Palin's situation is familiar to female doctors with kids

When John McCain announced his vice presidential nominee, Sarah Palin, some observers raised a delicate question: Is the ambitious mother of five children taking on too much?

She returned to work as Alaska's governor a few days after giving birth to her fifth child, a son with Down syndrome. What's more, her 17-year-old, unmarried daughter is five months pregnant. Some say her family needs her more than the nation. But supporters were onto something when they pointed out that few would ask the same question of a man.

Sarah Palin represents an extreme version of a working mom. Yet among female doctors, her situation balancing a demanding job with family life is familiar. In the peak of training, we often work 80-hour weeks in stressful situations. And since more women are going into medicine - in my medical school class, 58 percent were women - more doctors are having children. It happens that our prime child-bearing years coincide with our most rigorous training.

As every woman in medicine has heard, there's no good time to have a child. During medical school, you need to study. During residency, the hours are long. If you wait until after training, you could be in your mid 30s. We know better than anyone that birth defects increase with maternal age.

The profession of medicine has come a long way in accepting motherhood. At the University of California at San Francisco, where I went to medical school, I could zip up to the private breast-pump rooms during my intensive- care rotation and use the hospital-grade facilities to save milk for my daughter, who was born during my fourth year. Certain residency programs offer "flex-time," where you share a spot with another resident and work part time for a longer period to complete training.

Our foremothers are also a great resource for achieving balance and sanity. After my daughter's birth, I struggled to see how I could return to work when all I wanted to do was cuddle and stare at my baby all day.  During an hour-long phone call, a mentor made me realize how lucky I am to be both a mother and a doctor. She was a role model to her son, who loved to tell his friends how his mommy was a physician and scientist.

Another doctor mom who had four children told me how to keep my head clear: When you're at work, you're a doctor. When you're at home, be a mom. Don't let yourself get distracted.

Some of the most difficult challenges for physician moms come from our own colleagues. A director of another program told a friend of mine that he would allow her the state-mandated time off after having a baby - six weeks - but that she should know that other residents had complained about how much time she would be taking off.

A friend who was six months pregnant during her third year of medical school in another state had a checkup scheduled for the first day of her obstetrics and gynecology rotation. The attending would not let her leave for the appointment. To this day, she is still puzzled: Shouldn't the obstetrical doctor have encouraged prenatal care?

And then there are the real horror stories. A recent survey of 4,000 female surgeons by Columbia University researchers revealed that some residency directors have told pregnant residents to drop out. Others have suggested terminating pregnancy.

The old guard in medicine sometimes views a pregnant doctor or a mommy M.D. as a slacker who won't pull her weight.  But I've seen doctor mothers overcompensate and work even harder than others just to prove that perceived sentiment wrong.

Beyond the tricky logistics of day care and finding time for a husband, not to mention shopping for groceries and paying the bills, the toughest part of being a mother and doctor in training is the guilt.

I'm sure other working mothers can attest: There are infinite ways to make yourself feel guilty. "I shouldn't have stayed those extra few minutes when I could have been at the playground. . . . If only I had managed my time better, I could have made it back sooner to put my daughter to bed."

These thoughts plague me often, but they are not enough to make me rethink the choices I have made, along with an increasing number of young women.  Although Sarah Palin's political views don't overlap much with mine -  I don't believe in abstinence-only education, for example - she inspires me to make it all work.  I love being both a mother and a doctor, just as Sarah Palin undoubtedly loves her family and her job.

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Rachel K. Sobel, a second-year ophthalmology resident at the Wills Eye Institute at

Thomas Jefferson University, writes about her experiences every other week.

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