How do you deal with pregnancy during medical education in the US? originally appeared on Quora- the knowledge sharing network where compelling questions are answered by people with unique insights. Answer by Amy Chai, MD Internal Medicine, MS Epidemiology, on Quora: How do you deal with pregnancy during medical education in the United States? You wait until your training is over. My residency director always made comments about “effective contraception” (hint hint). I took a job immediately after residency and used an ovulation predictor to make sure that I would be due the month after my one year contract was up. I then took some time off. Child care was immediately a disaster because my spouse is a surgeon. That means you either have to have live-in childcare, or you can plan to take the baby into the emergency room with you in the middle of the night. We chose the latter; the nurses thought he was cute and you could dump him at the nurses station for an hour, strapped into the car seat. We could not afford a live-in nanny, and we did not have a home with a suite for live-in help. Plus, we had loans and we could barely afford to pay them back (we didn’t pay them off until age 40.) When baby number two came, I had to pump, pack the pump and the milk, pack the baby, the toddler, the extra clothing and drive to two different daycares because they did not have an infant space at the one daycare, and still get to the hospital by 8 a.m. Don’t even ask what happened if someone had a fever. Those were my “easy years” of fellowship, when it was not bad. After that, there is the significant problem of daycare hours and no after hours help. If you have hours that are not 8 a.m. to 6 p.m. you are one 100% screwed. I could not take the kids to a daycare. So, I had to hire a nanny who was able to stay “as late as needed” and I ended up paying her about half of my income, plus if you do it legally, you need to pay her FICA and unemployment taxes because you are her employer. The paperwork and the expense was insane. Then when the kids start needing to be driven to dance or music lessons, well, it goes downhill from there. Ultimately, I stopped working as a doctor, and so did many of my women doctor buddies. We are all married to men who make a lot more money than we do, and it literally makes no financial sense for us to work, especially when we are taxed at the top bracket because of our spouse. Now that the kids are in college, I work part time as a doctor. It is really just a hobby because I don’t need the money. I have to pay 15% FICA (self-employed) and 39.5% federal taxes, and 6% state tax. Now you can see why it is just a hobby. I would rather do volunteer work, because I hate giving the feds all of the fruits of my labor. And because I have it so good, I just paid $260,000 for child number two to go to college, and will pay $300,000 for child number one to go to med school because they won’t be eligible for a low-interest loan and they will subsidize everyone else’s kids, which is basically just another tax on you, the evil doctor. I told you my whole story because I don’t want you to think that dropping a kid from the womb is the hard part of motherhood. Baby days are the easy days. You have to look at the whole picture. Source
