On this episode of the Academic Medicine Podcast, author Emily Carroll, MD, MEHP, Research in Medical Education (RIME) Committee member Gary Beck Dallaghan, PhD, and AAMC MedEdSCHOLAR Kiani Gardner, PhD, discuss how medical student parents navigate their dual identities as physicians-in-training and parents and how medical schools can foster an inclusive learning environment for these learners.
This episode is now available through Apple Podcasts, Spotify, and anywhere else podcasts are available.
This episode is the second in this year’s 3-part series of discussions with RIME authors about their medical education research and its implications for the field. Listen to the first episode in the series on how medical students learn to navigate interprofessional interactions during clerkships. And check back in January for the final episode on equity in pediatric workplace-based assessment.
A transcript is below.
Read the article discussed in this episode:
- Carroll EK, Ryan MS. Parenting in medical school: An exploration into the dual identities of medical student parents. Acad Med. 2025;100:e15–e23.
Transcript
Toni Gallo (00:03):
Welcome to the Academic Medicine Podcast. I’m Toni Gallo. Every year Academic Medicine publishes the proceedings of the annual Research in Medical Education or RIME sessions that take place at the AAMC’s Learn Serve Lead meeting. This year, the RIME papers, including the one we’ll be talking about today, will be presented throughout the Learn Serve Lead meeting, which is taking place in San Antonio, Texas in November. All of the RIME papers are available now to read for free on academicmedicine.org. As in previous years, I’ll be talking to some of the RIME authors on this podcast about their medical education research and its implications for the field. Last month I spoke to doctors Kelsey Miller, Bonnie Dickinson, and Kelvin Pollard about new research into how medical students learn to navigate interprofessional interactions during clerkships. Today for the second of this year’s RIME conversations, I’m joined by Dr. Emily Carroll, one of the authors of “Parenting in Medical School: An Exploration into the Dual Identities of Medical Student Parents.” Also with us are RIME committee member Dr. Gary Beck Dallaghan and MedEdScholar Dr. Kiani Gardner. We’ll talk about the findings from Emily’s study, including how medical students navigate their dual identities as physicians and as parents, and how educators and medical schools can help them transition into these roles by fostering an inclusive environment. And so with that, I’m going to turn it over to Emily to introduce herself.
Emily Carroll (01:42):
Thank you Toni. And I just want to start by thanking you for having me here. It’s a real honor to be representing one of the RIME submissions this year. So my name’s Emily Carroll. I am an assistant professor in the Department of Pediatrics at the Warren Albert Medical School of Brown University. I attended medical school at the University of Virginia and completed pediatric residency at the University of Texas Health Science Center at San Antonio. And I obtained my master’s of education in the health professions from Johns Hopkins. I’ve worked mostly in the academic outpatient primary care setting, but recently I just started a new position as a newborn hospitalist at a women and infants hospital in Providence, Rhode Island where I’ve had the opportunity to work with both medical students and residents in the care of newborns.
Toni Gallo (02:25):
Welcome. Gary?
Gary Beck Dallaghan (02:26):
Hi, Dr. Gary Beck Dallaghan. I’m the assistant dean for accreditation at the Carle Illinois College of Medicine in Urbana, Illinois. Prior to coming here a little over a year and a half ago, I’ve been at several different institutions and have over 30 years of medical education research experience. Currently my focus is shifted to studying implementation of accreditation standards and how they impact people using interpretive policy analysis, which is a nice way to focus on studying the LCME without it being bombastic.
Toni Gallo (03:03):
Welcome. Kiani?
Kiani Gardner (03:04):
Hi, I am Kiani Gardner. I am an assistant professor of medical education at Duke University School of Medicine. I’m a basic scientist, so I live fully in the preclinical years for a couple of programs across our school and I am just really excited by UME. Also a parent so thrilled to talk about this topic with you.
Toni Gallo (03:25):
Well, thank you all for being on the podcast today. I want to start our conversation just asking Emily about her study, a little bit about what inspired it and what she did and some high level findings.
