Editors: Abhijit Pal, Elie Matar
It’s Orientation Day on my first day of medical school. I feel nervous, excited and ready to learn; this is the beginning of my career in medicine. But as I sit there during my first lecture I have one overriding thought that rarely left my mind over the next four years – what time would I be able to leave today?
Two weeks later, 8am, I would be settling in for a day of lectures. Many of the other students would walk in with coffee and breakfast in tow, spritely and ready for the day ahead. I would glance over at another student down the row and we’d exchange somewhat defeated smiles, for us, our mornings started four hours ago and it already felt like lunchtime. Success would be measured by whether or not we made it through to the second lecture awake. Now the lectures are over and I have graduated from medicine, a feat that at the time seemed an eternity away.
I started medicine when my daughter was the tender and challenging age of three months. I walked to my first day of orientation and left her and my son, four at the time, with Dad. Leaving my children behind was something that I would do over and over. It was difficult and didn’t get any easier with time. I knew that their amazing father would give them all the love, care and attention they could want, but as a mother who works or studies full-time it is not uncommon to question whether you are doing the right thing.
I could not have predicted the challenges I would face in juggling family and study. I spent four years in a hurried mess of studying, school drop offs and sleeping at inappropriate times. I was often running late or needing to leave early. There was always study or housework to be done. There was so little time to reflect on how we were surviving with everything we were actually doing. But as I come to the end of medical school I have had the time to reflect on the challenges I have faced. Here are some of the lessons I learnt on this incredible journey.
Lesson number one – Be present
Studying is stressful and raising children is stressful. It is easy to feel overwhelmed by the multitude of commitments and responsibilities you have. It was so important for me to make sure that walking through the front door marked a release of the day, a time to stop thinking about medicine and to start thinking about the kids. A time to let them have me and not someone whose mind was thinking about the week ahead. You have to separate family and medicine so you can appreciate both of them. Resenting one or the other for taking up time you’d rather spend with one or the other just spawns resentment and stress.
The advantage of not bringing medicine home with you is the ability to appreciate those two smiling adoring faces as you walk in the door. Being present for them never fails to remind you that the stress of today, the assignments, the signatures you have to get from your supervisor are all miniscule problems in the scheme of things. Being a mum means having the most precious gift of perspective.
Second year was a lot better. I felt like I was getting ahead on the academic side of things having taken the opportunity to spend time studying over the Christmas break. My daughter was sleeping through the night but tiredness never escapes you when you’re a mum in medicine. This year I learnt the next lesson.
Lesson Number Two – The power of power naps and studying smart not hard. Lectures finish at five minutes before the hour and start at five minutes after the hour. That is ten minutes of shut eye between each lecture and up to a forty-minute nap by the end of the day. By fourth year I had mastered the skill of sleeping on the bus which was a great pick up at the end of a long clinical day. With efficient sleeping so too came the ability to do efficient study. Studying medicine means adjusting to studying and thinking in a different way. In first year my study routine was kids both in bed by eight and study until around one or two in morning. I very much doubt I was the only student who did their study late at night but most would not have to be up at six again for breakfast and breastfeeding. You burn out pretty quickly and halfway through the year my marks told me I needed to change things up. Lunch breaks, lecture gaps, laboratory days – all fantastic day time study hours. Any parent in medicine will tell you that one hour of day time study is worth five done at night. Other parents will also vouch that kids make great practice patients in the lead up to OSCE examinations. Treating medical school as a full-time job meant keeping in line with lesson one and maximising time not spent studying at two in the morning.
Third year was the beginning of clinical years. My first attachment was Ear, Nose and Throat Surgery. I was dreading surgical term. I had heard about early starts, late finishes, bossy bosses. Fortunately my registrar was also a mum. When I told her I hated the fact that I was going to miss my son’s first day of school because it coincided with my next attachment she told me to promise her I would go no matter what – it was too important to miss. She was right. I went and I still got to the first day of orientation on time with everyone else. Had she not been my registrar, I probably would not have gone, as I would have been too worried about being a truant.
