I'm looking for advice from people who have been in my shoes before. For the past few months, I have been seriously considering taking a year or two off after completing my OB residency in June to stay home with my daughter. I feel as though I have already missed out on so much of her life and I think it would be good for me to step away from everything and enjoy being in a different role for a while. Part of the motivation lies in the fact that I will only be in this location for one additional year (while my husband finishes his residency) and then we plan to move if/when he matches for a year-long fellowship. Any job that I pursue would be quite temporary and basically a filler. My husband and I figured out that we could manage this plan financially without having to sell the house, so my job would basically go towards maintaining our lifestyle... and daycare. Right now, we have family helping us with childcare, but they live thousands of miles away and their intention was to help us until I graduate. Then there is the problem with being on-call: if I take a temporary job and my husband and I are both on call on the same night, who will watch the baby? Plus, an ideal job for me would be part-time. If I were able to find a part-time gig, then I'm not sure the compensation would be worth it after calculating in the cost of childcare. I'm pretty sure I can defer my loans for a couple of years if I'm not working (will have to confirm this). I realize that taking time off after residency will certainly make finding a job more difficult after. But at the same time, I don't want to end up wanting to take time off a few years down the road after joining a private practice, and then not having this option b/c I will have a tail to worry about. Would it be wiser overall to take the time off now before getting involved in all of that, or wiser for me to seek out some fill-in-the-gap, part-time, no-tail, low-paying job for the next couple of years (if this exists) and put my daughter in daycare/hire a babysitter for overnight calls? We plan to eventually move back near family so that they can help with childcare once we are finished with our training, so hopefully this is only a temporary conundrum. I've asked for advice around the workplace and there is no real consensus. In fact, the responses range from "staying home is a really bad idea" (mostly from people without children) to "you should absolutely take the time while you have it if you can b/c you'll never get these years back." I just want to make sure I have all the facts before I make this big decision. Any input would be much appreciated.

Professionally, it is better to work part-time than not at all. Taking a break will immediately narrow your job opportunities when you try to return. There are lots of barriers to re-entry, such as those credentialing forms that ask how many of each procedure you've done in the past 2 years, hospital by-laws that specify that you must be in active practice, the negative attitudes of potential future employers, and your own dwindling self-confidence.

Financially, it is better to work part-time than not at all. If I recall correctly, during forbearance your interest will continue to accrue, so it is worse than just delaying repayment. And you will definitely make more per hour than any childcare provider you can hire.

As for taking call, you and your husband can probably work it out so that you are not on call on the same night. He may have less flexibility in residency, but he may find someone who is able to switch calls with him. You can simply specify to your employer that you are not available on those particular nights.

Anyway, I'm just giving you some facts and you will ultimately have to make the decision that is right for you and your family. Good luck!

I agree with sahmd, it is better for you to keep your professional doors open if you even work a little bit now, rather than take an extended time off right after residency.

As an ob/gyn (out 2 years now) with a child I most certainly understand where you are coming from (actually there are quite a lot of ob/gyns on this site that are in similar situations). There is no 'part time' ob/gyn job that exists. With such high malpractice premiums ob/gyns are very expensive to recruit and hire. If an employer is willing to pay for your malpractice insurance (tail or not) you can bet that they are very unwilling to allow you to work part time (ie, your definition of part time and their definition are likely to be completely at variance). Your future colleagues are likely to have more than enough work with clinic and call and don't generally support a part time physician. That is a reality of the ob/gyn life. However, there are some notable exceptions that might work well for you now or in the near future.

#1) A new trend is the ob/gyn 'laborist' position that seems to be very popular in some parts of the country. This is basically covering all labor and delivery and ER patients for a designated period of time, either 12 or 24 hour shifts, a few days a week. There is no clinic coverage required. Most of the ob/gyn laborist jobs seem to be concentrated on the west coast and many of them require that you have 5 years post-residency experience and are already board certified, so you would have to wait at least that long before this might be an option.

#2) Locums work. There are needs all over the country and range from long term to just a few days a month, depending on what type of coverage is needed. Usually the client will want someone for clinic and call, but sometimes it is just one or the other. Even if you just covered a weekend or two out of the month that would keep your knowledge/skills up to date and you would have the added benefit of seeing how a practice works 'from the sidelines' before you are deeply entrenched in long term contracts, etc. I am currently working as a locum and although there are no benefits (health, life, disability are all paid out of pocket) the unseen benefit is that I can pick and choose where I want to work and for how long, each assignment has an 'end date' if i hate it, and I can spend a lot more time with my family in-between assignments. Also, the locums agencies will pay for all malpractice and work to get you licensed in the state where you are taking a job. Long-term this is not really sustainable but for now it has worked to keep me in the workforce on my terms (for the most part).

#3) Job share. Essentially this is one job split evenly between two doctors. You could consider this if you found a practice that would be willing to entertain such an arrangement. However, you also need to find someone with whom you work well and have similar practice styles. Patients may also get annoyed if they like one of you better than the other and pretty soon your 'half time' in clinic is eaten up with 25 patients crammed into one morning (read: you will be there all day anyway and not get compensated). In theory i think this works, but in practice some of the realities of how patients are (especially demanding ob/gyn patients) don't mesh into a job-share situation.

I am sorry you are in this situation right now. My other piece of advice would be to peruse this site to see how many ob/gyn docs there are who are actively trying to get out of practice and learn from the mistakes we made (make sure when you do sign a contract that they cover the tail or, if not, that they have a large signing bonus that does NOT come with a promissory note, so that you have enough up front to cover the tail if you do decide to leave the practice). Ob/gyn is a wonderful field but sadly the medical climate now makes it quite difficult to practice while maintaining the needs of your family as well. Good luck.

I say, do it. Take off the year. It will go faster than you think. It will give you time to spend with your child and plan for your new job, wherever that may be. Go for it. It sounds like this is what you already want. It is ok to take time off. I don't think a single year will be too hard to explain away, especially since you are waiting for your husband to finish his program. Good luck, let us know what you decide!

Thank you, everyone, for the great advice. Just as an update, I did a little asking around after hearing what you had to say and have been offered a year-long gig at one of the hospitals where I am training. It would be a 3 nights/week laborist position. I haven't made any final decisions at this point, but I think this is my best option thus far. I have also been in contact with several people regarding locums opportunities during that time. Haven't gotten really far with that option, but one person told me that he works with about 5 female physicians who all do only weekend locums so that they can stay home with their kids during the week. I'm curious to see what locums has to offer, but not sure it's worth the effort considering the offer I have now. There's one other option as well: doing a 1 year fellowship where the hours would be 7a-5p and there would be no weekends/no call. The only downside is that it is a resident salary and I would have to do full-time daycare. Plus, I'm not sure that this extra training would help me in any way with regards to ultimately working part-time somewhere. If I do the laborist job, I would probably have to get an au pair for the nights my husband and I would both be on call. However, I think I may have a better chance at being hired for other laborist jobs (despite the lack of 5yrs experience) after having at least one year of this type of experience under my belt. And if in the end I am miserable, I can take the year off that my husband is doing his fellowship. Thoughts/suggestions?

My advice would be to take the laborist job! It sounds great! Especially if they cover benefits (most locums assignments do not). Just my two cents. Good luck!

That sounds like a great option. I hope it works out well for you.