The following was posted anonymously as a comment on a blog I wrote about the difficulty one has in choosing a medical specialty. I was so taken with it that I wanted to give it more exposure. [Note: The comment contained a few typos, which I have corrected. Otherwise it is unchanged.] My response has been amplified slightly.

Since you are so senior to me, let me ask you for your thoughts. I got into medical school, studied, worked hard, got into residency and learned, spent hours and hours in the hospital, loved critical care and got into fellowship. Along the way met a guy (both were residents at that time), fell in love, and we both dreamt and read and learned and discussed cases. He decided on cardiology and I decided on critical care. Both got into fellowships …. worked hard, spent long hours in fellowship … we were committed. We ARE committed but divided…. We had kids, and now every day I feel divided. I have a feeling that all “old timers ” like you who worked for longer hours and did frequent night calls had a ” spouse” who would take care of your kids, and you did not have to worry as much. Times were different. Times were not so dangerous, and kids’ safety outside of the house was not so concerning.

In my situation, my spouse and I are both physicians in fields that require us to spend lots and lots of hours in the hospital. If I were to find a traditional practice and work every 3rd night, who would raise my kids? Who would teach them right from wrong? Everything is on the rise – drug abuse, physical abuse, dropout rates. I WANT to raise my kids and be there to guide them. So, yes, I want a practice where call frequency is less, where I can spend evenings with my kids (not because I want to have fun, but I want to be there).

We do not think about all this when we get into medical school, I did not think about this when I married my husband, and we did not think about this when we chose our subspecialities. Perhaps that was a mistake.

It was easier for us. There were far fewer women in medical school. My class of 180 had only 20 women in it. Our chances of marrying another doctor were much lower, especially since same-sex marriage was not in vogue back then. I was fortunate to have married a woman who is both a nurse and a saint. She took 13 years off from work to raise the children.

For you, taking time off would be very difficult. Have you thought about joining a group and working part-time, maybe with shorter hours and fewer nights on call?

I was touched by your palpable internal turmoil. My heart goes out to you. I hope you can find the balance you seek. Your last paragraph sums it up. Everyone in medical school should read it.

Do you think she made a mistake? What should she do now?

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 900 page views per day, and he has over 6,200 followers on Twitter.

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