John is a general practitioner and has just completed GPEP1. He was an ED trainee for four and a half years while raising twins. He lives in Wellington and now has three children—six and a half year old twins, and a two and a half year old.

• How does general practice fit in with your family?
  When the twins were born I was working as an ED medical officer in a provincial hospital. This meant regular shift work (basically an SMO roster) with no night shifts and regular evening commitments, rarely more than 40 hours a week. I had quite a lot of mornings at home, and never finished too late. Twins was a very tiring proposition aside from work, but the flexibility of a small town and an ED role worked reasonably well. General practice has worked much better in terms of family life. This has, in part, fitted in with the boys starting school and making family life more regular and weekends more precious. It has also been better due to the lack of evening shifts and nights, and so I’m less tired and more patient with family.
• You are eight years out of medical school—how have you fitted in training?
  We had the twins after two and a half years and then I commenced ED training. GP training has been over the past year. Part one exams were hard with children. Shift work as a registrar meant a lot more night and late evening/early morning shifts than a MOSS roster, and this took its toll on the family. For my wife this was the hardest thing about the training —the irregularity and the frequent evenings at work when you may not really see each other for most of a week. PRIMEX as an exam is also nothing like the demands of ED part one exams, in terms of a commitment to study either, and again it made for more availability for family.
• Do you have any advice for doctors-in-training who are thinking about balancing a career and kids?
  If possible, get as many exams out of the way prior to kids as possible. I wouldn’t wait until the end of training though as I have really enjoyed having children while I am younger and still flexible in terms of career path. If you are expecting twins it’s definitely worth ensuring there is a lot of support prior to their arrival. We moved back to Wellington to be near family when the boys were 10 months old. A smaller hospital was a very supportive work environment to have children. They were much more willing to offer leave and work around my commitments.
• How has a medical career affected your family?
  Shift work and exams made it a stressful few years for the family, and with multiple children support from family was really important. Shifts/registrar rosters made it harder for my wife to commit to regular activities as my roster was always unpredictable.
• What support do you get from your family?
  We moved home to Wellington when the twins were 10 months old to get support from my extended family. This included babysitting, which enabled some last minute changes to rosters etc. I get a lot of support from my wife and children as well. My wife is a full-time mum, which has made it a lot easier to work in both training programmes.
• How have you managed your training while bringing up a family?
  ED—splitting exams made it easier. Study is hard, and has meant that training and family are almost as much as I could do at one time.
• How did you find the support from your college?
  ACEM was good about splitting up exams so that part one exams could be sat one, two, three, or four at a time. I sat two at a time and this was much more manageable.
• If you were just graduating from medical school again, what would you do differently?
  Not a lot. If you could plan these things I might have sat part one exams prior to children.