child care – The Health Care Blog

Residency and Parenting Are Incompatible

Apr 22, 2025

By EMILY JOHNSON

Being a parent during residency requires one or more of the following:

● Family and/or friends nearby who are willing and able to provide free childcare

● A stay-at-home spouse/co-parent

● A spouse/co-parent who is willing to let their own career to be a distant second priority beneath family responsibilities and the resident’s career

● Significant amounts of generational wealth that allow you to outsource household and childcare obligations with money you didn’t personally earn

● High levels of financial risk tolerance and willingness to incur extraordinary levels of debt above and beyond average medical school debt ($234k!).

Because medical residency in the United States is incompatible with being a parent.

It is a Sunday evening, and I am writing this as I wait for my husband to get back from the hospital. He was “on call” today, which, in lay terms means his work hours were “all day.” He was out the door before I woke up, and it is now 9:30pm and Find My shows that he is still at the hospital. So that means he’s on hour 15 or 16 of his workday, and he could be leaving in a few minutes, or he could be there for another few hours (and I have no idea which).

I do know he got at least a 15-minute break today, because our toddler and I went to the hospital today to have lunch with him. Why interrupt his workday, drag a toddler across town right before nap time (thereby risking the loss of my cherished mid-day downtime because of the dreaded car nap), and pay for parking and mediocre cafeteria food on a Sunday? Because if I hadn’t, I truly don’t know when my son would have seen his dad next.

This pattern – out before the family wakes up, back after bedtime- is the rule, not the exception. An “early” day might mean he gets out before 7pm – but that doesn’t guarantee that he’ll see our toddler, who goes to bed between 7 and 7:30pm.

As a medical spouse with a young child, of the most infuriating comments I ever hear is among the lines of “but don’t they cap work hours now?” Or even worse – the occasional insinuation that perhaps today’s residents have it “too easy” because of work hour restrictions. Because the answer is yes – work hours are technically capped at 80 hours/week – but let’s talk about that:

First, here’s what an 80 hour/week schedule looks like, in case you haven’t worked one lately:

	Mon	Tues	Weds	Thurs	Friday	Sat	Sun
Start	6:45am	6:45am	6:45am	6:45am	OFF(but studying for upcoming board exam)	6:45am	6:45am
End	8pm	6pm	5:30pm	8pm		8pm	10pm
Total Hours	13+	11	11	13+		13+	16 (and counting)

Total: 77 + study time (Bingo! No problems here! Under 80 hours/week)

Second, from a caregiving perspective, an 80/hour week cap is laughable, because you can still miss 100% of a toddler’s waking hours most days of the week on an 80 hour/week schedule.

The Kids Aren’t Alright

Nov 23, 2021

By KIM BELLARD

America, like most cultures, claims to love and value children, but, gosh, the reality sure seems very different. Three recent reports help illustrate this: The Pew Research Center’s report on the expectation of having children, Claire Suddath’s searing look at the childcare industry on Bloomberg, and a UNICEF survey about how young people, and their elders, view the future.

It’s hard to say which is more depressing.

———

Pew found that the percentage of non-parents under 50 who expect to have children jumped from 37% in 2018 to 44% in 2021. Current parents who don’t expect to have more children edged up slightly (71% to 74%). The main reason given by childless adults for not wanting children was simply not wanting children, cited by 56% of those not wanting children. Among those who gave a reason, medical and financial reasons were cited most often. Current parents were even more likely – 63% – to simply say they just didn’t want more.

This shouldn’t come as a huge surprise. Earlier this year the Census Bureau reported that the birthrate in America dropped for the sixth consecutive year, the largest percentage one year drop since 1965 and the lowest absolute number of babies since 1979. It’d be easy to blame this on the pandemic, but, as sociologist Phillip N. Cohen told The Washington Post: “It’s a shock but not a change in direction.”

In many ways, having children seems like ignoring everything that’s going on. We have a climate change/global warming crisis that threatens to wreak havoc on human societies, we’re still in the middle of a global pandemic, and our political/cultural climate seems even more volatile than the actual climate. One Gen Xer told The New York Times: “As I think of it, having a child is like rolling dice with the child’s life in an increasingly uncertain world.”

Yikes.

Take Your Mom to Work

Aug 12, 2020• 1

By KIM BELLARD

If you are a working mom, or married to one, or simply know one, you know that it is tough to balance a job and raising a child even under ideal circumstances. Even if she has a supportive spouse, chances are that it is the mom who ends up providing the most child care, and whose career it impacts the most.

But, of course, these are not ideal circumstances. Prior to the pandemic, women had made great strides in the workforce; more women had payroll jobs than men, for example (although they continued to be paid less for them). Those gains quickly came crashing down once the pandemic hit. It is believed to be the first time that job and incomes losses have hit women harder than men. Some are calling our pandemic-driven economic downturn a “shecession” as a result.

That’s bad enough, but the even bigger danger is that the pandemic could set back women’s careers for a generation.

A recent study by Collins, et. alia confirmed what most might have guessed: in the wake of the pandemic, women are more likely than men to have reduced their work hours to take on additional child care responsibilities due to school/daycare closing — four or five times as much.

The study found that:

Scaling back work is part of a downward spiral that often leads to labor force exits—especially in cases where employers are inflexible with schedules or penalize employees unable to meet work expectations in the face of growing care demands.

We are also concerned that many employers will be looking for ways to save money and it may be at the expense of mothers who have already weakened their labor market attachment.

Even more worrying, lead author Caitlyn Collins, a professor at Washington University, says: “Our findings indicate mothers are bearing the brunt of the pandemic and may face long-term employment penalties as a consequence.”