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Starting a Family at Different Stages of Training

Starting a family can look different depending on your stage of training. Some of these considerations are detailed below.

Your Family Plan

While the table below outlines practical aspects and considerations for starting a family at different stages in a medical career, it also also important to consider your own family plan and how your age may impact your fertility (if this is relevant to you).

Anchor 1

What does starting a family look like in...

Anchor 2

Advantages

Considerations

Medical School

  • Depending on timing, may be able to use summers as leave and not extend training

  • Can be considered "low stakes" in comparison to other stages of training

  • No responsibility for patient coverage while on leave

  • No source of income 

  • During pre-clerkship years, more challenging to take parental leaves that are less than one year

  • May only participate in CaRMS provided that medical school is completed before July of that year

  • Challenges when returning to school to balance parental obligations and expectations as a student (i.e. no vacation, exams etc)

  • May not be as many peer mentors who have children

Residency

  • Depending on province, EI top-ups for varying lengths of time are available

  • No responsibility for patient coverage while on leave

  • Flexibility in length of leave

  • Possible extended health benefit coverage (i.e. fertility medication, breast pumps)

  • Possibility of organizing rotations to have gradual/lighter return-to-work

  • Returning to work can allow for skill-building in a supervised environment

  • Break in training may temporarily impact skills/knowledge

  • Attitudes towards taking leave can be program/director dependent

  • Residency is thought of as the "busiest" stage of training

  • Need to study for exams

  • lower income in comparison to staff/fellowship to support a family but higher income than in medical school

Fellowship

  • Depending on type of fellowship and province, EI top-ups for varying lengths of time are available

  • No responsibility for patient coverage while on leave

  • Possibility of organizing rotations to have gradual/lighter return-to-work

  • Flexibility in length of leave (depending on program)

  • Returning to work can allow for skill-building in a supervised environment

  • May have a higher income than in residency

  • May be eligible for provincial benefits if you have an independent practice license (salary or billings will count towards income)

  • Fellowships may be Royal College Accredited or not

    • If a fellowship is Royal College Accredited - it will be treated as an extension of residency which means you will have all the same benefits as within a residency program and will be covered by your provincial union

    • If a fellowship is NOT Royal College Accredited - the supports will be more variable

  • Flexibility in time off is more variable than in residency

  • Often able to obtain an independent practice license and make extra income moonlighting

  • Need to study for exams

  • May not be eligible for EI if you are an independent contractor 

Staff

  • Higher income to support a family

  • Some parental leave support through provincial government 

  • Length of leave flexibility is dependent on your physician team

  • May have extended healthcare benefit coverage for fertility treatments (OMA OPIP $7000 fertility medication coverage) 

  • Income on leave may be lower than you have become accustomed to with a usual staff-level income

  • Patient roster to hand off or find locum for

  • Return to full responsibilities after leave

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