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Take an extra year?

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5 years 8 months ago #92537 by healthymom2be
I am a 3rd year pregnant with my first child. I am due July 31st - could our little guy have chosen a worse time? I don't think so, but it is what it is. The timing is tough because I need to do a medicine sub-I to get a LOR before residency applications are submitted late Sept/early Oct. I am thinking about going into internal medicine at this point.

If I do a sub-I before the baby is due, starting right after I finish 3rd year, I will be going up until a week before my due-date. I really wanted to take step 2 during this time so that I could improve my score (step 1 didn't go that great).

While I could do a rotation 1 month after the baby is born, it seems risky - I have no idea if I'll end up with a c-section o complications, or if the baby will come late, or if I won't be emotionally ready to work 60-80 hours a week (I am guessing I won't be).

What makes this even more confusing is that I don't have a ton of classes to take during 4th year; I actually will have 3-4 months off with the baby if I want. It seems ridiculous to delay graduation a year because of one rotation - I will have plenty of time to get things done and have time off with the baby. I have two choices:

1. Complete a sub-I before the baby is born and hope I can make it through. Take step 2 after the baby is born. I would match and graduate with my current class in 2015. Most people are telling me not to do this because who knows if I will go into labor early and then probably have to repeat the entire rotation.

2. Delay matching until 2016. I don't have many credits, so I would actually graduate August 2015. I would need to try to find a job or do some research during this time. I am a little worried about how this gap will look. It technically won't be on my application as a gap since I will submit my application a month after graduation. However, I would think the question "what are you doing now?" would come up in interviews. Does any one know if this gap between graduating and matching would be a red flag?

Any thoughts?

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5 years 8 months ago #92538 by justperusing
Hi, I have a similar due date to yours. My first question is, have you talked to your dean or an advisor about your schedule?

Second, do you absolutely need to get a letter from your subi? At our school, many people do, but it's not a necessity. If you have attendings from third year rotations you can ask, that will work. This is what I'm doing. I decided I would rather take step 2 before baby comes and defer my subi until the spring.

One thing to think about if you wait to take step 2 is will you be breastfeeding? You will have to do this during very limited break time if so. Seemed stressful to me.

Bottom line is I think there should be a way to work it out if you don't want to take a year off. If you do take a year off, it certainly wouldn't be the worst thing either. Good luck to you!
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5 years 8 months ago #92540 by healthymom2be
It is nice to know there is someone else in this situation.

Yes, I have talked to an adviser and dean of student services. They both have said something along the lines of, "While it can be done, it will be stressful and you will be less competitive without a subi." I am more interested in community programs, which are less competitive, but you still never know what is going to happen.

Yes, I did think about breastfeeding. There are a few women in my class who had this issue during step 1. They contacted the governor's office and there is now a law in our state that women who are breastfeeding get double break time so they have use 1/2 to pump and 1/2 to take breaks. I would still prefer to not have to worry about that.

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5 years 8 months ago - 5 years 8 months ago #92545 by tr_
In your shoes I would absolutely squeeze the sub-I in before you have the baby, unless you are having a complicated pregnancy where your Ob specifically says you shouldn't be on your feet a lot. I would do it *even if you plan to delay matching,* because you will still need to do it at some point and it isn't going to be very much easier with an older infant than a younger one. And even if you do go into labor early you may not have to repeat the whole rotation, it may be possible to work it out so you only have to make up the time you missed. Anything that requires your physical presence that you can do now, do it now, not later.

In my experience, most people with young infants don't want to work 60-80 hour weeks at all. Realistically you may not be much happier to be away from your 6-month-old most of his waking hours than you will be to be away from your newborn that much.
Furthermore, depending on who your supervisors are, you may get docked in your eval for noticeable reluctance to stay that extra hour or two to get a complicated patient tucked away with all the boxes checked, when your nanny is already over her time limit or day care is about to close. Or for having to take pumping breaks 3-4 times a day that nobody else needs to take.

Conversely, I think you actually get cut more slack/look 'hard-core' for handling a tough rotation with a big pregnant belly. People may even offer you a chair or tell you to take a rest, and they're likely to think you're awesome for working so hard despite your very obvious pregnancy, and you won't have the pull of a baby at home to make you really really need to leave on time. You may feel crappy but you'll be able to tuck away that patient if you need to.

Nobody thinks better of you for having to leave on time to get home to your baby, even if they understand it (which they may not, if they don't have kids themselves). But they probably will think better of you for being the hardcore pregnancy lady doing the 80-hour weeks. It's ridiculous but it may well matter for your eval.

Study time on the other hand is MUCH MUCH easier to work around a baby (especially a newborn who sleeps a lot) than it is to work around a clinical rotation. MUCH MUCH MUCH easier. Pumping during the test is not fun but it's totally doable, no biggie. It's just one day. No comparison to trying to manage a tough inpatient rotation with a young infant. No comparison.
Last Edit: 5 years 8 months ago by .

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5 years 8 months ago #92553 by nightowl
I agree with tr_ 100%. Mom of two and resident myself. Currently bf'ing a 2 mo old. I couldn't agree more on all of these points.

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5 years 8 months ago - 5 years 8 months ago #92554 by healthymom2be
This is great - thank you! Everyone I have asked has not had children at this point of training, so I felt like they couldn't give me realistic advice. Most of the people I talked to (students and school officials) were more hesitant and just said to take the extra time. If they have legitimate reasons it would make more sense, but it seems like they wanted to just make everything less stressful (but I'm in med school, having a baby, and eventually will be a resident...things are going to be stressful). Tr and nightowl - you sound like you're more my style :) Thanks!
Last Edit: 5 years 8 months ago by .

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