Emily Carroll (03:37):
So as the title implies, this is a qualitative study of the lived experience of medical student parents through the lens of social identity theory. And so in the way of background before I delve into the study details, I think it’s important to disclose that I became a mother a few months into my second year of pediatric residency while my husband conveniently was also an orthopedic resident. We lived in Texas at the time far away from family support. And overnight I went from a thriving trainee to just barely surviving. And despite a very supportive program and peers, balancing parenthood with medical training and the schedule, the mental and physical demands that that entailed, proved to be just about impossible. And while I always say that becoming a parent made me a better pediatrician, I really feel that being a parent trainee has sparked my passion for medical education reform and that has led me to this study and why I’m here today.
(04:40):
So during my time as a fellow in the MEHP program at Johns Hopkins, this study was first conceptualized alongside my then instructor and later colleague, Dr. Mike Ryan. So we dove deep into the literature on parenting in graduate and undergraduate medical school and truly were shocked to find a paucity of data at all pertaining to the undergraduate medical population. Even just the number of medical student parents in the US is a very hard statistic to come by. And arguably nonexistent. I had so many questions, but I acknowledged that exploratory work was really what was needed to lay a foundation and we really needed to know what it was even like to be a medical student parent before we could ever answer any of the subsequent questions. So how we decided to tackle this problem is that we conducted semi-structured one-on-one interviews with 11 current and former medical students who experienced the birth of one or more of their children during medical school.
(05:44):
We recruited our sample from outside of our home institution of UVA at the time using social media such as Facebook has a physician moms group or the Student Doctor Network. Also just word of mouth with our colleagues and snowballing. And we were really committed to obtaining a sample that was representative and diverse for all the different paths that do encounter parenthood during this time so that we could most comprehensively understand it. And our interviews, the topics centered on priority items that had been identified in the literature for GME and also from social identity theory literature. So the reason we decided to use social identity theory as the theoretical lens, if you will for this study is, because we hypothesized that so much of this student parent experience was likely related to how they were reconciling two seemingly irreconcilable roles as a student and as a medical student or as a parent, excuse me, and as a medical student.
(06:46):
So with our interview data, we did a reflexive thematic analysis and we chose this option because we felt that it allowed myself and my co-investigator to instead of bracketing our experiences, to leverage and utilize them to enhance our analysis, it affords more creativity, more flexibility and how you examine your data. And we felt that ultimately that would lead to a richer understanding of a quite complex social phenomenon.
(07:19):
The results that we found was that the experience of having a child during medical school was absolutely situated within a greater social context, the power structure and hierarchy of the medical education establishment. Student parents we found encounter a quite uniquely challenging learning environment that we suspect hinders their identity formation by failing to support both of their roles and forcing them to rather choose between the two of them and compartmentalizing their role as a student and then compartmentalizing their role as a parent and not allowing those to coexist in the same space. We ultimately identified four themes that described this experience. One was generally a negotiation of these dual identities, the next two being forms of identity capital, which are assets that are available to an individual to reconcile or assert a certain identity that they hold or a role. And then finally we found our final theme was that they navigate a hierarchy within the clinical learning environment. That’s it in a nutshell. I know we can get into more of the details as we further our discussion.
Toni Gallo (08:36):
Thank you. Yeah, I’d like to dig into that first theme a little bit of students navigating those two identities of medical student and parent, especially because they’re sort of developing both of those identities at the same time coming into the field of medicine and also for those who are new parents. So I’m wondering how you all looked at those findings in the paper and some of the comments from the students around that. And then also thinking about your educator hat and how can schools help students as they are trying to not just think about their professional identity but also this very important personal identity.
