Career indecision-sonographer or PA? Where does baby fit in? Urgent!

January 31, 2013 7:32 AM

I am 35, my husband is 44. I have always struggled with my career, and recently quit my job and entered a sonography program. Just before entering the program I am in, I also applied to PA school. I have been offered a place in PA school, and I do not know what to do. Lately my biology has caught up with me (baby. now.) and I do not want to put off baby much longer (we could start trying to conceive in exactly one year if I stay and complete the sonography course-I am in the second quarter of a two year course). If I switch to PA, (program is also two years but does not start until 7 months from now) it means either having a baby during my clinical year and going straight back to rotations (ouch) or putting baby off for TWO more years...also ouch. It is worth noting that I do not think that I am strong enough/career motivated enough to leave my baby for 12-14 hours per day, which is why either way, I would like to have the baby at the end of either program, so that I can stay home for a few months before starting my first job. Please see more inside.

I picked sonography because I think it fits my lifestyle requirements (I would like to work part-time when I have kids, at least the first few years), but long term I'm not sure I would be happy doing the same thing, day in, day out. Also, most of the people close to me are very high up in the medical field (doctors), and although my friends love me and do not judge me, I can't help but feel a little embarrassed that having a tech-level job makes me seem lazy, or not as ambitious, or not as smart, etc. PA, on the other hand, is something that I have always been drawn to (I have worked with PAs for years) and to have been accepted to a program is a huge opportunity that I feel horrible about turning down, and I fear that I might regret not doing it while I have the chance. That said, it is a much more expensive program than sonography (70k as opposed to 15k), so doing it will mean that I am taking away my freedom to possibly scale back after baby (b/c I will have large loans to pay back).
My husband is very supportive of whatever I decide, and does not seem to care that we will be extremely old parents. But I am spooked by the experience of several friends in my age bracket who had problems conceiving, etc. and I really feel like if we want to do this, we need to get working on it, soon. Do I forsake my opportunity for a fulfilling career to start a family? Please help me. I have to let both programs know in just a few days.

posted by acornsarebrown to education (22 answers total)

Do not wait for the baby if you want baby now, and don't turn down the PA program if you're interested because of it. You don't have to be able to time the baby precisely to go into the PA school! There are certainly other ways to deal with that situation - babies can't be planned that precisely anyway.

There's a reason why PA school costs more - because it allows you the opportunity to make a lot more money. I think being a PA is a great job, and if you're interested, you should go for it!
posted by treehorn+bunny at 7:39 AM on January 31 [1 favorite]

It sounds to me that you would be more fulfilled by the PA path, and I can testify now that the longing isn't likely to be mitigated if you go with the sonography path alone. And that just puts off the baby path for one more year. Although...it does quintuple your loan burden, but if your pay, benefits, and satisfaction as a PA would be commensurate with that increase, that seems like a more than worthwhile trade-off.

I'm a Very Old Parent (conceived at 38, turned 40 when she was 7mos old), and I can say that you may well resent time away from your little one, because I know I sure did. If you want to be a parent, it's just as wonderful at almost-40 as it would have been at not-quite-40. So, what if you took a middle path on that and started the TTC journey halfway through your last year of whichever program you pick? That way, you'd be no more than 6mos along at the end of it if you conceive right off. And you'd be well on your way to next steps in your career if not.

I would say that you should look into getting well-integrated into whatever professional organizations and networking opportunities there are for PAs in your area/online before the baby break (whenever that ends up being) so that you can keep your knowledge and connections fresh for when you're ready to return to the workforce. I don't know if this is precisely pertinent to the PA world, but I know it helps with other paths to keep an eye out for any continuing education that could be a gap filler/resume builder to make one a super attractive candidate when it's time to transition, so maybe look into whether or not that's valid.

Seems to me like this is super doable and would make you happiest. Go for it!
posted by batmonkey at 7:57 AM on January 31

Talk to the PA program about how they do leaves of absence and see how much flexibility there is in terms of delaying or interrupting clinicals. I bet you'll be happily surprised by their answer.

The higher level your skill set is, the more flexibility you'll have in general. There are part-time sonographer gigs but they pay less per hour so you'd have to work more to make the same amount. They're also unpleasant from what I can gather, often long shifts, weekends, nights, or unpredictable per diem work. That's part time but it really sucks to work opposite your spouse or scramble for childcare at the last minute, and I wouldn't call it family friendly.

