Residency Advisor
The myth that you can either be a good doctor or a present parent—but not both—is garbage. But it’s also not completely random which specialty you pick if you want kids during training and don’t want your life to completely implode.
So if your brain is spiraling with: “What if I get pregnant intern year? What if daycare closes at 5 and my shift ends at 7? What if I’m on nights and my partner also works nights and the baby gets sick?”—you’re not being dramatic. You’re asking the right questions.
Let’s actually talk about which specialties realistically support having kids during residency, not in some vague “work–life balance” brochure way, but in the “who is going to pick up my kid from daycare when my attending adds one more case at 4:45 pm” way.
First: The Harsh Reality They Don’t Put on the Brochure
Residency is not “family-friendly.” It’s “family-possible with a cost.”
The law (in the US) says:
- You get a minimum of 6 weeks of parental leave via ACGME across programs now (many combine this with vacation or short-term disability to get to 8–12 weeks).
- There are maximum duty hours (80 per week averaged, 1 day off in 7, etc.).
Reality:
- Programs can technically be “supportive” and still leave you scrambling to find childcare that covers 5:30 am to 7 pm.
- Some specialties act like having a kid is normal; others act like you just committed a crime against the Match.
Here’s the scary part that people whisper about in call rooms: the same parental leave policy feels wildly different depending on your specialty’s culture and schedule.
That’s why the specialty matters. Not for whether you’re “allowed” to have kids. But for whether you can survive it without burning out or feeling like a constant failure at home and at work.
The Big Picture: Lifestyle Friendliness by Specialty
Let me give you the blunt, pattern-level truth first, then we’ll go into the ones that actually support having kids during training.
| Category | Value |
|---|---|
| Dermatology | 9 |
| Psychiatry | 8 |
| PM&R | 8 |
| Family Medicine | 7 |
| Pediatrics | 7 |
| Internal Medicine | 6 |
| General Surgery | 3 |
| OB/GYN | 3 |
| Orthopedic Surgery | 2 |
This is not perfect or universal, but very roughly:
- Top lifestyle specialties (best aligned with having kids): Dermatology, Psychiatry, PM&R, some outpatient-heavy Family Med, some Pathology, Radiology in the right programs.
- Moderate but workable with support: Pediatrics, Internal Medicine, Anesthesiology, EM (with huge caveats).
- Brutal while training, especially with pregnancy or very young kids: General Surgery, Ortho, Neurosurgery, OB/GYN, most surgical subspecialties.
Let’s dig into the ones that people with kids actually survive in, and the ones where you need to be very, very realistic going in.
The “Most Realistic with Kids During Residency” Group
Dermatology: The Gold Standard of “I Can Actually See My Family”
Derm is the cliché answer for lifestyle, but there’s a reason for that.
- Hours: Most derm residencies are close to normal business hours. Call is often home call, and nights are rare.
- Predictability: Clinics run on schedules. Your day usually starts and ends at almost the same time.
- Pregnancy/parent culture: I’ve watched multiple derm residents have kids during training and actually see them. Often more than many fully trained surgeons see their own.
The downside? It’s insanely competitive. You don’t pick derm only because you want kids—that’s a fast track to disappointment if you don’t match. But if you like the field even a little and you’re already somewhat competitive, it’s honestly one of the easiest residencies to combine with early parenthood.
Psychiatry: Mentally Heavy, Logistically Kinder
Psych isn’t “easy”—the emotional load is real—but from a schedule standpoint, it can be very compatible with kids.
- Hours: Often 8–5ish on many rotations, with some call but far less intense than surgery or OB.
- Nights/weekends: Usually limited and more predictable. You’ll still have them, but fewer.
- Program culture: Psych tends to attract and retain more people who care about boundaries and wellness. Not always, but a lot.
I’ve seen psych residents breastfeed between clinics, adjust outpatient templates a bit around pumping, and attend kid events sometimes even on weekdays. That’s…rare in many other specialties.
PM&R (Physical Medicine & Rehab): Underrated Lifestyle Win
PM&R flies under the radar, but for people who want normal-ish human lives during residency, it’s attractive.