Emily Carroll (09:17):
This is really the crux of the paper and our findings. And so what I take away from this is that to help students navigate these dual identities, I think first and foremost, we need to address the structural biases that are rampant within the medical education establishment. And I think there are many there that selectively disadvantage student parents over other students. And the biggest one of these is when it comes to time, and this came up throughout every interview and honestly we all have lived it. This impossible challenge of allocating your time accordingly between all your roles that coexist and students feel that deeply and student parents feel that even more deeply. And an egosyntonic, if you will, allocation of time or being able to spend your days and your hours and your minutes as you feel is congruent with your priorities is a privilege unfortunately for a medical student.
(10:20):
And I don’t think they are encountered with the reality of that until they have something outside of the role of being a medical student that challenges how they choose to spend their day. And so I think keeping that in mind. Something to target would be to help create flexibility or restore agency to our student parents to be able to better spend their time in a way that feels appropriate with what their priorities are while also not compromising their performance as a student. Things that came up and were actually suggested by many of the participants were universal duty hour restrictions. Instead of putting the onus on the student parent to say, my child’s daycare ends at 5:00 PM I need to go and pick them up and ask for that as an exception. Instead making it so that the workday for a student, all students, falls within a reasonable limit that would allow them to live a life outside of that role. So sort of an equalizer within the medical learning environment. And I thought that was a very poignant example of what we can do to help them navigate this day-to-day clash between their two identities.
Kiani Gardner (11:39):
I was really struck by that suggestion as well, just from a general, what a humane way to approach the task of all medical students and that particular identity, even without the added layer of parenting. I loved that they were along those lines. I was actually wondering in thinking about this problem from that identity theory as well, the students who became parents in their medical school journey. Well, I think of students approaching parenthood as probably sort of in that non-traditional med student sense of maybe they’re perhaps a little bit older, they might be partnered. And so I wonder when I think about an identity as being a med student, I think about also the dynamics of feeling included and belonging in that larger med student identity. And I wonder for the students who became parents if they felt that they were very much entrenched in their med student identity, they felt like they truly belonged, and then maybe adding a parent layer removed them a little bit from that. Or maybe do they come into med school already feeling a little bit distanced from the larger social identity of the med student? Did you get a sense for one way or the other with these participants?
Emily Carroll (12:51):
I would say it’s a little bit of both. Certainly there was the commentary on the integration socially with peers was challenged as soon as they became a parent. And a lot of that was tied up with logistics of not being able to be at the library at 10:00 PM with their peers who don’t have children to care for at home, social obligations on the weekends being limited because of your family status and not necessarily being able to engage in the same activities outside of work and school. But also I would say challenging their identification with other medical students. And this goes with the assimilation to one group versus another. So they didn’t necessarily resemble the typical medical student prototype now that they had these other obligations. So outside of schedule, they were tired more. They were up all night feeding an infant and they couldn’t show up they felt in the same ways that their peers would, they couldn’t put in as many hours studying as their peers could. So they felt like on many domains, they no longer looked like the prototypical medical student peer. So if that sort of gets at your question.
Gary Beck Dallaghan (14:01):
So that also makes me wonder how much of an internal conflict that they might have because their identities have been uprooted as opposed to when I was at University of North Carolina, we had several students that came into medical school that already were parents. And so yes, they came in with that identity as a parent already and then took on the persona of a medical student, but they were able to identify their tribe, I guess, in their classes of other people who had children as well. So they were able to connect in that way and still felt a sense of belonging and camaraderie with them. But going through it and having a child right in the middle of medical school, I would imagine created a bit of cognitive dissonance in some ways for them as well.
Emily Carroll (14:50):
And I think this cognitive dissonance presented itself from the lens of social identity theory as identity dissonance and stress. And I think the stress that I heard so deeply in every interview was this idea of I can’t be in two places at once. I can’t do it all. I can’t be both. I can’t compete with my peers who don’t have children at home and all these other responsibilities, nor can I compete with a stay at home mom, the relative who’s participating and taking their kids to the park at nine o’clock on a Tuesday. So there was this idea of I don’t belong with either group and therefore I’m lost and I’m struggling because I don’t identify and I don’t belong to either group specifically.