Just going off of what I've seen doing research on job boards and such.
posted by the young rope-rider at 8:03 AM on January 31

I want to also qualify my response by saying I'm a physician, and when I was in medical school and residency and fellowship training I knew plenty of people who said "oh, I can't have a baby now, I'm doing my rotations" or "I can't have a baby now, I'm just starting my fellowship" or whatever it was. Now of course they are saying "I can't have a baby now, I'm just getting started in my new job as an attending" - guess what, it's no easier or more convenient to have a baby when you have a full time job either. There were people all along the way who either accidentally or purposefully had a baby during every one of those stages of training, and made it through, and now have lovely children and the career they wanted.

I also speak as a woman who thought I could "plan to have a baby at the end of fellowship" and a year and a half after I started trying to conceive, finally succeeded with the help of a reproductive endocrinologist. My due date's next week.... (that's part of why I say, why bother trying to wait, when you want a baby, try to have one! Doing it the way I did is expensive and stressful...)
posted by treehorn+bunny at 8:03 AM on January 31 [3 favorites]

Now I'm really multi-commenting but I did not notice your comment about not being able to scale back after the baby because of the loans. Not necessarily true - it depends on your situation. I have been working part time for the past 6 months myself (and hope to do so again in the future) and I graduated with $185,000 in loans. A PA salary is good - especially if you go into certain higher paying specialties. That means you can afford to keep paying on your loans, work part time, and possibly still be making more than what you'd be making as a sonographer... make sure you've looked into the salaries, interest rates on loans, and your own budget before you decide that your dream is impossible...
posted by treehorn+bunny at 8:10 AM on January 31

Look, you definitely know you want a baby. You're not entirely sure about the career (or at least, there are likely several paths to get there). Just start trying now. You don't know, at this point, whether you'll conceive next month, next year, or never.

As far as sonography vs. PA... that's a tough call. You're already in the sonography program, and it costs less and is quicker. Plus it has more flexibility later. So if it were me, I would say: start trying now, complete the sonography program, and maybe you'll have a baby during your second year, or right after you finish, or not until you are in your first job, but either way you'll manage.

Babies seem to come at exactly the wrong time no matter what, so it might as well be wrong-time-now rather than wrong-time-later (or never).
posted by rabbitrabbit at 8:19 AM on January 31 [1 favorite]

Wow, this is my first post on metafilter and I am absolutely touched by the responses-thank you everyone!
Treehorn + Bunny-I have to be completely honest and say that although I love science and have a strong background in health care-I think that part of my hesitation to switch to PA, even though it excites me, is that I am terrified of the responsibility that comes with being a PA. Did you feel any fear when you started your training? I don't know if I should interpret this feeling as normal, or as a red flag that I am not capable of taking on the role of PA. Obviously, as a sonographer, it would be next to impossible for me to hurt anyone, unless I hit them over the head with the transducer.
posted by acornsarebrown at 8:21 AM on January 31

I think you should start trying for the baby now and arrange everything else around it and take whatever maternity leave you need to finish your programs.

Working 12 hours/day after you have the baby is going to suck, but it's going to suck if the baby is 6 months old and it's going to suck if the baby is a year old and it's going to suck if the baby is five years old. The baby is going to be asleep from around 7-7 (give or take an hour on either end) from the time it's 3-6 months old for the foreseeable future, so that's what you're going to have to work with regardless. That said, a 3-month old baby is still really tiny, so try to make your maternity leave more like 6 months if you can.

I wouldn't wait, and I also wouldn't want to be in a very demanding phase of my career right after I had a baby. But you can't tell yet when you'll conceive, so you can't plan that exactly. All you can really know is that your fertility is declining as you wait. I'm not normally a big alarmist about fertility, but I really can't recommend that you wait 2 years at 35, unless there's a really good reason for it.
posted by yarly at 8:23 AM on January 31

Oh also - if you are not really career motivated now, you'll be even less motivated after the baby. I don't mean that you'll be a bad employee; but you certainly won't be looking to work to fulfill you. Work will become a way to earn money and still be able to get home to see your kid on time. All the stuff like "will my doctor brother look down on me" will fade, I'll wager. So you might want to consider another option: find a family-friendly, flexible, reasonably well-paying job now, and start trying for the baby, instead of trying to perfect your career.
posted by yarly at 8:27 AM on January 31 [2 favorites]

acornsarebrown, as a medical professional, you hold people's lives in your hands.

If you weren't terrified, I would worry about you.
posted by treehorn+bunny at 8:30 AM on January 31 [4 favorites]

Also consider what a higher salary will mean ten years from now. What if your kid has special needs and requires out-of-pocket therapies or equipment? What if she's brilliant at math and desperately wants to go to Math Camp and hang out with kids who won't tease her? What if your spouse loses his job and you become responsible for all expenses? What if he gets bullied at public school and there's a good private school down the block?

