In Financial Planning
Helping physicians take control of their household finances.

As many of you know, the residency match is completely unpredictable. Some graduating medical students will move closer to family, while others might have to move several states away from home. The latter scenario can definitely be a challenge if you have kids.

So, what do you do if you have children, a spouse who works, and you’re far away from home? And, how can you find quality, yet affordable, childcare that will accomodate the intense schedule of a resident?

It might seem impossible, but it’s not. Below are a few ideas.

Hire an Au Pair

An au pair is a nanny who comes to live in your home from another country for a set period of time, usually a year. There are many different agencies who can match you with an au pair. Some of the most popular ones are Au Pair in America and Interexchange. Keep in mind, this is also a great way to have your children learn a second language early on.

Au pairs can work flexible hours up to a certain amount each week. So, if you have to work on a Sunday but you’re off on a Monday because you’re post-call, you can ask your au pair to work on days that you need her to.

You will have to provide food, housing, and some educational costs for your au pair. So, before making this decision, sit down and run the numbers, comparing the cost to hire an au pair with the cost of putting your children in daycare. Chances are, if you have more than one child, an au pair can be a wise financial choice.

Use a Day Care Affiliated With a Hospital

Many hospitals have daycares on campus, and these daycares are familiar with the unpredictable schedules of physicians. These daycares are often open early and stay open until late.

If you are still in medical school and you know you want to have children in residency (or already do have children,) make this a part of your residency program research.

Find out which hospitals have daycares on site, what their hours are, and what would happen if you need them to watch your children later than usual.

Many hospitals offer a reduced rate on childcare costs for their employees if they use their on site daycares, so this is a great option for many residents.

Seek Out Flexible Jobs

My friend, Catherine Alford, is a wife of a second year resident and the mother of 3 year old boy/girl twins. (And, she’ll be a guest on my podcast in a few weeks, so don’t forget to tune in!)

Cat spent time building a blog with the goal of becoming self employed when she became a parent. She knew that she wanted a job she could take with her anywhere since she had no idea where her husband would match for residency.

Today, her blog and freelance writing business now produce a full time income, but she only pays for 25 hours of childcare a week.

Because she can work when her young children nap and after they fall asleep at night, she’s been able to manage her freelance clients while being a mom too.

Of course, becoming a blogger isn’t the only flexible job in existence. Spouses of residents who have kids can learn new skills, like graphic design and coding, and learn how to build businesses during their off hours.

I personally enjoy being an entrepreneur because of the flexible hours. I can speak with my physician clients in the morning, pick up my son from pre-school, and work more at night after my children go to sleep.

My wife and I have found a way for her to pursue her career as a pediatric pulmonologist and me to grow my financial planning practice. With the help of family (we had no family near us in residency so moved closer to family after fellowship,) we’ve been able to save on childcare cost, hire part time babysitters, and find a way to make it all work.

Ultimately, the residency lifestyle isn’t an easy one, but if a non-physician spouse can find a way to build a flexible career or work remotely for a company, that can go a long way in reducing childcare costs.

Consider Living Apart

While living apart from your spouse and your kids is definitely not preferred, sometimes it might be necessary.

I know a married couple who are both residents. The husband pre-matched in psychiatry in New York City, which guarenteed him a residency spot. However, his wife wanted to match general surgery. Knowing how unpredictable their schedules would be with two residents in the family, his wife purposely ranked programs in her home state of Florida first.

She matched in Miami, which is what she wanted because her mother and extended family help take care of their little boy. They are in now in their second year of living apart, and they are surviving. But, it’s not easy. Still, these are the hard decisions some families have to make to ensure their kids get quality childcare during the grueling training years.

Build Your Own Village

Lastly, it’s important to remember you’re not alone. There are many people in your area who have a spouse and children while enduring residency. It’s important to build your own village when you’re not close to your own family.

I’ve befriended many men via the DMD Facebook page, a private Facebook group just for dads married to doctors. There are similar private Facebook groups for women. One popular one is called Lives of Drs Wives.

You can even form your own spouses group at your local hospital. By meeting other people married to doctors, you can work together, exchange babysitting for those rare date nights, and even get recommendations of nanny’s, babysitters, and daycares from other residents who are further along in their journey.

Residency can be very isolating, so be sure to tap into your village to find out some of the people who are living similar lives to the one you are.

What type of childcare options did you use in residency? Or, what advice do you have to current parents going through their residency journey?

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