Toni Gallo (15:30):
And one of the things I know the students mentioned was seeing physician parent role models and how helpful that was to have that to look to as an example. Could you talk about that too, that piece of the study?
Emily Carroll (15:44):
Absolutely. It was very clear that these havens of support existed and they were sought out by these students. And those havens of support were faculty who shared of and disclosed that they were parents that they, maybe it was something as simple as saying, “oh sorry I’m late. I was doing daycare drop off.” Or just something little like that that made them realize, oh, you too are dealing with what I’m dealing with. And we don’t have to pretend that that didn’t just happen, that I don’t have these other responsibilities outside of being a doctor and I don’t have to show up here and pretend I didn’t just have a crazy morning feeding my newborn and getting them to daycare that we can talk about this. And so now it opens the door, it would open the door to those student parents to say, me too, me too. And then maybe in the instance that something happened and they got a call from daycare and I had to go pick up my child, I feel as though I could reach out to that person and that person might understand. And so that was very much resonated throughout the interviews of finding those people who specifically positioned themselves as, it’s okay, I’m a parent too. And that was very much welcome.
Kiani Gardner (17:00):
I’d love to talk a little bit more about that role modeling. One thing that I really appreciated in this paper was Table 2 with suggestions and just one thing that I want to say is it’s so frequently we read about these big problems in education and are left with a very sort of like, oh no, sense of almost dread about how hard things can be. And so papers that offer suggestions and a path forward are always just so uplifting and I think really helpful. So thank you for that. And yeah, a big part of that table was this idea of having role modeling to create a safe learning environment. And I want to agree, I have small children and I have always been sort of surprised by the number of students at the end of a academic year or a semester who thank me for being honest and upfront about my family and our personal circumstances.
(17:53):
And it made me reflect because every time I’ve told them about my kids, it had sort of been accidental. It had been exactly like you explained, I was really frazzled. I’m so sorry, I lost my train of thought just then because I was up all night or shifting a meeting online because a kid is sick. And so it always felt to me like a moment of weakness professionally when my role as a mother bled into my work. And what you’re suggesting is owning that and maybe bringing it more forward as a solution that feels like maybe low hanging fruit, but as a faculty member, I’d sort of like to hear what did your participants maybe specifically say were the ways that they felt welcomed by faculty members who were parents being forward about their parenthood? Because I very frequently feel like I shouldn’t expose that part of my life to my students.
Emily Carroll (18:48):
I wish I had more robust examples and they really didn’t surface because I think it truly was as simple as identifying the resident or the faculty member who shared about that they had kids, that they were a mom, that they were a parent, a dad, young children, and they just sought them out. I think from the 11 interviews that we did, nobody offered a poignant example of something elaborate that was done to make this happen, which I think goes to your point of this being low hanging fruit of just if you just exist in yourself in all your forms, if you bring yourself, a merged identity, to your role as a physician educator. And I think the impact of that could be tremendous in opening the door to support this population of learners and who knows many other populations of learners that might identify with some other aspect of who you are outside of your physician role. And so this transparency I think is what I hope to be one of the greatest takeaways and potentially something an actionable item that you can try tomorrow of starting to say, instead of trying to pretend or trying to put only my best foot forward, let me put my full self forward and see what happens for my learners. It’s just a thought.
Gary Beck Dallaghan (20:04):
Well, but it also speaks to transparency on the part of the institution. One of the things that struck me when I was reading this is that these comments and the themes that emerged from it are stemming from the individual’s experience, but what it failed to do was take into consideration the greater responsibility of the medical school as to all students. So it’s not just students who might be experiencing this phenomenon of having a child. They’ve got to taken into consideration the broader student body and what they’re doing. And sometimes the schools don’t know some of these things that are occurring at the individual level. And so if students aren’t coming forward with that to express some of those needs, then there’s no way that the administration could even do some of these things to help them out. And so there needs to be communication going back and forth and transparency on both sides about what can and can’t be done. That was one of the things that as I was reading this, I was thinking it’s like as somebody who does accreditation and looking at all of our policies and all that other stuff, these are individual students that there may not be the very many of ’em. And so how do you address that and what services could be made available or communicated out so that way they know they’ve got someplace to go.
