I had never thought of posting about role-dissonance, but I will try. I guess I will post it in general discussion, but it really only started applying when I became clinical.
To reply about this thread: I haven't really felt guilty about not staying home full time with my children.

There are a number of reasons for this. I think the biggest two are: (1) We can afford to pay for great childcare. My babies (now 1 1/2 and 5 1/2) have really gotten a lot out of their experiences there. Even at a really young age they are learning to socialize, and learning that other people care about them and can meet their needs. (2) My husband and I have knocked ourselves out making sure our kids are not there endless hours. Lately we have been slightly overwhelmed, but usually I drop off late and my husband picks up early, so they are not there more than 7 or 8 hours most days, including nap time. As it is I am trying to change my hours so I will hire someone to take them in the morning and be more available in the afternoon.
I watched my mother be a stay-at-home mom. She loved being our mother, but it is really clear to me in retrospect that she needed an outlet for her professional energies because she essentially over-volunteered, and was too omnipresent for us. (She had been an audiologist.) I was a doctor before I had children, and I put an awful lot into getting here and, despite many current headaches with medicine, overall find my job very personally and financially rewarding. I also find home-making chores really unrewarding, which isn't true for many women. I don't feel fulfilled cooking, cleaning and so forth and I am a much better physician than home-maker, so I would not feel very competent if I did only that and would not be very happy over any longer term. I would much rather earn money and pay our weekly housecleaner. In order to get my husband to agree to a second child, I offered to stop working for awhile, but it isn't what I prefer and fortunately he didn't ask me to. I am sort of part-time since child #2, though, and for the time being I haven't been taking call. Actively raising your own children with 2 kids and 2 full-time jobs would be pretty unbearably exhausting for my family, particularly since my husband travels some for his job.
This has turned into a really long thing. Sorry (if you are still awake

). I do hear a LOT from many, many moms about the guilt thing, though, so I hope it may be helpful to hear from someone who hasn't really felt much that way but does do a bunch of things to try to minimize it.