Fertility and Medical Education

I want to have kids young and I want to get married young. This is a strange thing to hear from a twenty-two year old in 2019. “Don’t you want to live your life and not be tied down?”, “You have to be established in your career first.”. Other women look at me as if I am telling them I want to be a housewife and I’m setting the feminist movement back sixty years. These are the types of comments I get from my friends. The same friends who at twenty-two are done with school, begin their careers, and start living their adult lives.

I want to go into medicine. The research and clinical experiences that I've had have made me even more excited to go into the field. There are so many basic science, clinical, ethical, and logical questions to be explored in medicine. I am so intellectually stimulated and motivated that I am now at this point where I don’t think I can live without medicine in my life. I say this because time and time again, I try to convince myself not to do it, and I can’t.

I have the basic concerns of student loan debt, length of training, overt inequities in the field, realities about the medical-industrial complex, disadvantages faced as a woman, a first-generation college student, and a child of immigrants. From these viewpoints, I have weighed the pros and cons and I still choose medicine.

But one factor that I cannot reconcile is not being able to have kids until much later in my life, or not have kids at all.

When I was in high school and throughout most of college, I had a plan of graduating college at 21 (I have a late birthday), finishing medical school at 25, and finishing my three-year pediatric residency at 28. I thought I would get married and have a baby during that time (possibly during medical school or residency). But that was before I ended up taking two gap years before medical school, and developing a passion for cardiology. Now my plan is graduate medical school at 27, finish internal medicine residency at 30, finish cardiology fellowship at 33, and possibly do another fellowship and ultimately finish training at age 34. Then I will have to take a few years to “establish” myself in the field before I can have a baby. And that’s if I don’t have to take any additional research years to become a more competitive candidate.

I’m still very young and I am inundated with older adults telling me so all the time. But with my young age, I recognize that I can be short-sighted and too focused on one goal at a time and not clearly look at the big-picture of my life (both personally and professionally).

My wanting kids in my twenties is a preference. Just like women who want to wait until their thirties or forties, or women who do not wish to have kids at all.

This is what people want for their lives and that is perfectly fine. But it seems my wish for how I want my life to pan out may be next to impossible. I know myself and my personality and I know that if I am in school or training, I will not risk having a child and not giving that child the attention that he/she deserves.

I always had these concerns and anxieties in the back of my mind, but they didn’t become realities until I read an article in Time magazine by Dr. Arghavan Salles.* She wrote an emotional piece discussing how she spent her fertile years training to be a surgeon and putting her personal life on hold. Now that she is thirty-eight and ready to have a child, she is struggling to get pregnant with IVF. I don’t mean to cause any distress or offend anyone struggling with infertility in any way, but I was sobbing as I was reading that article, imagining myself in her shoes. I would be completely and utterly devastated if I wasn’t able to have my own biological children. I am well aware that there are other ways of having children and being happy and fulfilled, but again, wanting biological children is a preference, just like wanting or not wanting children is a preference. There is nothing wrong with any option and is up to each individual person.

So I wrote this piece in order to ask this community of brilliant and inspiring physicians what your journey was like. I don’t believe I can possibly balance being a medical trainee and a mom at the same time. Other women have done it, but I don't think I'm cut out to do both and be a superwoman like all of you moms out there. For those physicians struggling with infertility, looking back, was it worth it? Will it be worth it for me? What advice would you give young trainees for whom having children is a top priority in their lives just like medicine? Should I choose a different career such as Physician Assistant?

*If you are interested in reading Dr Salles' article, I've linked it here: https://time.com/5484506/fertility-egg-freezing/

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