Emily Carroll (21:33):
And your point to that, if a student doesn’t disclose they’re having a baby or their wife just had a child or something to that end to then garner that support, then how can the medical school support them if they don’t know? And it is interesting that you mentioned that because there was a diversity in how different participants approached that. And it is what we captured with our theme of an intangible identity asset, and that is personality and this tendency to speak up and to advocate or to disclose that they were going to have a child or had a child and they wanted accommodations and they wanted to enforce these boundaries and make sure that they crossed their T’s and dotted their I’s. And then there was the complete opposite end of the spectrum where they wanted to put their head down and just weather the storm. And I don’t want to be different. I don’t want anybody to know, I don’t want special accommodations because that might be looked upon unfavorably. And so both of which I think had benefits and detriments to it, and they both were forthcoming with that. But it was a very interesting dichotomy to hear about.
Gary Beck Dallaghan (22:44):
Well, and do you think that’s part and parcel of the culture of the institution that they were at? Because I could see some of the medical schools have a reputation of being pretty rigorous and pretty intense. There are places that I think have a softer and general approach to things with the students, and so they’re a little bit more open to students coming forward with things. And I mean I know here we’ve just been talking about having duty hours. I mean, we’ve got a duty hour policy, and so the students know exactly what their expectations are and when they leave and everything else. So it’s not a secret. It’s produced, it’s in a policy, it’s out there for them to look at. And I don’t know if all schools are like that and I don’t know how open they are to things. So it just made me wonder if part of that was based off of the culture of the institution that they’re at.
Emily Carroll (23:38):
I’m sure it absolutely is. A few participants disclosed that they specifically applied to their medical school because they knew it had a culture of being family friendly and they anticipated that they would be having a child during their years. And if you have that foresight, then that’s great. I think it’s also notable to say that we should seek to achieve that culture across the board. And sometimes policy isn’t necessarily enough and having duty hours and enforcing duty hours are two different challenges. And so whether a student speaks up to say it’s past five, I need to go, even though everybody knows they’re supposed to go at five, is both an intersection of the student’s personality but also the culture of the institution. And that’s a hard problem to tackle for sure, and not an easy one.
Toni Gallo (24:32):
So there was a quote around this and it was about there being a culture shift to recognize that medical students are not just medical students. And that was in the context of medical student parents. But I think that kind of applies, Kiana, you might’ve mentioned it earlier, students have many identities. They are not just students when they come to medical school and they’re needing to be this larger kind of culture shift and whether it is policies that will help student parents but also all students. And I’m curious how you all, if there are things at your institutions that you think are working well in that way or things generally that you think could change in the culture of medical education that would help students be able to have a safe learning environment, an inclusive learning environment where they don’t have to just be medical students.
Emily Carroll (25:25):
I can start with that one. So I love this quote. I think there is so much power behind this. And the participant is essentially saying, please help medical students achieve a merged social identity. That is basically what I gather from this. And it’s so ironic because the medical field attracts some of the most well-rounded, talented, brilliant individuals because our rigorous admissions process demands that they be these rich, well-rounded individuals and then as soon as they matriculate, we sort of slowly progressively force them to jar up those other identities and put them on a shelf in the name of complete dedication and commitment to their medical training. And the irony there is that what the medical field needs is their humanity. What we want is them to present themselves at the bedside with everything that they can bring to the table from all of their identities.
(26:19):
And so yes, this is a culture shift to look at the student and say, well, what could you bring? I know you’re the student, I know this is where you stand on the hierarchy of medical education, but you before were a nutritionist, what can you bring to the table here from that hat to this patient encounter and allow them to do that. And what you as a parent, you are seeing this child, what can you bring to this encounter? And you’re allowed to do so because medical students don’t look like medical students did a hundred years ago when the Flexner Report came out and we decided this was the best way to train doctors. And I think this is the call for reform in some way, and it’s easier said than done, but we need to meet our medical students where they are and who they are in order to better serve our patients and them.
