I find that article totally offensive. How dare she, as a specialist, tell me how to live my life as a PCP? So, by her reasoning, the large percentage of women in primary care who are working part time shouldn't be able to do it. Well, then, who will??? There aren't exactly people lining up in droves to be primary care docs, let's face it. She can sit there from her perch and salary 3-4x mine and criticize all she wants. But I'll bet she doesn't have to have the same emotional investment and conncetion with her patients. The main reason I started working part time is that it was waaay too draining to give that much of myself every day. And it wasn't something I realized until after I had started practice and became attached to my patients. The main thing that makes you a good doc, actually giving and caring about your patients, is what is taken out of you on a daily basis. So, you need to replenish. I don't owe jack sh*t, thank you very much. I have spent my entire career in a community health center and volunteering. I give plenty. I deserve a life. How dare she.....

I also agree part time is relative- are we talking a total amount of clinical hours here? How many, exactly? I know some full time academic surgeons who work in the OR 1-2 days per week. Is that enough?

Path, would you include delivering babies in your 'surgical' specialty qualification? There is a lot of debate in FP about how many babies one needs to deliver in a year to stay 'compentent'. And whether or not that is catching the baby, or includes labor management. I would also reply to your question about what other professions people can quit and reenter-teaching, for one-I have several friends who are going back now after 8 plus years off to raise their children. Nursing, for another, if you keep up your certifications. And it isn't easy to quit medicine altogether for 5 plus years and then just go back, check out some of the reentry threads. I think working part time for as many years is a good trade off. You aren't losing the person altogether.


But, seriously...part time for us is a normal job for most people....and that doesn't include the countless nights, weekends, and holidays that have been given up or interrupted. Yes, I signed on for it. But I damn well don't owe anyone anything.

There's absolutely NOTHING wrong with quitting ANY career and returning later. The problem is when women expect to, for example, quit for 5 years then expect to get tenure at the same time as the woman who did NOT quit. Said woman then gets pissy and blames the "system" for her being denied tenure and not her choices for the delay. Those types of attitudes are selfish, self-centered, and make the work environment difficult for ALL women.

Also, how many women here have had a bad surgical outcome from a part-time surgeon? I have, so my position on this is valid IMHO.

Would 1-2 days/week in the OR be enough if your kid had a tumor in the brain stem? Can you honestly say you'd be Ok with a "part-time" surgeon in this case?

I'd say the answer to this question depends on how much your decision inconvenienced your colleagues. I got pregnant in grad school but my 4 week absence didn't in ANY way adversely effect my labmates. But if I had had a 3 year old at home at the same time, it likely would have.

Thing is, I didn't start this debate about women becoming pregnant during residency AND expecting special treatment, and I obviously won't end it.

But it's clear I'm not the only one who at the very least questions these types of choices when the people who depend on you can't, because of your CHOICES.

As for entitlement issues among women Docs, I've spoken on that for as long as I've been participating on this site, and quite frankly it seems to be getting worse as the "me" generation comes of age. Actually, I think the moniker Princess MomMD is more than fitting in a few cases, LOL!!!

BTW MCAT, August 2011!!!

Just....wow.

I suppose if by "entitled" you mean entitled to have children during training and not regret it in the least, then you can call me Princess Sunshine. <3 <3 <3

<struts past piles of junk to read two journal articles, shower, and pack lunches/pump before getting up at 4am tomorrow>

Well if the tiara fits................................

And you KNOW you've taken what I mean by "entitled" out of context, unless you expect to be Chief Resident, but have only been there half-the time.

Ok, so I lied.

Second comment! Perfect timing, Kevinmd.com!

http://www.kevinmd.com/blog/2011/06/doctors-choose-medicine-family.html

I actually had a few comments from admissions staff on the decreased years of practice I would provide society (keep in mind I am actually less than 10 years older than a traditional student!). My response was that with me, I had already done the work-family balance, and felt much more comfortable there versus at home.

I saw many people trained in SW who worked just long enough to pay off their loans (or until their partner could cover payments) and then leave the field. Sometimes it was to care for children, other times it was simply d/t the burn out of the field. I also saw people come back to the field after several years without a problem- part of that is likely due to the fact that SW has traditionally been dominated by women, and therefore has a much more realistic perspective of work-family balance in a challenging field.

But this article is offensive. I will be paying back my loans, with tons of interest. I do not owe my life to the field of medicine. If I choose to see three less patients per day than a male (or female counterpart with a different personality) so be it. My patients deserve the best care I can provide, IMHO, and if it makes me 'less productive' to do so, so be it.

