I guess it is conventional wisdom that the fourth year of medical school is the best time to have a baby. But lately there have been a lot of posts about the big downside of fourth-year babies: what do you do about internship? Do you defer the match for a year? Do you struggle through? Do you quit because it is unbearable? What if your husband is an intern, too? If fourth year is not the best time, then what is?

I think this is something important to consider when planning one's family, but I didn't want to hijack another post where someone is asking for help for a particular situation. I also don't mean to be critical of anyone who has made that choice. My intent is basically to discuss the pros and cons for the people who have not decided yet.

I've been wondering about the same thing. I'm hoping it's easier if your baby is earlier in 4th year - my baby will actually be just over a year by the time I start intern year. But, I'm still more worried since starting using this forum than before!

Nonetheless, I don't know a better time, either. Even if it hasn't been perfect, I've really cherished the flexibility I have gotten this year to be home with my baby much more than would be feasible probably any later time in my career...

Having recently done just what you're asking, I can say that it has been both good and bad. I think if you're going to plan to have a baby in 4th year, make sure you deliver early on.

I had my daughter in early December and I had a few bad experiences with interviews. I was unable to travel to some of them due to the timing and distance (I'm in a DO program so interviews start in November for us). I had a few programs offer me interviews, but when I called to ask if I could schedule them 1-2 weeks earlier than the date they offered, I was removed from consideration entirely. I thought OB/GYN programs by the very nature of their specialty would be slightly more understanding when asking an applicant to make a 500+ mile trip so late in pregnancy! I did end up going to all the interviews I was offered that were within a 4 hour drive up until I was 39 4/7. It was really tough, but I did get a lot of good feed back for being brave enough to do it.

I ultimately decided to put off the match for a multitude of reasons. One of them being that you cannot predict how you will react to being a mother! I was pursuing the intense and unpredictable field of OB/GYN with the thought that my passion for work would somehow unaffected by becoming a parent...I was so wrong!!! I used to be all about "the job" and now I'm more into being a mom than I could have imagined. I want to have a residency and career that will allow me the most time for my family. Personally, I've found that with Family Medicine.

Schedule "easy" rotations for your first few months back. I was lucky enough to be on a sub-specialty rotation with a fellow MomMD who would let me get my work done and go home. I'm still working on trying to assert myself enough to make my colleagues understand that I'm nursing my daughter and I have to take breaks to pump. It seems to be something that the male students, residents and fellows I've encountered think that you can just ignore in the name of productivity.

I agree with AmmaMD, I have been able to be home with my daughter a lot. The past month she has usually only needed 1 bottle a day while I've been gone...I can't say enough about the hours on sub-specialty rotations! :-) Even if some of the things you read on the forum make you a little wary, I've found it to be a wonderful resource and a great place to get advice and support!!

I just wanted to say that having a baby at the beginning of 3rd year was really hard (it terms of schedule, being away so much), but really AWESOME that she was a year old during MS4 year and i have had so much more free time at this point in her life where she is so active, learning so much, and saying new things every day.

I feel like I have had more time to adjust to learning how to be a mom in medicine before i start intern year and feel more prepared (if it even possible?) for it. I can't imagine having the feelings i had after just going back to work when she was 2mo old and trying to be an intern slave at the same time!

Granted, there were many times that i wanted to quit (look at my old posts!) but i some how figured things out and feel like med school is more forgiving in this regard than residency will be!

I totally agree. I'm due to deliver at the beginning of 4th year. A lot depends on the school. The beginning of 4th year is packed with subinternships, getting letters, and applying for the match. Plus you will have to use some/all of your vacation months for interviewing (esp if you are going into a competitive specialty). I would suggest aiming to be due sometime Sept-Nov so you can get your application ducks in a row yet still have a lot of time with your baby.

I decided to take a year off between 3rd and 4th year to be with my baby. I'm excited to spend so much time with her, and she and her sister will be 2 and 4 by the time I start residency. I'm sure it will still be tough at those ages, but at least they'll be almost out of diapers, no longer breastfeeding and not waking up at all hours of the night (right?). Hopefully this plan works out!

Just my 2c

I had my second near the end of 4th year and started residency when she was about 12 weeks old. I had a nice and relatively long maternity leave in that sense, and started her in daycare near my hospital. It was a rough year, but I would still rather have had an infant than tried to be pregnant as an intern. I was not breastfeeding due to some postpartum complications, but I imagine that would have made it much more difficult.