I think so much emphasis is put onto time spent in the first few years as the most important part of parenting, and it is important, but it's also important to consider the long-term financial stability and opportunity that a more challenging career can provide.

Plus, having a mother who really enjoys a highly skilled career is something that really pays off as an example for kids, especially girls. I've always been super proud of my mother's career, and once we were more independent she still had a lot going on that was interesting and fulfilling. A lot of my friends' mothers were pretty lost and bored once the super needy early childhood phase was over.
posted by the young rope-rider at 8:38 AM on January 31 [6 favorites]

You definitely could hurt someone in the role of sonographer- by missing something important. Any time you are caring for someone else it is a responsibility. I know a lot of medical professionals who act very blasé about their roles as caretakers, but in deep and truthful conversations will reveal their fears (surgeons especially). It's normal and natural. If the thought of being a PA excites you then that is what you should do! Babies are impossible to 'time correctly' and you'll manage no matter the timing.
posted by PorcineWithMe at 8:42 AM on January 31 [1 favorite]

I think so much emphasis is put onto time spent in the first few years as the most important part of parenting, and it is important, but it's also important to consider the long-term financial stability and opportunity that a more challenging career can provide.

Yes, despite what I wrote before, I agree with this. It's just that (for me, anyway) the baby refocuses your goals. Work is part of creating a good life for your baby, which puts a lot of the other ego-related stuff about work into perspective. So instead of caring about your image so much, you care more about things like "do I leave my job feeling energized so I can be a better partner & mother"; "does this job pay me a fair wage for my work so I can support my family." I don't think mothers should dial back their careers at all, but rather focus more on practicalities.
posted by yarly at 8:53 AM on January 31

If two options seem roughly equal, but one is markedly higher prestige, choose the LESS prestigious option. Somebody on mefi said that, and it really stuck with me. I can't find the exact quote now. But the idea is that status and prestige warp our judgement in ways we are not even aware of.

So I'd go with sonography. I'm a 43 yr old female pharmacist, and I had my first kid when I was doing prerequisites for pharmacy school at age 33. He turns 10 next month. My younger kid (age 6) was born between 2nd and 3rd year of pharmacy school.

In the 10 yrs between where you are now and where I am now, my perceptions changed in ways that are pretty common, I think.

* Status gets less important. I mean, you are 35. Your friends and family are as impressed with you as they are going to get. Some jackass can always find ways to make you feel less-than, it's unavoidable. So focus on being proud of what you actually are, and most people around you will take their cue from that.

* You get freaking TIRED. I used to have the ability to pull all-nighters, and I wasted it on college. Oops. Conserve your energy.

* Once children show up, they become VERY important. Career motivation goes down. My children are getting more brilliant and competent with every passing day. The same is not true of my co-workers.

* $70K is a lot of debt. My debt is not quite as high as an MD's, but it's > $100K and it does limit you.

* Your fertility markedly declines around age 35. If you guys can get pregnant the easy way, well... the easy way is easier.

I think you need to try really hard to take the status of being a PA out of the equation. In most people's 30's status is a big issue. Then suddenly in your 40's, you just cease to give a shit. It's like how romantic drama can seem so compelling when you are a teenager, then suddenly becomes tedious when you are an adult.
posted by selfmedicating at 9:03 AM on January 31 [4 favorites]

I am a nurse (with a four year degree). I have two kids and I work part time and don't have major loans. Prior to kids I was absolutely sure I'd be an NP with a focus on critical care by this point, but you know what? There is no extra money, prestige, or excitement at going back to school and more knowledge that's worth the flexibility of being able to be part time and still make decent money while being home with my kids the majority of the time. They'll be little for a couple of years and then they'll be big and I can always go back then. More difficult career paths have been taken.

So. Were I staring down debt and unsure about whether I really wanted to work long days and do lots of paperwork as a new mom, I'd personally choose sonography for the time being. If it were me, anyhow.
posted by takoukla at 9:27 AM on January 31

Without speaking to any of the other factors: you can't time babies like that. You might get pregnant your first month, it might take you years. If you are 35 and you know you want to give birth, I would start trying now. It took me a total of 2.5 years of trying (charts, OPKs, temping, etc) and 4 miscarriages to get two children.

