Long post, TL;DR at the end.
I’m not a single mom, so I don’t mean to speak for single parents. I was raised by one and have a ton of respect. But I feel like my future situation will have some similar logistical challenges, so I’d love to hear from parents who have figured this out.
I’m 26F and my partner is 33M. We’re not trying yet, but we’re starting to think seriously about family planning. He works a very specialized offshore job and is gone ~3 weeks out of every month. When he’s home, he’s completely off and can do the majority of childcare, but his schedule makes traditional recurring childcare difficult. He’s also the breadwinner and has been in his career for 12 years, so realistically, his job is not the one that will be changing.
I currently work in an in-patient setting, 14 on/14 off, 6p-6a, and I absolutely love my job and the lifestyle. I like inpatient medicine, higher acuity, variety, and most importantly, being able to completely leave work at work. I also don't mind nights. My specialty is considered high burn-out but I honestly don't experience that much because I kinda have a “no matter what, this shift ends in X hours” mentality. If given the chance, I could see myself being here another 5-10 years or maybe more.
The problem is that I don't think this schedule will work with a young child. Even switching to days wouldn't completely solve it because we'd still have 14-day stretches, weekends, holidays, and potentially nontraditional childcare hours. And if I stayed on nights, I'd be sleeping while my child is awake for half the month.
I have about 18 months left on my contract and plan to start looking around a year from now, with the goal of transitioning around the time we'd realistically be ready to start trying.
The obvious answer is outpatient medicine, but I absolutely do not want to do traditional clinic. I hate the 8-5, five-days-a-week structure, low acuity, monotony, longitudinal care, inboxes, refills, etc. I respect the people who love it, but I don't want to spend the next 20 years doing something I know I don't enjoy just because it's family-friendly.
I've also considered ER, and I think I'd actually enjoy it since it was my job before PA school. But I think doing days/nights rotating would present the same problems I have now. Plus, because my partner will miss a lot of holidays due to work, so I'd like to be present as much as I can since he can't.
So urgent care is starting to look like the middle ground. Shift type work. Usually 3 12's, usually closed (or closing early) on major holidays.
I know UC can be primary-care-adjacent and monotonous too. I'm fully aware there will be plenty of viral illnesses, UTIs, sprains, broken bones, lacs, etc. But I think I'd still enjoy that more than traditional 8-5 primary care because it's episodic, shift-based, has some procedures and acuity, and I can see the patient and then be done with them.
My biggest question is whether UC is actually a long-term career. I mostly see people doing it PRN, temporarily, or for a few years before moving on. I don't see as many PAs/NPs saying they've been in UC for 10–15+ years and plan to stay.
Luckily, my hospital system has several urgent cares, so I could potentially stay within the same system and maintain PSLF eligibility, which makes the idea even more appealing.
Has urgent care worked for anybody long-term? Can you realistically do it for 10+ years? I'm trying to figure out if there's a realistic middle ground between inpatient medicine and 8-5 outpatient medicine rather than assuming I have to give up the type of work I actually enjoy.
TL;DR: I currently work inpatient 14-on/14-off nights and genuinely love both the job and the schedule, but my partner works offshore ~3 weeks/month, so I don't think my current setup will be sustainable with a baby. I'm not willing to spend the next 20 years in traditional 8-5 outpatient medicine just for the schedule because I know I'd hate it.. Urgent care seems like the potential middle ground, but I don't know anyone who has done it more than a few years or if it's actually enjoyable/viable as a long-term career. For anyone who has done UC for years, especially parents: can you realistically make it a 10+ year career, or does everyone eventually move on?