Yes, there is a double bottleneck, both at med school admissions and residency positions. So should those with family histories significant for early MI or colon cancer be selected against during the process? They certainly have the potential to have a decreased number of 'productive' career years compared to an individual whose family members tend to live over the age of 90.

This is an interesting thread. I actually feel like there are quite compelling arguments on all sides, but I don't balance it out the way the article does, certainly.

I do think she does a surprisingly crummy job of arguing her case, missing what I think is the most critical component: while lots of professions involve people who received subsidized education, medicine is one of extremely few where our training not only costs the public money, but we learn on their very bodies, with their health, their lives, in our hands as we learn. This is true not only for those patients who patiently waited through my first 5 times starting an IV, doing an LP, delivering a baby, breaking bad news, suturing a hand wound... it's also true for everyone who eg had their critical, high stakes surgery done by a first year attending rather than the person with 15 years experience who just finished training that person. There is a very real, completely human cost to every physician who goes through training, and I think a lot about that as I consider my career options.

That said, I also think that she does a poor job weighing the reasons that it can be important to allow women to work part time at times. As others have said, the "full-time" work week of a physician is way over 40 hours... and, for all of her grousing about middle of the night surgeries, she is still in anesthesia - a much less grueling specialty in terms of total hours than many (can I just mention how much I *HATE* the "well, I was able to do it, so... that just proves everyone can!" argument when superficially cited??). But if you work as many hours as is currently expected of full time... it really can be near impossible for many people to be highly involved in their kids' lives. Especially if, say, they happen to find that they have a sick parent who needs care just at that time, too. And maybe they do a bit of volunteer work just every now and then. And perhaps take a few hours a week to read the paper and try to have an occasional say in our political process. And just imagine if they every now and then tried to take some time to step back and think about what actually matters in life for a few minutes a week, too, on top of that!

The thing is, though, if we say anyone who wants to be able to be there for their sick parent and their young kids at the same time just shouldn't have been in medicine in the first place... well, I think it's pretty easy to see that a lot of people might not find the people who are left in the profession the people they really want beside them or their sick and vulnerable loved one the day they're terrified, hurting, and making painful and difficult end of life decisions. Just for example.

If our profession is seen as a technical field where you are to accomplish over and over ad naseum certain difficult skills that you learned via repetitive training, then it is completely clear that the best system for society is to do everything it can to train the smallest number of the most capable people who can possibly cover the required workload if they do NOTHING in their lives but work. Nothing at all. This is the perfect ideal! There are three reasons, however, that doesn't actually make sense: (1) You have to have a deal that is capable of actually attracting the people you want to have working for you. (2) You have to allow those people to live lives that don't turn them into bitter or empty or hopeless or completely out of touch individuals who will not be able to relate to their patients even if they want to. And, I would add, (3) it's just wrong.

All of these things are a balance. Yes, I think there's some very real loss to society when someone goes all the way through training and then decides early on to leave the profession entirely. Yes I think that probably if that person had known from the start that was their plan that they probably shouldn't have trained in the first place. But no, I definitely don't think that we'd be better off (1) not ever letting anyone with any shred of doubt that they might ever end up having other priorities in their life into the field of medicine or (2) forcing a bunch of people who ended up realizing this wasn't right for them keep practicing while miserable and resentful (I wouldn't want that person for my doctor!).

Also, I wanted to mention that I think the teacher comparison is actually a very good one. There is a huge shortage of teachers, especially for younger students. Clearly this is a critical profession. Because of this, our society does very purposefully work to fund training of new teachers. But it is completely accepted that eg a very large fraction of elementary school teachers will end up taking a maternity leave or two, and often cutting to part time for a little while or job sharing for a bit here and there. Yes, this is in some very real ways a loss for society when they do so. Nonetheless, we tend to think it's pretty obvious that we just can't afford to say "hey, anyone who wants to ever make their own kids a priority in their lives shouldn't go into teaching". Similarly, I think saying that noone who ever wants to be able to make their family a significant priority in their lives should ever be a doctor is making JUST as fundamental an error.

As far as taxpayer support of medical education goes, the state support of the state U I graduated from has declined to the point where folks are starting to question why it still bears the name of the state. Who supports medical education at that school (besides the students who pay tuition)? The academic docs who see patients, some of whom actually work *gasp* PART TIME!
A doc over at Sermo pointed out earlier today that we all pretty much "gave back" by just completing a residency. Residents work their butts off for less than minimum wage if you calculate it on a per-hour basis.