- Hours: Often similar to IM or better, with many rotations roughly 8–5.
- Call: Often home call or limited in-house call, depending on the program.
- Culture: Less “macho”, more team-oriented, tends to be more chill about real life.
If you like neuro, musculoskeletal medicine, and function, PM&R is a very solid “I want to be a doctor and a present parent” specialty.
Family Medicine: It Depends Massively on the Program
Family med can be either:
- A humane, continuity-based experience with outpatient focus.
- Or a “you’re covering everything and everyone and also doing OB and nights and inpatient and clinic and…” kind of grind.
But compared to surgical fields, it’s still usually way more compatible with parenting.
Factors that help:
- Programs that are less OB-heavy or where OB is optional.
- Strong outpatient emphasis.
- Reasonable call systems and clear backup when someone is out for parental leave.
You can absolutely have kids in family med residency. I’ve seen multiple residents do it. The main stress is honestly childcare hours and the chaos of some inpatient rotations, not constant 100-hour weeks.
Pediatrics: Great Fit Long-Term, Mixed Bag in Residency
Peds people are usually very pro-kid. But the system is still the system.
- Good: Culture is accepting of having children. Co-residents and attendings are often very understanding about sick kids, pumping, etc.
- Hard: Inpatient peds, NICU, PICU—these rotations can have nasty hours. Nights, 28-hour calls, weekend stacks.
Over three years, people make it work. It’s very common to see pregnant interns, second-years with toddlers, breast pumps in resident rooms. But don’t romanticize it. Peds hours during certain blocks are still brutal.
The “Manageable But Tricky” Middle: You Can Do It, But Know the Tradeoffs
Internal Medicine: Flexible Outcome, Tough Training
IM residency itself:
- Wards, ICU, nights: rough with a newborn. No way around that.
- Clinic: a bit of predictability once you’re on more outpatient rotations.
Where IM shines is long-term flexibility. You can end up:
- Outpatient clinic with regular hours.
- Hospitalist with block schedules (7 on/7 off can be surprisingly kid-compatible for some families).
- A niche that balances your life if you choose it carefully.
Kids during IM residency are very common, but you will have months where you barely see them awake except on your golden weekend.
Emergency Medicine: Weirdly Great for Some Parents, terrible for Others
EM sounds bad for kids (nights! weekends! random shifts!), but there’s a nuance:
- Pros: No rounding. When your shift ends, you leave. No pager at 2 am post-call when you’re home with your baby.
- Cons: Nights + evenings + weekends are guaranteed, including holidays. Childcare for 7 pm–3 am…not exactly standard.
For dual-physician couples or people with flexible partners or extended family nearby, EM can actually be okay long-term. During residency, though, the rotating circadian chaos is rough, especially pregnancy + nights.
Radiology & Pathology: Quietly Family-Friendly in Many Programs
People stay away from these early in med school because they don’t “see patients” much, but if we’re being brutally honest about family life:
- Many rads and path programs have more consistent daytime hours.
- Call exists (especially for radiology), but it’s often more predictable and sometimes home-based later on.
- The culture in many places is less “live at the hospital” and more “do your job well during the day.”
Not universally, but I’ve seen a lot of residents in these fields have kids and seem less chronically destroyed than their surgery counterparts.
The Brutal Group: Can You Have Kids? Yes. Will It Suck? Also Yes.
Let me be very clear: people do have kids in these specialties. All the time. They survive. Some even thrive. But if you’re already anxious thinking, “How will I manage bath time if rounds never end?”—these are the specialties where that anxiety is not irrational.
General Surgery, Ortho, Neurosurgery, Surgical Subspecialties
- Hours: Early pre-rounding, full OR days, late sign-outs.
- Call: In-house 24s, frequent nights, weekends, trauma.
- Pregnancy: Standing in the OR for hours, long calls + third trimester, unpredictable days when a case gets added at 4 pm and runs until 9.
It’s doable if:
- Your support system is rock solid.
- Your program is not completely toxic.
- You’re okay missing chunks of bedtime, weekends, and holidays for years.
