Having a child is a life-changing experience at any stage of life. It can be especially disruptive when done during the rigid and rigorous physician residency training process.
Three physicians who took different approaches to family planning during their residency training shared insight on their experiences during a panel discussion held during the 2024 AMA Annual Meeting. Here is a look at how their experiences affected their training, and the insights they had to share with other medical students and residents who are thinking of starting a family.
A complicated pregnancy
When she began training at a surgical residency program, Emily Cleveland Manchanda, MD, MPH, was aware that it might not be the most supportive environment for starting a family.
“It was an old-school, come early-stay late boys club,” said Dr. Cleveland Manchanda. “I was one of three women out of 23 residents. And I knew what I was getting into. And I was like: I can do this anyway."
Dr. Cleveland Manchanda had pregnancy complications that forced her to go on bed rest at 20 weeks, and she gave birth to her son—who has cerebral palsy and just finished 3rd grade—15 weeks early, when he weighed less than two pounds.
Despite a complicated pregnancy, traumatic birth and expecting at least a four-month NICU stay, she was told that an extended maternity leave would delay her training because her program was unable to work with an off-cycle resident.
“That led to this whole path of reconsidering my options, and figuring out that I was going to transfer out of plastic surgery. I got my MPH as I transferred into emergency medicine,” said Dr. Cleveland Manchanda, now an assistant professor of emergency medicine at the Boston University Chobanian & Avedisian School of Medicine. “And that led to a place where the grass is actually greener.”
Dr. Cleveland Manchanda—who also is the interim vice president for equitable health systems at the AMA Center for Health Equity—went on to have two more children, one during her year as a chief resident, and another as an attending. While all her kids were born premature, she felt well supported by her program director and institutions during these later pregnancies and maternity leaves.
“If you're planning to build a family during residency, it's really important to understand what the pathways are,” Dr. Cleveland Manchanda said. “No one in my program had ever had any complications in their pregnancy…. But, it's important to know what the context is and what you're going to ask.”
Dive deeper:
- How does parental leave affect physician resident performance?
- Residency program leave policies offer new parents some clarity.
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Supporting a spouse giving birth
Now an assistant professor of emergency medicine at Rutgers University School of Medicine in New Jersey, Scott Pasichow, MD, MPH, and his wife had their first child during his second year of training. When investigating how coverage would work for his potential absence, he was told it shouldn’t affect his training schedule.
His reaction at the time: “What happens to the mothers?”
By working with his residency program, Dr. Pasichow was able to schedule a research month around his wife’s due date. The baby, however, had other plans—arriving three weeks early. That meant that Dr. Pasichow had to work a few shifts before taking five weeks off to help his wife and the baby recover.
“Every aspect of your life is impacted by having a child, whether you're giving birth, not giving birth, or adopting,” said Dr. Pasichow, an AMA member. “And so, just keep that in mind as you're going into the training process, and whatever you want to do, whether it's preserving your fertility to a future time where it might be easier for you to integrate children into your life or having a child during training. Just make sure that you're thinking about the other pieces, because it will impact the things that you want to do. It's very workable, but it takes planning.”
Dive deeper:
Delaying for training
Early in her residency training, Jade Anderson, MD, was burned out. After two years as an orthopaedic surgery resident, she was considering leaving medicine altogether.
“I made the decision to switch into radiology after some mentorship,” said Dr. Anderson, an assistant professor of musculoskeletal imaging and intervention at University of Wisconsin-Madison. “I knew I didn’t want to be pregnant at all during training. But also, by switching, I was going to have to do seven years of training, versus my original five.”
At 32, Dr. Anderson opted to undergo fertility preservation treatments. The process of freezing her eggs was covered by insurance, which is not the case in all states. She was able to take part in the egg-retrieval process, which takes place over two and half weeks, while continuing her residency rotations.
“I was super happy that I did it,” said Dr. Anderson. “My labs [for measuring fertility] were actually really low. I didn't know I was already having some potential aspects of difficulty conceiving in the future, so I'm glad that I did that. Please don't delay it if you're thinking about it."
Dive deeper:
- AMA backs resident physicians’ access to fertility preservation.
- Find new ways to help medical students, residents get child care.
The AMA Thriving in Residency series has guidance and resources on navigating the fast-paced demands of training, maintaining health and well-being, handling medical student-loan debt, and other essential tips about succeeding in graduate medical training. Those tips include insight on ways to save time on personal tasks from former residents and how to balance parenting and GME training.
