You're right, mai tai, the match is a very good system and I don't think anyone would want to go back to how it was before. The match already anticipates the OP's situation by spelling out the consequences of not going to the program with which she was matched. The consequences are pretty extreme, which should serve to deter most people from doing that. Now that they have been spelled out here, the OP may indeed decide that her situation is not severe enough to take that risk. If she does decide to take that risk, she will have to live with the consequences, and hopefully her specialty is forgiving enough that it will not prevent her from practicing medicine in the future.
And how will one person's breaking the match contract affect all other women in medicine? Will it give other women one more choice in the future? Will it demonstrate to others that the consequences are *not* worth it? Will women be discriminated against because of it? Will the media get hold of it and twist it out of proportion? I don't have a crystal ball so I don't know. I just want to wish the OP luck and I hope everything works out well for her, whatever she chooses.
There are 2 totally separate issues here:
One is supporting this woman on making the "right" decision for herself, her career and her family, while informing her of the REALITY of the world today and how others are likely to react to her decision. The second issue is how family-friendly the medical profession is or should be, and how we as female MDs on such a forum can effect a positive change in our field. To be honest, at this moment in her life, I doubt the OP cares as much about the second issue. She just needs to figure out what to do, right?
I think the bottomline is: Ktoldread, you have to know that there most likely will be very serious consequences if you decide to break the match contract. Whether it's right or wrong is obviously open for debate, but even the supportive sisriver can't argue with that fact. It's up to Ktoldread herself to weigh the possible negatives of such a decision against her own life circumstances. If your reasons against going are compelling enough for you, then you do what you have to do, grit your teeth, and try to do as much damage control as possible.
Yes, having a child is certainly a huge life-changing event. (I know, because I gave up my medical career to be a SAHM.) And I definitely agree that the medical field SHOULD become more family-friendly. HOWEVER, imagine if every woman or man can use having a child as an excuse for breaking their contract. That would completely defeat the meaning of contracts. Even though I'm a supporter of women physicians, I would imagine that, if I were the medical director of a practice or hospital, I would be less eager to hire someone who has a history of breaking contracts. Having a child is huge, but it's neither preventable nor completely unexpected. It's a part of normal life, and it is in a totally different category from other life events that actually make breaking a binding contract more understandable to most people - such unexpected things as injury, illness, death, etc.
no, no, no...do NOT screw with the match-this could be a very bad career move, and you've worked SO hard for this! I moved across the country for my first choice surgery program, made great friends, had my daughter FAR away from family, and although we've since moved back to be close to family, those 4 years away were good- both professionally and personally. Your residency colleagues will be your family for the next 3 years and you will be fine-despite how scary it may seem right now!