If you want surgery and you want kids during residency, it’s not impossible. But you need to go in with your eyes wide open and pick programs with actual human beings, not just massive case volumes and “grit” culture.
OB/GYN: Ironically One of the Hardest Fields for Pregnancy
OB/GYN is full of women, many of whom want families, so you’d think the system would be great for resident parents. Sometimes it is. Often it’s not.
- Reality: L&D nights, frequent pages, surgeries, clinics, emergencies.
- Pregnant while delivering babies: You can be 32 weeks pregnant doing a 24-hour call catching other people’s babies. It’s…a lot.
Good OB programs absolutely support pregnancy and parental leave. But the workload is still heavy and absolutely not “lifestyle friendly” as a resident.
Comparing “Kid-Friendliness” Across a Few Key Specialties
This is oversimplified, but when your brain is spinning at 2 am, sometimes you need a snapshot.
| Specialty | Hours Predictability | Call Intensity | Culture Toward Parents |
|---|---|---|---|
| Dermatology | High | Low | Very supportive |
| Psychiatry | High–Moderate | Low–Moderate | Supportive |
| PM&R | High–Moderate | Low–Moderate | Supportive |
| Family Med | Moderate (varies) | Moderate | Usually supportive |
| Pediatrics | Moderate | Moderate–High | Very supportive |
This table is not gospel. Programs vary wildly. But if your main anxiety is, “Will this specialty structurally fight my attempts to be a present parent?”, the pattern is pretty consistent.
Timing: When the Heck Do People Actually Have Kids?
If you feel like there is literally no good time, that’s because…there isn’t. There are just differently bad but workable times.
Typical patterns I’ve seen:
- Late MS4 / between med school and residency: More control over your schedule, but terrifying because of money and insurance and moving.
- PGY2 or PGY3 of a 3-year residency (FM, peds, psych): You know your program, you’re more competent, and you’re (slightly) less terrified of everyone.
- Research year(s) in competitive or longer residencies (surgery, subspecialties): These can be a breather where people cluster pregnancies because the call usually eases up.
You can also absolutely have kids intern year. People do. It’s just more chaotic because everything is new at the same time—your role, the hospital, and your baby.
Things That Matter Way More Than They Tell You on Interview Day
Program Culture > Policy Sheet
Every program will say they “support families.” Ask questions that corner them into reality:
- “How many residents have taken parental leave in the last 3 years?”
- “Did they have to extend their training?”
- “What support systems helped cover their workload?”
- “How is pumping handled during shifts/OR days?”
Watch their faces. The vibe gives away more than the words.
Your Support System Is Not Optional
You need at least one of these:
- Partner with flexible schedule.
- Family nearby willing to help.
- Financial ability to pay for extended childcare / night nannies / backup care.
Residency + solo parenting with no support is…possible, but brutal. Like, “I don’t know how you’re still standing” brutal.
Childcare Logistics Are the Silent Killer
You can survive hard work. You can’t teleport.
- Daycare usually runs something like 7 am–6 pm.
- Rounds often start at 6 or 7 am.
- Cases run late. Admissions roll in at 5:58 pm. Night float changeover is 7 pm.
You end up paying for:
- Early drop-off fees.
- Nannies to bridge the gap.
- Backup care when your kid gets sick again for the third time in one month of RSV season.
None of this is a reason not to have kids. But it’s why some specialties with more predictable daytime hours are a lot less soul-crushing for parents.
Visualizing the “Kid-Friendliness Curve” Over Time
Here’s roughly how different paths feel over the years if you care a lot about schedule sanity and kids.
| Category | Derm/Psych/PM&R | FM/Peds/IM | Surgery/OB |
|---|---|---|---|
| MS4 | 7 | 7 | 7 |
| PGY1 | 6 | 5 | 3 |
| PGY2 | 7 | 6 | 3 |
| PGY3 | 8 | 6 | 4 |
| Fellow/PGY4 | 8 | 7 | 5 |
| Early Attending | 9 | 8 | 7 |
Scale 1–10, where 10 = “kid-friendly.” This is not scientific. But it matches what I’ve watched in real people’s lives.
