One advantage of childbearing or parenting during residency, compared with medical school, is that you will have some income to pay for child care, even if it is a fraction of your future salary. Otherwise, it’s hard to identify many professional upsides to having a baby during residency, especially internship, as compared to other times during your medical career. As mandated by the Accreditation Council for Graduate Medical Education (ACGME) since 2003, resident physicians in all specialties can work a maximum of 24 hours in a row and they cannot work more than 80 hours per week. Most residents will spend a striking proportion of their residency training working close to the maximum. As a resident, you will have little control over your schedule, frequent overnight call, and significant sleep deprivation from working very long hours. Now re-read the previous sentence in the context of parenting. As the mother of an infant, you will have little control over your schedule, frequent overnight call, and significant sleep deprivation from working very long hours. In fact, many physician-mothers have said that the first year post-partum was more exhausting than internship, which makes it hard to imagine combining these experiences.

If the physical exhaustion weren’t enough, residency is packed with emotional stressors such as being newly responsible for high-stakes clinical decisions and potentially life-threatening mistakes as well as bearing witness to suffering and death. Fatigue, emotional stress, and inflexible schedules can threaten the milk supply of even the most dedicated breastfeeding resident.

In spite of the physical and psychological demands of the first few years of being a doctor, many residents with young children are successful at saving some emotional energy for their families (DeJong, 2001). Some physician-parents feel that having children during residency worked well for them, since their infants primarily needed physical care, which could be provided lovingly by other family members or childcare providers. Older children notice their parents’ absence more and require more emotional availability, which may be easier to provide after residency is over.

A recent qualitative study of women in a Canadian family medicine residency program highlights some of the major challenges of combining motherhood with residency training (Walsh, 2005). The study showed that long hours, unpredictable work demands, guilt over increasing colleagues’ workload, and high personal expectations caused severe stress for pregnant residents. Both pregnancy and early parenting were made more stressful by the long and unpredictable hours of work, sleep deprivation, guilt due to absence from work, psychological pressure to avoid “giving in” or “asking for help,” and occasionally, unsympathetic faculty. The residents in this study experienced more support from colleagues and supervisors during their pregnancies then they did post-partum as new parents. The major challenges associated with returning to residency training after having a baby were fatigue, breastfeeding difficulties, and caring for sick children.