Work Life Balance in Medicine

Last week I received this thoughtful comment that I wanted to share with you guys, and instead of my usual skinspiration Monday post, I wanted to share my response to how to achieve work life balance in a medical career. This is a question I had while training and I’m sure many of you out there have too. I want to point out that I’m still trying to figure out work life balance myself, but I hope that sharing these thoughts will help some of you who are deciding whether or not medicine is the right path for you.

Question (edited for length)

Hey Joyce

I was wondering if you have any advice for me in my situation based on your experience on the road to become a medical professional.  I am worrying about the balance with my personal life that I may not have as a doctor. Is it possible? Am I cut out for it? I’m a male and have been told that it is much easier for a male since they are not usually the ones taking care of the household. However, that factor is important to me and I want to be there for my wife and children and be a present figure in there lives.

know there are specialties that claim to have a nice balance, but what if that is not a specialty I am interested in? What if I fall in love with a field that requires a lot of time out of me? Is it worth pursuing if it means it will affect time with family despite my interest and liking for the field? Or are doctors able to have more control over their hours than what I may think?

My thoughts

Dear Mark,

First of all, thanks for asking such a great question. Oftentimes in the path to medicine, discussing lifestyle is a taboo subject. However, why in the world should we feel bad for considering family and personal life into our decision to become a doctor and in deciding what kind of physician to become?! You are ABSOLUTELY RIGHT to start thinking about these important considerations early on.

It’s true that becoming a doctor takes a lot of sacrifices. It’s a lot of time spent in school (~4-5 years of medical school and ~3-10 years of residency depending on the field) and a huge financial investment. If you want to be in the medical field but have shorter training, alternative occupations include becoming a physician assistant (PA), nurse (RN), or nurse practitioner (NP). My advice to decide between all of these roles is to talk to PA’s and nurses and NP’s and see what their lives are like at work and at home. Also, shadow nurses, PA’s, and doctors to see how their roles are different and the level of autonomy they have in their day-to-day jobs. If you have doubts, try to explore all the possible alternate career paths. At the end of the day, if your heart is set on becoming a physician, then I say go for it. 

The time demands and sacrifices vary depending on your level of training. In the first two years of medical school you will be mostly studying and working on research or other extracurricular activities. In your 3rd and 4th years of medical school you will be working long hours on inpatient rotations and trying to study afterwards and on the weekends. As a resident, quite frankly, you will be working hard no matter what field you’re in. But you want to work hard as a resident because those years are your opportunities to see everything you can and learn as much as you’re able to in order to become competent in your field.

I’m still a resident, so I cannot speak for what life will be like as an attending out in practice. That is a huge caveat, because maybe you’ll ask me this question again in 10 years and I’ll have a totally different answer. But from what I’ve seen and experienced so far in my medical school and residency, some fields are definitely more family friendly than others. In general, fields that are mostly outpatient or mostly shift work tend to have more controllable schedules. In dermatology or ophthalmology, for instance, you see patients mostly during clinic hours, which is typically 9 am to 5 pm (for the most part you can set your hours as well). Dermatology tends to have fewer emergencies, so you will not be on call much, meaning you won’t be called into the emergency room after hours to see a sick patient. Some of my friends in emergency medicine work a set number of shifts (~12-15) per month and while their time in the hospital is stressful and busy, they get the rest of the month free to do what they want. In inpatient medicine, some hospitalists work 2 weeks on, 2 weeks off. In contrast, in fields that do require you to be on call after hours, such as surgical fields, ob/gyn, or intensivists working in the ICU, it is more likely that you may have to go to the hospital during your off hours to attend to medical emergencies. Many of these attendings take call in shifts as well, so it depends on your call schedule to see how often you may need to go into the hospital after work. If as a medical student you fall in love with fields that require you to be on call, then you have to decide, is your love and intellectual curiosity for the field enough to surpass the possibility that you may have to go into work during time with your family in the future? It’s a really hard decision to make in your 20’s.

Financial reward also plays a factor into what field may be the one for you. Everyone has his or her own unique situation when it comes to finances. Things to consider include how many loans you’ll have from medical school, whether or not you’ll have a spouse and will that spouse be working and how much will they be contributing, how many children you have, the cost of living where you settle down, just to name a few. These can also play a role in which field is the most attractive to you.

For more information on choosing your specialty check out my more inclusive post here which goes over many factors you should consider other than lifestyle and financial considerations that I focused on here due to Mark’s question.

The best advice I have for you at your stage is to find physician role models at different stages of life whose professional and family lives you admire and want to emulate. Reach out to doctors at your institution or local neighborhood and see how these practicing physicians balance work and family life. Find doctors whose personalities and professional goals match yours, and see how they live their lives in these specialties. Ask them if they’re happy, do they have time for family, do they still love their jobs, and would they choose this specialty again if they could do it over? You may be surprised; a field that you may not be interested in at the beginning may suddenly become more interesting if you have a role model who is very excited about it and shows you why they love it. This is the best way in my experience to gain insight into whether one specialty is the right future professional and personal fit for you.

Some interesting reports and data from online surveys that may offer additional information beyond what you can find from talking to attendings:

2017 Medscape Lifestyle Report

If the survey respondent could choose their path again…

2017 Medscape Physician Compensation Report

1st Doximity Physician Compensation Report 2017

For all the other physicians out there, how do you manage work life balance?