(27:11):
And so I think where do we start with that? It’s a big question, but I personally think that something we can do is to shift how we assess and what we value, what attributes we value in students for the Match process, for just their evaluations at the end of a rotation. I think we need to emphasize competency rather than this person stayed late, they came early, they were an animal, they worked harder than any other student that I’ve worked with or the extracurriculars, this robust extracurricular profile because it selectively disadvantages any student who just maybe would otherwise show up to do that, but just simply can’t. They don’t have the means, they don’t have the time. That’s my thought.
Kiani Gardner (27:55):
Yeah, I was thinking along the same lines as you, particularly with admissions about how we, and at Duke, I think we give lots of opportunities for our students to explore their various identities through our opportunities for different… their third year, their research on… And I think a lot of medical schools are doing that. One thing that does sort of dawn on me though is the way that we’re, I think traditionally thinking about identities, even this paper sort of challenged me a little bit because when I think about identity, to me a medical student identity is sort of a transient identity. You’re a med student for such a short period of time that maybe leaning into that and fully sort of owning that might even seem unimportant when a student is doing so much to eventually earn that physician identity perhaps. And so I sort of think about the way that we are encouraging students to explore and to cultivate their different identities through medical education makes me think that perhaps one of the reasons why we not all institutions have a very family friendly identity goes back to what Gary was sort of saying in that I think there’s a lot of us who aren’t necessarily considering that parenthood is an identity that a medical student frequently would don.
(29:05):
And we think about encouraging our students and our learners to find their researcher identity and their clinician identity and perhaps even an identity in policy and health markets and these very academic pursuits. And we frequently de-emphasize the identities that they might have wanted to pursue outside of med school. And it is a hard thing to do, but I think Gary’s point of really having a good idea of who our students are when they come in and who they become in that time with us is an important start to that. And really to your point, Emily, I think it’s telling that we don’t really know how many students become parents during their UME. That right there is an indictment on perhaps an environment that encourages students to either not or not disclose, which is worrisome. Absolutely.
Toni Gallo (30:01):
So what else jumped out… Gary, Kiani, what jumped out at you as you were reading this paper?
Gary Beck Dallaghan (30:08):
Well, I kind of brought up some of the things that I was noticing while reading it. And like I said, I read it from the perspective that this is coming from the voices of the students. So I knew it was their lived experience and there was a side of me that was kind of wanting to have a counter argument or not argument so much, but perspective from the college administration side of things just because it is challenging to meet the needs of all the students and where their different identities intersect and how that might impact things. Because at the end of the day, the school is responsible for ensuring that the individuals that they’re graduating are qualified to go onto the next level of training.
(30:55):
And so one of the comments that kind of stood out to me was this whole notion of some of the participants felt penalized if they would need to take a leave of absence or delay graduation in some way, shape or form. And those are things that are out of the school’s hands. I mean, there’s limitations on what we can do based on accreditation standards. And so as much flexibility can be built into the system as possible. But at the end of the day, if there’s something untoward happened, if God forbid the medical student ended up having a baby born premature and had to be in the NICU for a long period of time, chances are they would be advised to take a leave of absence to be able to focus solely on the family, which to me is the more important thing to do. And it’s not intended to penalize a student by having them graduate late, but I mean that honestly would be the more caring thing to do because you’re saying you don’t want them focusing on the medical education side of things, that’s not what’s important right now.