This was when I learnt Lesson Number Three – Quality of time, rather than quantity with the kids is what is important. There is always a way to make time for the kids for the big stuff (and the little stuff every now and again too). Maybe I got lucky throughout my clinical years in so far as that my supervisors were generally understanding. However, I think the real reason is that supervisors can tell if you’re working hard and if you’re genuine. I always tried my best when I was with my teams so I never felt like I had to apologise for being a mum. Other mums will say that prioritizing the important home commitments and study commitments goes a long way in feeling secure as a mother and keeping up with the demands of the course. You cannot be at everything your child does but you can make them feel like you were around for the important things. In addition, it works both ways as you have to focus on maximising quality experiences and learning on your attachments. You don’t necessarily learn more by spending countless hours on your attachments but you might be a better student the next day because you’ve had some time to appreciate your home life. Having so little precious time with the kids means you also make the most of every minute, which means more memories, more outings and more fun. Sundays at the beach, park or bowling, rather than studying – yes please!
In fourth year I spent a lot more time on campus making sure I studied more and got the most out of my attachments. The kids were easier at this point. School life was stable, they knew where mum went everyday and when I get home in the afternoon. I would be greeted with little running footsteps after I knocked on the door. Highlight of my day – everyday.
Which brings me to Lesson Number Four – Never discount other people’s struggles. It is easy to say that your stress as a mum is bigger than the stress of someone else that does not have kids. As doctors we will talk with and counsel people daily on their problems. Comparing their problems to your own stunts your ability to empathise. No one’s stresses are less or more challenging than your own – they are simply their own. Many students work throughout their degree at night and on weekends. I am blessed that my spare time is filled with park trips and playing games.
And finally Lesson Number Five – Every student with children is getting through it in their own special way. For my family we got very used to our routine (or lack of routine). The constant change that came with eight-week block changes actually feels like stability after a while. But every family finds their own rhythm in the course, ways to feel connected to their kids, and people who they can lean on for support whether it’s partners, parents, grandparents or friends. Like all medical students it’s the support network around you that makes the difference in getting through each year.
Yes being a mum in medical school is hard. I anticipate that being a doctor as a mum will be harder but I have met countless women doing the same thing and know my family and I will adjust as we always do. In first year I went to a lecture where a panel of female doctors spoke to the female medical students about being a woman in medicine. One of the questions from the audience was “what is the best time to have a baby as a doctor”. I cannot say what it is like to have a baby as an intern, resident or registrar, but my answer to this question would be that during medical school, although it seems like nothing could be harder, it is probably one of the most flexible periods of your life. But really, while planning for a pregnancy is important, if you are ready things will generally work out no matter where you are in your training. Being guided by your personal choice will allow you to know when it is the right time in your life.
Writing at the end of four years studying medicine there are endless reasons to say why it was hard – the hours, the content, the examinations, the examiners, the facilities, the placements, the holidays. But really at the end of four years, it has taken just one month for it all to seem a distant memory. A faded horizon that I am slowly walking away from, with a fuzzy nostalgia obscuring the skyline. Not many people can say they spent the first six months of their medical degree expressing milk on their lunch break, but I can, and I think that is an achievement in itself. People always ask me how have I done this with two kids, and the answer will always be I would not have it any other way.
Originally published: Dec 13, 2015
I wrote this blog just before starting Internship, a little over a year ago, giving advice on being a mum in medical school. Not much has changed from being a working mum in medical school to one working as a junior doctor. One thing that’s improved is not having to study at home or at night after a long day. Though I think this will be short lived with specialty training applications, exams and programs fast approaching.
More than ever I value quality rather than quantity of time with the kids. Partly because I now have even less time with them.
The starts now are earlier and finishes are later. And there’s.…night shift! Though for me, night shift has its advantages. I see the kids a lot during night shift weeks, essentially getting home for breakfast and school drop offs plus having a normal dinner time – the kids are asleep while I’m working so it seems like I’m home all the time, and then you get a few lovely days home to spend together.
The lesson of being present has been an important one. There have been countless days where I’ve been exhausted, haven’t had time to eat, have been affected by patients or the workload. But coming home to my family helps me to relax, release and recharge for whatever the next day brings. Being home and being present at home goes a long way in reaching that ominous ‘home life balance’ junior doctors are always told about.
I do not think anything could prepare my family and myself for the challenges of juggling working as a doctor but we adjust and move forward and I know there are many more lessons to come!