It is hugely hugely difficult. I take my hat off to those of you having to balance young children, on-call rotas, shifting from hospital to hospital and having to do all the additional publications, QIPs etc in no time.
Are you on DNUK? It is worth posting on The Couch. There will be good advice from people who are still in training, who have popped out the other end, or who have left medicine. The recently demitted LTFT rep to the BMA is very active on there, and so is one of the current co-chairs.
It is worth seeing if you can get some support via the Deanery. There is access to life coaching through the PSW usually. Do you feel you can approach your TPD to access this? Some Trusts also have a consultant responsible for careers support.
Nobody can tell you what to do, but these can be useful resources when you are making your decisions.
I didn’t have my daughter until I was already well established as a consultant (not the plan, but that’s how life worked out), so I don’t have a comparable life experience, but I’d add these points, which are my personal thoughts and opinions only.
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If you do stay in medicine, it will not always be like this. There is more stability and control over your job plan when you take a substantive post, whether as a consultant or not. Even the fact that you are not having to make new childcare plans every year will help.
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children have two parents. One career does not have to trump the other. At the moment you might have to play “clinic, theatre, on-call” top trumps, but your other half could go LTFT as a consultant. Depending on the trust, they may be happy for him to shift SPA work out of the hospital, which would free him up for childcare, even on a full-time contract. (There also seems to be less and less benefit in being more than 10 PAs too)
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I think you said that you are 60% LTFT, so it can’t be cut back further. It is possible to step off the training wheel, either temporarily or permanently, without having to leave medicine, or even your speciality. For one, there is OOPC which might give you the breathing space to work out how you want to proceed.
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I know that you have mentioned that it is not possible to retrain in another field. It really is. It isn’t usual, but it is certainly not rare for people to change specialities. If you feel that surgical life is just not going to be possible, it is possible to change. Yes, you will need to go back a few steps, but at ST3, you really are still at the beginning of higher specialist training. Not saying this to belittle where you are - it is a huge achievement to have won a London surgical training number - but more to say that you are a long time a consultant, and there really really is no rush. I do appreciate that your training has been and will be longer for going LTFT. There are different challenges, different anxieties and different frustrations on the other side of the CCT.
There are also many roles in medicine that are more family friendly, but they are often in specialties that we never think about as we don’t spend much time in them when training.
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In the nicest possible way, you need to be absolutely sure that if you leave medicine that it is the right decision for you for the long term, because you are right that it is highly unlikely for there to be a way back into a surgical career after a long career break. You do not want to resent your children in time. I did not intend to have my child so late. However, because the way the cards fell, I knew that I did not want to be a Prof, or President of my royal college or my speciality society or other similar national role. People might say that I have become much less ambitious, but I know that these paths are closed to me because I have chosen not to follow them because I want to spend more time as a mother , not because becoming a mother closed those doors.
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As doctors, we are all conditioned to be high achieving and uncompromising, with our eyes firmly lasered in on the next hurdle. Most of us have never failed anything or ever not been a successful. Most of us have just accepted that you go to work, do your full days work and then come home and write a paper or work on a QIP in your own time. And these get added to our c.v.s as markers of success. And then we have families, and it all gets complicated. We don’t have time to dedicate every hour to doing all this extra stuff. Doing all this extra stuff takes away from our family life. If you asked, and people answered you honestly, a lot would say that they constantly feel like a big fat failure. I do! On the face of things, I look very success, and very sorted and colleagues would say that I am very good at what I do. However I feel that I am crap at my leadership role, crap at my educational role, not as on top of my clinical stuff as I should be, and worst of all a terrible terrible mother. I constantly feel like a failure and stressed as there isn’t enough time to do things properly. And I think that’s the key. We are so used to striving to do things perfectly, we feel rubbish because we know that we could do each part better...if only we didn’t have the other part. I’ve had to learn that sometimes good enough is good enough. That is a bit of a digression, because my point is that we are all crazy driven, and you are not alone. You are not the only one to feel this way, it is immensely challenging.
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lastly, I just wanted to add that it is OK to say no, that’s it, I quit. There is no shame in it. No failure. It is just that you want something else in your life, something that is much more important than work. Anyone who judges you for it can just p* off.
Actually at this very point in my life, I could have written the same title of your post.
Good luck with all the decision making. Would highly recommend a post on DNUK for sage viewpoints, if you haven’t already. You can post anonymously on The Couch.