(32:08):
So there’s that perspective that I think needs to be looked at for future studies with this because there are areas where I can see not conflict so much, but just misunderstandings about what’s happening and how things happen that could be explored a little bit more just to help out. But again, I fall back on that whole notion of how transparent are we about all of these things and how clear are things? I can tell you we spent probably six months working on an absence policy, so students’ days off and different things like that. And I still don’t understand what the damn policy means, quite frankly, there’s so many nuances to it. And I’m just like, this is just ridiculous. I don’t know why we have to make this so complex. And so honestly, I felt bad for the students because when I was reading it, I’m just like, I don’t even understand this thing. So good luck. There is a need for more transparency on both sides of the fence with all this stuff I think and anything else. And that’s really one of the things that stood out the most to me reading this.
Emily Carroll (33:18):
Gary, I so appreciate your perspective offering that because absolutely it is I think the flexibility, as you said of medical education to accommodate leaves of absence without graduation delay, and that was always the line. I wanted to know how much I could take without having major repercussions to my future, to not delay my Match, to not delay X, Y, and Z. And to a point… from their perspective, this is what I want… from your, and I appreciate your perspective with all the years being in your position, the dean’s office, of there’s only so much we can do to then also grant you a degree that is acceptable by all of these standards that we have to uphold. And I think in a world where we still have one Match and board certifications that happen at only certain times of the year, true flexibility cannot be achieved because… maybe this is my years working with Dr. Mike Ryan, but competency-based time variable training I think would be the ultimate solution perhaps of true accommodation because ultimately nobody’s advancing until they’ve demonstrated competency. So if it takes you X number of years, six years versus three years, and you have a baby sometime and then you just have a longer path. But the way that it’s set up now with these benchmarks that just can’t be moved in their current form, I agree with you. Our hands are tied to a point.
Gary Beck Dallaghan (34:54):
Yeah, because there’s so many external forces that are working against it, and I know Mike’s very passionate about competency-based medical education and I just wrote a blog for the Alliance for Clinical Education pointing out how much of a misnomer that actually is because we don’t have that anywhere in this country. I mean, it’s a framework that people are using to design medical education, but it is not truly competency based because nothing is time variable. It’s all locked in. And so we need to stop pretending that that’s what we have because until somebody figures out a way to actually make it that way and not have it penalize people for needing to decelerate a little bit, to spend more time on something to gain the competence. And that’s my concern is if we did that, residency programs might look at people worse. So there’s a lot of stuff that would have to be unraveled, but I still think that there’s ways of being flexible within the medical school environment to still allow for that.
(35:54):
But again, it just comes back to how much are people communicating these things and working and being creative. It’s very easy for people to get locked into things and say, well, the policy says this and that’s what you’re stuck with. And I grew up believing that rules were meant to be broken. You ask for forgiveness after you’ve done it. And so there’s no reason to be tied so tightly to a policy that you can’t be flexible and be more humane. And we need to, I mean, because like you guys have said, the medical school classes, people are coming back later. Here at Carle probably 30% of our students are non-traditional. They’ve had careers before they came here in engineering, and so they’re walking into this place with families already. And so you got to learn how to be flexible.
Kiani Gardner (36:48):
One thing that stood out to me in reading was really honestly how kind of universal a lot of the struggles that these med student parents were expressing felt to just becoming a parent. And I appreciate that you were very purposeful in recruiting recent new parents. I think it was within two years, they had to be within two years of their UME and the baby had to have been, I think, less than one to mitigate recall bias. But I think back on my becoming a parent. At the same time, I got my first big NSF grant and had all of these other joins on my time and feeling a lot of the same struggles, distances of identities, trying to merge these different identities, trying to uphold myself to a level of excellence that felt impossible.
(37:32):
And now three kids in and further into my career, I look back at that time and sort of say, I think what both Emily and Gary has said is there’s only so much we can do I think talking about institutionally but also talking about people as people. And I would love to see the study extended to include reflections of physicians now who did become parents throughout medical school with a little bit more maturity in their parenthood identity to look back and say, this really was something I absolutely needed. Or perhaps to look back at some of these struggles and say, that would’ve been hard if I became a parent in any place, in any career, in any role I was because becoming a parent in and of itself is just such a big identity shift.