I had my first in February of fourth year and start residency at the end of June. I think the timing has been great.

I applied to anesthesia programs and am glad I was pregnant at the time rather than having a newborn. It is easy to take a fetus on interviews and I didn't have to worry about pumping or childcare while I was gone. I didn't have any issues with being pregnant at interviews and it made residents more open about sharing how family friendly the residency program is.

After i had the baby I was able to take my vacation months to use as maternity leave and then came back to an easy rotation where everyone was very flexible about pumping. Also it's the end of fourth year and I'm sure everyone understands where my motivation is right now... As long as I pass I'm happy

My son will be 4 1/2 months old when I start residency and I think it's a good age. He sleeps 7-9 hours (like 7pm-3am on average) and then 4 hours (330-730) so getting up to nurse him once is very doable. It will be hard to leave him I'm sure but we will have lots of family support for child care and everything will work out.

Anyways, this is the only way I've done it so I can't compare it to having a baby at another time during my medical career. I would recommend this route though, especially if you think you can match near family.

i had my first toward end of third year--so he was around 1 by the time i started residency. had number 2 in second year of obgyn residency, and number 3 4th year of residency. med school was a great time to have a baby-- i got to take a little extra maternity leave with him, and i feel like that was more important with my first than with the other 2 (had the standard 6 weeks with each of them).

i was pumping during interviews for residency, and took my son with me on interviews (which meant traveling with someone else). When i interviewed for fellowship i was pregnant, which was much easier. however, when flying while pregnant, there's always the chance you'll have a complication and end up stuck somewhere delivering a preterm infant in another part of the country--that can complicate things too.

however, once it came time for the match i restricted my choices to stay close to my mother, who could pinch in and help out with my crazy schedule--i knew my little guy wasn't going to have much time with me, so i didn't want to take him away from his Nana too.

you do have to think about how many children you might want, and how you want to space them. when starting out it is so easy to just think about a good time for the first one--but if you want them close together, that means the next one in residency--which can be harder.

It did get easier with the others--and i eventually had to move away from my family when number 3 was 6 months old to pursue fellowship--it was easier being a more experienced mom being away from my family.

I was still breast feeding when i started residency, and i breastfed all three for about 14 months each.--there are few true emergencies that can't wait 10-15 minutes for pumping. you do have to get over the guilt of spending 10-15 minutes doing something personal (multiple times a day, at that), when there is a lot of pressure to feel like you are holding your own, not slowing anyone else down, not asking anyone else to cover for you. i just had to decide that if it took me an extra 20 minutes in clinic, so be it.

Bottom line is, you're probably going to be a doctor forever (in order to pay off your student loans, and send all these kids to college, anyway) so if there are delays along the way, so be it.

i'm now going into private practice. i'm joining a bigger practice that has a maternity leave in the contract (6 wks)--many practices do not, and being out in practice can be a tough time to take an extended leave if you're in a small practice--you can feel guilty hanging your partners with having to cover for you. believe it or not, maternity leaves can be better covered in residency/medical school, than in private practice--something to consider.

I had my 2nd baby in April of 4th year. I planned this well in advance and stacked my schedule so that I was done with school in February and planned to take a year off. I deferred the match 1 year and my year with my children was the best decision I've ever made! It gave me much needed time with my infant and 3-4 year old and also a break from the rigors of balancing medical training and family life.

I think it is not considered as much as it should be. I don't think it has any impact on your competitiveness in the match and it might even give you and advantage so they know that you don't have a newborn at home (though they can't ask, I think its nuts to not tell them).

Bliss - that was my year off. And I was rejuvenated and psyched to start residency.

Hi!

I actually first posted the very same question on this forum in 2007. At that point I did not know if I should have a baby in third or 4th year. I am now a proud mommy of 6 month old twins! I got pregnant late in my third year and after finding out that i was carrying two babies, I realized that it would be best for me to "flex" my 4th year (meaning I prolong applying to residency by one year, take as many classes as I can while Im pregnant, and then take some time off once the babies are here). This worked out very well for me and I am currently applying to residency. I wished I could have graduated with my class, but to tell you the truth, it is amazing being home with my babies. I still have two classes to take before I graduate, but the last year has been incredibly chill and allowed me to not be stressed during my pregnancy about finishing on time. This time also allowed me to spend months with my babies (a priviledge I would not have if I was pregnant during residency). When I start my internship, my twins will be almost one and a half, at which point I will have to put them in daycare. It has been hard, but well worth it.