‘Having it all’ has become a popular concept in modern life. The idea that you can progress in your career to be a consultant or GP partner, earn a six-figure sum, have a happy marriage with the production of several well-adjusted children, still give dinner parties and read the journals every week might seem a little far-fetched to most of us.
If you want to succeed, you have to plan. Many female doctors in training or in the early years of partnership are at the stage in life when they start thinking about all things baby related, and being in their late twenties or early thirties, they realise that their biological clock is ticking. There are pros and cons of having a baby at different stages of your career.
The registrar year
The registrar year has become a very popular time for reproduction. You are the right age, you are supernumerary, in theory at least, so your going off on maternity leave should not disrupt the team too much.
You are required to complete your traineeship, so your trainer is obliged to take you back, however inconvenient this may be for him or her. With some planning, it is possible to fit more than one full-term pregnancy into one registrar year — and this has actually been achieved.
First, check your contract of employment. These are standard nowadays, and you should find that your rights are broadly in line with the NHS scheme.
To qualify for benefit, you must have 12 months’ continuous NHS service, without a break of more than three months, immediately before the start of the 15th week before your estimated delivery date (11th week in Scotland).
You are entitled to 26 weeks’ paid maternity leave, consisting of eight weeks full pay, 14 weeks’ half pay and four weeks’ statutory maternity pay or maternity allowance, whichever applies. This differs from NHS provision, under which you would have eight weeks’ full pay and 18 weeks’ half pay.
Your 52 weeks can, of course, be taken at any time, and most people start their leave as late as possible.
Remember, however, that trying to work when you can hardly fit behind the steering wheel requires single-minded determination — and a large car.
As a salaried GP, your rights are similar. If you are employed by a GMS practice or primary care organisation (PCO), you should have a contract that is in line with that negotiated between the BMA and NHS Confederation, allowing you the same provision as a GP registrar. The allowances for both registrars and salaried doctors differ from those for NHS staff because they have not been updated in line. The BMA suggests that, as a salaried doctor, you should negotiate with your practice to give you the same rights as your hospital colleagues.
Partner in a practice
As a partner in general practice, there are other issues to consider. Not so many years ago, no well-organised practice would have taken on a woman if there was even a hint of fecundity about her. When I joined my present practice, there was not even a maternity clause in the practice agreement.
Nowadays, many of our applicants are bright young women who may well want to reproduce, which is as it should be. Having said that, it has to be conceded that pregnancy in a partner comes at a cost to the remaining doctors — both financially and in workload, because a locum will never fully replace a partner.
As a partner you will continue to receive your partnership share. The partnership will be eligible to receive an allowance from the PCO to help with the cost of locum payments, and in some cases a higher-rate discretionary payment is available. This should be researched before you embark on a pregnancy. Failure to attract a sufficient sum should not stop you, but it is helpful to let your partners know their position.
There will be an expectation that you return to work after 52 weeks, and this can be the most difficult part. Working a 10-hour day, organising childcare and running a household demand a very helpful spouse and a superhuman amount of energy.
You may decide that you want to reduce your hours, and again this is something you should at least mention to the partnership early on.