-quarter’s time, for example, would work only nine of the 12 block rotations that year, with another part-timer picking up the rest.

“It is complicated,” she says, “but I have no regrets about doing it. It offers some people an important opportunity to complete their training and to do it in a family-friendly way.”

Copyright 2005 American Medical Student Association