Long before she became a dean, or even a doctor, Suzi Rose, MD, MSEd, was a young medical student, about to add a new role to her eventually long list of titles: mother. It’s a challenging choice for many, but even more so for those who choose to combine parenthood with a burgeoning career in medicine.
“I was the only student in my class to have had a baby during medical school,” notes Rose, who’s now senior vice dean for Medical Education in the Perelman School of Medicine (PSOM) at the University of Pennsylvania. “There was no infrastructure to support the advancement of the curriculum, and I was lucky to be able to figure it out on my own. I would like to think this has changed, and the support for students is more widespread.”
As today’s medical students would say, the struggle is (still) real, but juggling parenthood and studying is a lot easier with the formal support structures that Rose and her colleagues have made, as well as the informal ways in which student parents support each other.
Rose had her first child in 1985 as a fourth-year medical student, during the three-month window between graduation and residency. Caring for a newborn in this situation required, as Rose puts it, “incredible support, backup plans, and flexibility.” (In those days, as a new internal medicine resident, she was on call every other day or every third day, and didn’t get a full day off for seven months!)
Luckily, her family was able to depend on her husband as the main caretaker, through several moves as her career advanced, with the assistance of live-in nannies and au pairs as well as babysitters. Rose also benefited from the kindness and understanding of her bosses, including professor of Clinical Medicine James Reynolds, MD, AGAF, FACP. He was chief of Gastroenterology at the University of Pittsburgh when Rose, fresh off of her fellowship, joined Pitt at the same time she had her second baby. “I felt the pressure to embark on a new job with professionalism, and unfortunately only took about 10 days off before going back to work,” she remarks, adding, “That was on me, and not Dr. Reynolds!”
Building Support Systems
Thankfully, in the years since Rose began growing her family, many things have changed for the better. The Family and Medical Leave Act became the law of the land in 1993, giving many employees in the United States the right to take time off to care for a new child in the family, with benefits protected, and to return to their job. Additionally, the Patient Protection and Affordable Care Act, enacted in 2010, not only required insurers to cover breast pumps and breastfeeding supplies, but also mandated that many employers provide reasonable break time and private space for staff to express breastmilk. Some employers also offer tax-advantaged dependent care flexible spending accounts that can be used to pay for daycare or other childcare expenses.
At PSOM, students have gained supports, too. Those adding children to their family are encouraged to take advantage of not only family leave but can also consider a transition of the family leave, when ready, to a scholarly leave. During a scholarly leave, a student is engaged in full-time scholarly work but there may be more flexibility with time and autonomy of the schedule, which can be more accommodating for the demands of parenthood than clinical work in the full-time required curriculum which has a more prescribed schedule. The Jordan Medical Education Center — PSOM’s medical education space — is home to a lactation pod which provides a clean, comfortable, and private place to people expressing breastmilk or nursing children. PSOM’s Student Affairs has also further expanded its resources for students who become parents. And the Family Resource Center at Penn has been providing resources to PSOM students and postdocs with children since 2010, such as emergency back-up child care and free Care.com memberships, family-friendly and parenting events specifically designed for student and postdoc parents, and more, at their 3615 Locust Walk facilities. All of these resources are helpful to students who choose to become parents, such as 2022 graduate Kirsten Sandgren, MD, who is now a first-year Psychiatry resident at Penn. She is mom to 3-year-old Imogen (aka “Mo”) — who arrived at the transition from preclinical learning to clerkships — and “fourth-year baby” Mirren, who’s quickly approaching her first birthday. After Mo’s birth, Sandgren was able to work on a master’s degree in Bioethics and participate in research through the department of Otolaryngology before returning to her medical degree program. She credits the school and in particular, retired PSOM registrar Helene Weinberg for helping her plot a course to balance her family and personal needs with her medical education. “I am sensing a move toward more proactive support of parents, and I think it’s very exciting that there may be more matter-of-course institutional support moving forward,” she says.
Doreen Lam, a fourth-year student, similarly found a wealth of institutional support that helped her balance her studies with being a mother to Siena, who was born in Spring 2021. “For example, the Registrar’s office was able to accommodate clerkship scheduling requests to ensure I could avoid the emergency department during the 2020 winter surge before a COVID-19 vaccine was available,” she reports. Lam’s advisors have helped her schedule clerkships and electives in consideration of her parental responsibilities. In addition, she felt supported by residents and attendings both during pregnancy and upon her return from maternity leave: “Having children during medical school remains uncommon, but the reality is that many attendings and residents also have children and understand the challenges that come with childcare or pumping.”
Student parents also garner support from networks of peers. For instance, according to Lam, an informal group of PSOM students and recent graduates, all of whom are parents, is a reliable source of advice on balancing studying with parenting, recommendations for childcare providers and pediatricians, hand-me-downs, and general commiseration. “It's a group that has grown over time, and has hopefully helped normalize the notion of medical students becoming parents,” she says.
Indeed, agrees Sandgren, “Hands down the most invaluable support I have found is from other parents in the medical school, and that's something I've tried to pay forward whenever I can.” She talks about medical school administrators who shared their cell phone numbers for new-parent questions and offered to pass on items their own kids had outgrown. Sandgren also leaned on Dr. MILK, a Facebook group (not specific to Penn) of medical students, trainees, and physicians which discusses lactation; and the Penn Family Resource Center for providing a place to nurse or express milk, programming and books, and access to a service for finding caregivers.
Work in Progress
As much as PSOM has improved in its support of student parents, there is still more to tackle.
“Our work in this area will never be done,” reflects Rose. “I am passionate about this because family is key to me.” Her mission is to remove as many obstacles as she can to help students pursue the career they’ve dreamed of, while simultaneously enjoying their family life.
“That involves flexibility in the curriculum, but without any compromise on the rigor of training — what we call compassionate education with rigor. We need to work closely with our students to meet their personal as well as their professional needs, and that will take continuous consideration of the educational environment, support, and identifying needs and gaps for our learners.”