I'm graduating from medical school next month and starting residency at my home program in internal medicine the following month. I have this crazy delusion that mid-way through my intern year, I'm just going to waltz into my program director's office and say, "Hey, how about a part time residency?" And he's going to say, "Suuuuuuure! Why the heck not?"



This may be pure insanity, and I may get totally slapped down when I ask, so I figured I'd try to post occassionally about my progress in this endeavor, in case anyone else out there is harboring similar dreams.

Anyway, I got one step closer today. I was chatting with my research mentor -- who, let me just say, is a gift and a blessing. LOVE this guy -- and he flat out asked me if I'm planning to negotiate a part-time schedule as a resident. I was stunned. My mentor is a) a super fancy-pants division chief, b) a phenomenally productive researcher and c) married to a fellow physician who stays home to raise their three kids. I love the guy, but I didn't suspect he'd be so amazingly supportive of my life as a mom. I admitted I am planning to ask for part-time and he encouraged me to go for it. Offered to help with the negotiations! Quelled my fears about the impact of part-time residency on my career!

Oh, I am happy. Having my mentor behind me and supporting me when I go to talk with my program director will help a lot, I think.

I'll keep y'all posted. I was also thinking it might be helpful to have an informal "working group" of people who are doing something similar, if there's anyone else out there, reading this. Maybe we could put our heads together in terms of creating a presentation to deliver to program directors ... ultimately, that might be a useful resource to post somewhere on mommd, like a powerpoint presentation or something. Just thinkin' out loud here.

Thanks for the update, Emily. Keep us posted!

ps-how long do you want to extend your residency? e.g. 40h/week for 6 years? or just first year? on 2 months, off a month?

The bummer for me is that now most IM programs are 80h/week for ALL 3 years to accommodate the ACGME requirements. For me it would almost be better front-loaded with less call PGY2 and 3.

Also, what kept you from asking about it sooner, rather than waiting until you get halfway through intern year? Just because of timing with the match?

(You don't have to answer such personal questions if you don't want to! )

I don't think short days/weeks are really possible, given the call structure as it stands now. I think I'll probably ask to spread R2/3 over three years total and do two months on, one month off. So I'd spend four total years as a resident. (Doesn't that sounds like a dreamy way to get through residency? *fingers crossed*)

I don't know about "most" programs, but this wasn't the case at the places where I interviewed. I think I'm looking at eight or nine call months as an intern, then six as a R2 and five as a R3. Something like that. So there are a good number of 50-60 hour weeks mixed in there (consult months, out-patient electives). Some programs are heavily front-loaded (UCSF and MGH come to mind; I've heard Hopkins). Some places free up several months for research as a senior (BWH).

I think you might be able to find something like this ... but you're planning not to move, yes?

Well, first off, the schedule for next year is already made, so there's no rush. I'm all-in for next year, and I think that's probably a good thing, in terms of my training. Second, I'd like to jump in, work hard, and prove that I'm a strong intern before asking for any special favors, ya know? I want to come from a real position of strength for this negotiation, with no questions about whether or not I'm performing adequately. Finally, I guess it's possible that internship will either be a) so terrible that the idea of dragging my residency out sounds atrocious or b) so do-able that I'll feel OK about continuing full-time. So I want to actually give it a try before making changes.

I was biking home in the Northern California sunshine yesterday and feeling so darn optimistic about all of this!

Thanks, Emily, for the info! Your post motivated me to check out FREIDA--apparently the IM programs in my area average 60h/week. Should I believe that? :crossfingers: I guess that wouldn't be *as* bad for all 3 years.

I really hope it works out for you! Please keep us updated. You must be graduating in a matter of days. Yay!

Back with another update, b/c (I think) I would have benefited from this thread a couple of years ago ... so maybe someone else is reading this.

Since my last post, I've actually started residency and my original suspisions were confirmed: a) my family is going to get through this year intact, no doubt and b) I am willing to move heaven and earth to negotiate a part-time deal for the next couple of years.

One surprise: I am the only parent, mother or father, in my intern class of 45ish people. So there are no potential job-share partners available that way. There are a couple of moms who are one year ahead of me, but neither of them are interested in job-sharing. So that was a dead-end, unfortunately.

Since then, I've met with my research mentor who continues to support my part-time aspirations and even offered several concrete suggestions that may help. (As an aside, it is difficult to overstate the usefulness of a good mentor.) For instance, he offered to keep me involved in research during any off blocks, and pay me accordingly, so I won't be without salary/benefits. (This sounds perfect as I'm not actually looking to be a SAHM for any stretch longer than, say, a weekend.) Similarly, I've toyed with the idea of short-tracking into fellowship, so it appears I won't necessarily have to make up any/all of my off blocks. And I may be able to enter fellowship off-track (at my home institution), so that could smooth the logistics as well. I'm still not exactly sure how the final permutation will look, but I think I may end up with something like six months off, scattered between R2 and R3, no make-up, and go straight into fellowship. SWEET.

I also met with one of my chief residents, who offered to broach the subject with our new program director on my behalf. I haven't yet heard how that conversation went, but the good news I learned from the CR is that schedules for next year won't be made until April, so I have six months or so to hammer out the best soluation.

I remain optimistic!

That is a fabulous development, E!



One question: especially with IM, is it that imperative for everyone to go through it full-time? It seems the program directors have to be flexible for all the anesthesia interns, med-peds, med-neuro, med-psych, etc. etc. etc who are on one month and off the next...maybe it wouldn't be that big a deal to miss a resident here and there (esp one who doesn't need benefits)?

Anyways, GOOD LUCK, I hope things move along swimmingly for you from here on out.

One more update and then this thread is through ... because they said YES!

!!!!!

I'm going to add one total year to residency with 12 off blocks scattered throughout my R2/3 years. Hopefully it will look like 1 call month --> 1 non-call month --> 1 month off. Rinse, repeat X 12. (Doesn't that sound pleasant?)

During the off months, I still have to do continuity clinic (for a total of 36 months including intern year). And my program expects that I'll use the off time to get some research done, which is totally A-OK by me. Good, even. I think this part-time solution may actually end up being a good thing for my career because my research CV will be expanded prior to fellowship.

Oh, I am happy. And grateful. And a little giddy. And did I mention happy?

(If anyone has questions re: the actual process of asking, I'm happy to report my lessons learned via PM. If I had it to do again, I'd probably do it differently.)

Hooray hooray hooray for you! Time to celebrate!

Congrats! If anyone could pave the way at your program, I had no doubt that it would be you