CHESTThought Leader BlogLife as a Fellow: Sharing Pregnancy News Head On While in Training

Life as a Fellow: Sharing Pregnancy News Head On While in Training

By: Allison Greco, MD

When I told my 85-year old grandfather that I was pregnant, his response was, “Are they going to let you finish your fellowship?” He was happy (over the moon, actually, once things sunk in), but he was also concerned. I’d like to blame his line of questioning on the times in which he was raised, but the reality is that, even in 2020, physicians-in-training need to ask themselves some hard questions when trying to plan parenthood and making family decisions.

I chose to postpone the decision about parenthood until there was no longer some next step to work toward in terms of medical training: my final year of fellowship. Medical trainee or otherwise, I don’t think anyone can tell you what’s best in terms of timing for you and your family. The reality for me was that my spouse and I were both in our early 30s, had been together for several years, and just felt ready. I’m not sure that part is entirely unique to medical training. My partner’s nonmedical career offered a bit more flexibility, which allowed him to fully support me in choosing a time that worked for my career. Of course, there were lots of medicine-centric decisions as well: How would we afford childcare with my trainee salary? How would pregnancy affect my impending job search and start date? Did I want to be pregnant or have a newborn at home during my first year as an attending physician?

There’s No “Good” Time

Probably like those who are not medical trainees, we decided that there was no such thing as a “good” time to start a family, and I found out I was pregnant the week before my interventional pulmonology rotation. This meant that I had to avoid fluoroscopy and excuse myself for a number of procedures, during a time where I had not even had my first obstetric appointment.

This gave me a lot of anxiety for several reasons. I wasn’t ready to make my news public—at least not until I had seen a physician myself—and I would be outed as soon as I excused myself from a case. There was also the unknown impact on my day-to-day schedule: Would I be sick or so tired that my performance would be affected?

Don’t Leave Your News to the Grapevine

I decided to dive in head first. After all, my colleagues and supervisors were physicians. I certainly wouldn’t have to explain the risks associated with the early stages of pregnancy to a group of doctors. I decided to tell my program director immediately. If I needed time off because of an early obstetric issue, I knew I would need backup. I also knew I wanted my program director to find out from me rather than through the grapevine.

Your Colleagues Will Be More Supportive Than You Might Think

I had what turned out to be a wholly unnecessary amount of anxiety in the days leading up to meeting with my program director, because I was overwhelmingly supported by my supervisors.

During one particular bronchoscopy at that time, I handed over the scope to my attending, letting him know that I needed to step out for the procedure.

“Are we saying congratulations?!” he asked excitedly.

I responded, “I will neither confirm nor deny anything.”

He nodded, patted me on the shoulder, and grinned. “Well, we are all hoping for the best here.” At the time, I don’t know if he realized how supported and understood I felt after this simple gesture.

Telling my program director was equally straightforward. She was supportive, excited, and kept my secret (as did the interventional pulmonary team) until I later made my news public.

The rest of my pregnancy has gone smoothly so far. I am incredibly fortunate in that I did not battle with infertility or have any of those high-risk medical conditions that so many other women must face in addition to the struggles of being a medical trainee.

…And Accommodating

My cofellows and attendings have dubbed my future child the “fellowship class baby,” and they have been happy to accommodate scheduling changes. They threw me a surprise baby shower. When the COVID-19 pandemic overwhelmed the New York City area, the department staff made sure myself and any pregnant women in the department were responsible for telehealth outpatient visits rather than for direct patient care.

Institutional Culture and Fit Are Important

I now acknowledge that at least part of my comfort level in addressing my pregnancy head on within the division came from my level of comfort with my colleagues and supervisors as well as the culture of the institution. For this I am grateful. I acknowledge that others may not share in these experiences for a number of reasons, but it has made me appreciate how important the fit and culture of a program can be for a trainee facing similarly difficult decisions.

At the end of the day, the hardest questions I ever faced when it came to my pregnancy were those that were self-imposed—exactly how a personal decision such as the one to become a parent should be.

Allison Greco, MD

Allison Greco, MD, is a Fellow in Pulmonary and Critical Care Medicine at NYU Langone Medical Center. In 2013, she earned her medical degree from Jefferson Medical College at Thomas Jefferson University, where she also completed an internal medicine residency in 2016. She served as Quality Improvement Chief Medical Resident at Thomas Jefferson University Hospital from 2016 to 2017 before joining NYU for fellowship training, where her focus continues to include medical education, patient safety, and quality improvement. Her research interests include innovation in medical education, quality improvement and patient safety during cardiopulmonary resuscitation, and point-of-care-ultrasonography. She will be joining the NYU Langone Medical Center as faculty in July 2020.