AANS Neurosurgeon | Volume 29, Number 1, 2020


The Challenges of Starting a Family During Neurosurgical Residency Training

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Years ago, in providing pre-marital advice to my soon-to-be wife and myself, a prominent and well-respected neurosurgeon warned us, “Neurosurgery is a jealous mistress.”  The practice of neurosurgery, he told us, is highly demanding of its practitioners’ time. It does not respect holidays, anniversaries, birthdays or even mealtimes. Maintaining relationships, marriages and families is difficult and requires extensive effort and tolerance. The demands of the surgical discipline are particularly onerous during residency training, and adding children to the mix during this time increases the complexity exponentially.

Residency training is a time dedicated to learning the complexities of neurosurgery and requires total self-immersion. It is reasonable to question if a resident can adequately meet the demands of both their training as well as those of being a parent. There does not, however, seem to be a reasonable alternative time for a neurosurgeon to start a family.  Parenting during medical school can be equally trying, and the time following residency completion is dedicated to establishing a new practice, and its associated trials and responsibilities can often exceed those of residency. As a result, having children as a neurosurgical resident appears to represent “as good a time as any.”

In the past year, three members of the neurosurgical resident staff at Albany Medical Center in New York, Drs. Gooch, Paul and Riccio, have had children during their PGY-5, PGY-4 and PGY-3 years, respectively. Each has provided a description of their experience over the last year with the life-altering event of having a child during residency. Each illustrates the challenges encountered and the extensive efforts required to overcome these obstacles.


Dr. M. Reid Gooch, his wife Lauren and daughter Vivian

M. Reid Gooch, MD
For everyone, becoming a parent is a wonderful and amazing experience. For a neurosurgery resident in particular, becoming a parent is also wonderful and amazing…as long as someone else can bear the majority of the child-rearing burden. In fact, the baby introduces one to an additional call schedule and, this call schedule is much like the neurosurgery call schedule, as it requires both planned and unplanned periods of complete commitment. It is self-evident that I cannot reliably “cover both calls”, and for this reason (among others), I will always be indebted beyond possible repayment to my beautiful wife. She manages to work full time as an architect, yet also take the majority of the “baby call,” and thus, allow us to experience the joyful and lovely moments of our daughter, while I continue my neurosurgical training.

Pauls son ben

Dr. Paul’s son Benjamin

Alexandra Paul, MD
There are a lot of things I did not realize when I decided to have a child during neurosurgical residency. I did not know how guilty I would feel for leaving my crying child in the middle of the night to come in to do a case and take care of someone else’s family member. I could not predict that I would feel my heart drop whenever I heard a pediatric patient crying, or I would get chest pain when seeing worried parents waiting in the hall. I was not aware that sometimes having three layers of backup care is not enough, and we would be left scrambling trying to cover. I did not know that there would be days where I felt like I was not succeeding as a resident or as a mother. But, I also did not realize that those crazy, sleepless, newborn nights would bring my husband and I even closer together. I did not anticipate how much support I would have from the faculty and residents in my program, or that walking in the door after a long day and seeing my son smile is the best thing in the world. Having a child during residency is hard; there is no denying that. But, if you surround yourself with support and have an amazing spouse, it can definitely be done.


Dr. Alex Riccio and family

Alexander Riccio, MD
Neurosurgical training is notoriously very rigorous and allows for the resident to pursue a limited number of extracurricular activities.  The idea of having a family in residency has become more reasonable with the onset of work hour restrictions and a trend toward valuing the overall quality of life of residents. 

My daughter was born approximately one year ago during my third year of Neurosurgery residency and my wife’s third year of Otolaryngology residency. We have a unique situation as we are both surgical residents and both leave the house usually before 5:30 a.m. — long before day cares open. As I have to come to realize, there are several factors that can make having a child, or children, in residency much easier. For my wife and I, having both of our families living locally has been essential. They are more than willing to help out with babysitting during the week. 

We also have my cousin and a hired babysitter a few afternoons per week. A full time or live-in nanny or day care would be other options; however, on resident salaries, these options are difficult, as they are notoriously expensive. At home, our schedules after work have changed and are dedicated to spending time with our daughter; playing, feeding her and getting her ready for bed. This then limits the time for us, including time previously dedicated to studying and preparing for the following workday.

At the end of the day, it is worth the life adjustment and the extra work because of how much joy your child brings you. It is incredible how much your perspective changes once you have a kid and how much love you have for him or her. Regardless of your situation, having a kid during residency is possible; it is just a matter of going with the flow and surrounding yourself with supportive people.


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John howe | March 14, 2016 at 2:49 pm

from a retired neurosurgeon,

I am very happy for you three( 6 ). The career is meaningful but family trumps it, at least for me.