Also, my PCP had her first kid during residency, and she said it sucked but she can't think of a better time to have done it. Having a baby during a high-commitment career is just going to be a challenge, no matter when you do it. A totally surmountable challenge, to be sure, but don't think there's some magical choice that can make this easy.
posted by KathrynT at 9:30 AM on January 31

Taking on a lot of debt now also seems like a bad idea, especially because if you take maternity leave in the middle of the program, you may have to start paying it back or put it into deferral where it continues to accrue interest. And you know what would REALLY suck? Only finishing 1/2 of the PA program and then being $50k in debt with no degree to show for it.
posted by yarly at 9:52 AM on January 31 [1 favorite]

You say you have concerns about the stress involved from the responsibility of being a PA. Keep in mind that if you come out of school with 70k in loans and soon realize that the responsibility is really too much you may really regret your choice plus you'll have a ton of debt.

I'm a PA. While there are aspects of it I like if I could go back I would never choose to do it again. My colleagues who love being PAs are the ones who felt like medicine was their passion in life. The ones who went into it for other reasons feel similar to myself. I wish I had an idea that I was going to feel this way before I started school because I would never have made the commitment, both in regards to time and money.

If you do decide to go ahead with PA school then I don't see why you should have to wait to try to have a baby. Realize that getting pregnant isn't an instantaneous thing for many people and if you really want a baby then go ahead and start trying to make that happen. You can work the other stuff out.

Good luck.
posted by teamnap at 10:34 AM on January 31 [1 favorite]

Teamnap, how realistic is it to assume that I will be able to work part-time (4 days/wk) as a new PA?
posted by acornsarebrown at 11:43 AM on January 31

I have a friend who is a woman and a PA. Anecdotally, it has not been a fulfilling job for her and it has been impossible to have with a family. There have been several reasons for this, that I can tell. She's working in small offices, often supervised by one or two older male physicians who do not respect her or her time and who overwork her (there has been a pervasive pattern of demeaning her education and work by physicians, too -- the prestige hasn't carried as far as she hoped, which sucks). Also, because of the small office sizes (few employees) she's not protected by normal medical leave policies. She also has had very crappy benefits through work -- again, small medical offices can't offer the benefits of large hospitals. When she had a baby, she just quit and I don't know if she plans to go back to work. There don't seem to be many hospital jobs for a PA, by her report, just these small office jobs.

Maybe a career as a sonographer would actually avoid these traps? I have no idea. My friend's experience being a PA and woman starting a family (even her internship was a really bad experience, working for a disrespectful physician) didn't leave me with a good impression of what the profession has to offer.
posted by sweltering at 12:21 PM on January 31

Also, most of the people close to me are very high up in the medical field (doctors), and although my friends love me and do not judge me, I can't help but feel a little embarrassed that having a tech-level job makes me seem lazy, or not as ambitious, or not as smart, etc.

I am currently shifting from a "fancy title," well-paying, salaried job to a 3/4-time, hourly job without a fancy title. The most important thing to me is that I will have more time with my 2-year-old son. The "career stuff" became a lot less important to me after I became a mom, and that may happen for you, too. (Of course, it may not; who knows!)

You mentioned sonography would have a part-time schedule that would fit your lifestyle. I am surprised at how much time I end up missing from work for pediatrician appointments, staying home when my son is sick, staying home when his nursery school is closed, and missing work because I'm sick more often, with him bringing various viruses home, etc. If a part-time schedule is appealing to you now, it probably will be even more appealing (if your budget allows) after you have a kid.

Best of luck with your decision!
posted by trillian at 12:50 PM on January 31 [1 favorite]

Of sonography school, PA studies and having a baby, having a baby is the only one where you don't get a do-over. You can become a sonographer at 50, but the physical limit for childbearing comes a good few years before that.

If you're in your mid-thirties and you know you want a baby, prioritize the baby. Figure the other stuff around that. I was very career oriented before I got pregnant, and although I wouldn't say I'm less career oriented now, I am less ambitious now simply because I have to be. And carrying a big student loan and not working because I was home with the baby would have been very very stressful to me, I think. Having the baby, then studying, then working (fingers crossed) more or less right out of school and starting the loan payback just seems less angsty.

Anecdotally, I have a friend who planned out the whole timing of how she was going to fit school and babies in (she was trying to decide between a PhD and law school) in much the way you do up top. She had it planned out by the month, so that she would have the baby in her second year of law school just before Christmas, take a semester off and be back the following September. Or get pregnant while she was preparing for her comps, then have the baby shortly after and combine maternity leave with writing her dissertation. I don't remember all the details, but it was very detailed and very precise. I think she genuinely thought it was a plan that would work. But now it's six years later, she's forty, she has the PhD, but no baby. Largely this is because she couldn't get pregnant during the window she was supposed to get pregnant in, and then figured she should wait, and now she's on to the post-doc and unsure whether it's ever going to happen. And she really, really wanted a baby.
posted by looli at 6:20 PM on January 31