Work-Family Balance During Training: Advice from a New Mother

Written by: Joanna Spencer-Segal, MD, PhD
Published on: Feb 18, 2016

Work-Family Balance

Over the past two months, I have been at boot camp.  No, not for grant-writing or board review, but baby boot camp!  Our son was born in August, and as of this writing, I remain on maternity leave. 

It is common and wonderful for trainees to consider starting a family before their training is complete.

When expecting a child, you must make many choices about your training and career goals surrounding the birth.  This difficult task involves estimating your future needs, which in many cases may change as things progress with or without unanticipated complications to your health and your personal life. 

You will receive plenty of solicited and unsolicited advice as you go through this process.  Here is some from my pregnancy and first few months of motherhood.

First, know what privileges your contract or program grants to all pregnant women and new parents.  Are you automatically entitled to reduced work hours during your third trimester?  Do you have access to paid child care leave?  Do you have the ability to return to work part time?  Start early in researching this.  I also suggest familiarizing yourself with the Family and Medical Leave Act policies, which can be found at

Scheduling Challenges

Remember that you do not have to make the same choices as your closest colleagues or the most recent graduates of your training program.  There is often (though unfortunately not always) at least some flexibility to the standard leave offered to university staff, particularly if you are willing to take unpaid time off.  Speak to many others about their experiences to learn the range of possibilities before deciding what is right for you. 

You may face an uphill battle in arranging a child care leave, particularly a non-standard one.  It involves administrative work and interruptions to training schedules, and potentially inconveniences other trainees.  The latter can be particularly difficult for clinical trainees, but return the favor in good spirits for your colleagues in the same position, and it will work out fine.  Be firm and persistent in your requests for the time off that you need for yourself and your family.

Many trainees have concerns about the consequences of delayed training.  Having children will often delay the completion of your training or your tenure clock, by a few weeks to a few years depending on your choices.  As women become a larger part of the medical workforce, these “delays” will become so common as to be standard, and you will not feel “left behind” compared to your colleagues.  Check back with me in a few years about this, but I have a hunch that the rewards of spending time with my son will far outweigh a few months of delayed training. 

During pregnancy, many women need more medical attention than they ever have before.  A pregnant woman needs to be especially attentive to her own physical needs.  This can be challenging for clinical and research trainees alike, who in many cases are accustomed to skipping meals, spending all day on their feet, and working up to 80 hours a week on irregular schedules.  You may find it physically impossible to carry out the duties assigned to you and, in that case, do not hesitate to make changes to your schedule, or even to start your leave early if necessary.  You may fear that this is not possible, but once you speak up you will find that it is common. 

Combining a fulfilling career with a family is possible, but flexibility is key as you respond to the changing demands of your personal and professional lives.  As for me, I arranged a four-month leave from my fellowship training program in Michigan to be with my husband and son.  I write to you from Florida, where my husband’s work is now based, and where the three of us are enjoying these precious few months together.  More from me on the challenges of dual career families in a future column. 

I welcome your comments and questions at

Joanna Spencer-Segal, MD, PhD, is a second-year clinical fellow in Metabolism, Endocrinology and Diabetes at the University of Michigan, where she participates in the Physician Scientist Training Program in the Department of Internal Medicine.