You’re Not Selfish for Wanting a Specialty That Leaves Room for Kids
There’s a nasty little voice in medicine that says: “If you care about lifestyle, you’re less dedicated.” That voice is wrong. Or at least very outdated.
You can still be:
- A damn good doctor.
- A present parent.
- AND also someone who chose a specialty that doesn’t eat you alive.
Choosing derm or psych or PM&R or family med because you want to both practice medicine and tuck your kids into bed more than once a week isn’t weakness. It’s sanity.
Quick Reality Checks Before You Spiral
- There is no perfect time to have kids. Whatever time you pick, something about your training will make it inconvenient.
- Every specialty has parents. Even the worst ones. They find workarounds, allies, and systems.
- Some specialties genuinely make this easier. If kids are a core non‑negotiable for you during training, don’t ignore that just because surgery looks shiny on Instagram.
You’re allowed to choose a specialty that gives you a life. Including a small human who screams at 3 am and somehow still makes everything worth it.
FAQ (Exactly 6 Questions)
1. Is it unrealistic to plan on having kids during residency?
No, it’s not unrealistic. It’s hard, but it’s extremely common. There are pregnant interns, second-years with toddlers, chiefs with two kids. The “unrealistic” part is expecting it to feel balanced or easy. It won’t. But it’s not some forbidden thing that only superhumans do. Normal, exhausted, imperfect residents do it every year.
2. Should I pick my specialty mainly based on wanting a family-friendly lifestyle?
If wanting kids during training is a huge, non-negotiable priority for you, it should be a significant part of your decision. Not the only factor, but a big one. If you’re miserable in your specialty, your kids won’t fix that. But if you choose a field whose schedule you already know will make you resentful and absent, that’s a problem too. You’re allowed to pick something like derm, psych, PM&R, FM, or peds partly because you want time and mental space for your family.
3. Is surgery completely incompatible with having kids in residency?
Not completely, but it is one of the hardest paths. You’ll need strong support: partner, family, or paid help. You’ll need a program that has actually navigated resident pregnancies before and didn’t punish them. You’ll miss nights, weekends, holidays. Some people are okay with that tradeoff because they deeply love surgery. Others aren’t, and that’s valid. But no, it’s not “have kids or do surgery” — it’s “if you want both, prepare for some very rough years.”
4. How do I figure out if a program is truly supportive of residents with kids?
Ask specific, uncomfortable questions on interview day or second looks:
- “How many residents have had children in the last 3–5 years?”
- “Did they extend training?”
- “What’s your written parental leave policy, and how has it been applied in practice?”
- “How do you handle coverage if someone is on leave?” Also, watch who you see on interview day. Are there visibly pregnant residents? Are there parents talking openly about their kids? Or is it weirdly silent?
5. Should I wait until after residency to have kids instead?
You can. Many people do, especially in long residencies like surgery or in fields with 2–3 fellowships. But if you do the math, that can mean not trying for kids until your mid-30s or later. If that idea makes you uneasy—biologically, personally, or emotionally—then forcing everything “after training” might not be the best plan. There’s no universal right answer. There’s only: which regret would bother you more?
6. What if I don’t match into a “lifestyle” specialty and I still want kids?
You still have options. People have kids in IM, peds, EM, OB, surgery, all of it. You can:
- Time pregnancies around slightly lighter rotations or research years.
- Lean heavily on your support system.
- Negotiate for protected pumping time and parental leave.
- Choose a more lifestyle-friendly fellowship or attending job later (e.g., outpatient-heavy practice, hospitalist with block schedule, etc.). Not matching derm or psych doesn’t mean you’ve “lost the chance” to be a parent during training. It just means your logistics will be messier—and you’ll lean even harder on the people around you.
Key points:
- Some specialties—derm, psych, PM&R, many FM and peds programs—genuinely make having kids during training more realistic.
- Surgery and OB aren’t impossible with kids, but they’re objectively harder and demand more support and sacrifice.
- There’s no perfect time, only tradeoffs; pick the specialty and program whose tradeoffs you can actually live with as both a doctor and a future parent.