(38:15):
So I think a lot of what I read really resonated with me not having been a med student when I became a parent, but also just having been an academic, someone used to doing the most and being excellent and all of a sudden having something else that mattered so much more to me than the thing that was on my plate in that moment. And I think longitudinally, this could give us a lot of insight into how we support these students with policies, but also how we support them with just these transitioning identities, whether it’s parenthood becoming a student, leaving studenthood and aligning their identities continuously through their career path.
Emily Carroll (38:55):
Kiani, I absolutely agree. And absolutely I think that even as an attending, so when I had my child in residency, you get through the birth and then all of a sudden you realize, oh, now I’m a parent. Now I actually have to raise this child and be a trainee. But similarly, as an attending now and I have three kids and I don’t know that I’m any better at it. And so it’s this idea truly, whichever stage of being a professional you are and you encounter any sort of major crossroads with another identity, you’re going to be presented with a similar challenge. And one of the statements from one of the participants that didn’t make it into the manuscript that still sits with me several years later is she said that medicine will take of you all that you are willing to give it. And I think you could take out medicine and you could put any profession in there.
(39:48):
And ultimately what that means is that in the context of protecting who you are, your identities outside of whatever your profession is, to give each of those the best version of yourself is an essential skill that anybody needs to acquire in order to truly achieve this… a merged identity that you can be both and do both, but it’s up to you to assert those boundaries and figure out how you’re going to navigate that. And it can be aided by support from your institution, from colleagues, from role models, but ultimately it does fall on the individual to navigate that regardless of where you are in training.
Toni Gallo (40:28):
So we’re just about at the end of our time, if anyone has final thoughts they want to share, we can go around and do that. Emily, anything from you?
Emily Carroll (40:37):
I think that would just about summarize it that… Another quote that again sticks with me is when a participant said, “I’m asking for the allowance of existence. I’m not asking for anything crazy, huge accommodations, a change for all LCME requirements. I’m just allowing… being allowed to exist who I am in my whole self.” And I think that is something that we could all remind ourselves, keep at the forefront in any policy that we write and how we approach every interaction with learners of just how can we allow them as learners and ourself to exist in their full form.
Toni Gallo (41:16):
Gary?
Gary Beck Dallaghan (41:16):
I’m going to take a totally different approach to final thoughts and recommend this article as a fantastic example of how to describe a qualitative research study. The methodology section was exceptional and people could learn from that alone. So that was well done.
Emily Carroll (41:38):
Thank you, Gary. We worked, we had a lot of input and a lot of guidance on that, so I will not take all the credit for that by any means. But thank you. It did finally come together.
Toni Gallo (41:48):
And Kiani?
Kiani Gardner (41:49):
Yeah, I’m thankful for the way that you have brought together this really complicated set of experiences from students and it had just a progressive and forward thinking lens, putting forward possible suggestions, really concrete and discreet ideas about how to support these students. And also just ways to support learners in general in our medical education. It is a treat to leave a manuscript describing hardship with a feeling that there is a path forward. And that was just wonderful.
Toni Gallo (42:19):
Well, thank you all for being on the podcast today. I appreciate the conversation. Listeners can check out Emily’s paper and all of the RIME papers on academicmedicine.org, and if you are at the AAMC meeting, Emily will be presenting her paper, so you can check that out too. But thank you all again. I appreciate your time today.
Emily Carroll (42:39):
Thank you for being here. Thank you.
Toni Gallo (42:42):
Make sure you check back for the final episode in this year’s RIME series. We’ll be talking about a study looking at equity in pediatric workplace-based assessment. From Academic Medicine’s website you can also access the latest articles and our archive dating back to 1926, as well as additional resources for authors and reviewers. Follow us and interact with the journal staff on LinkedIn at Academic Medicine Journal. Subscribe to this podcast anywhere podcasts are available. Be sure to leave us a rating and a review when you do. Let us know how we’re doing. Thanks so much for listening.