Everyone's going to take a second to kind of describe some things outside of work in their lives that are important to them and what they do, and then maybe three tips on how they try and keep work-life balance. All right, I'll start. So my name's John Martin, I live and work in Rochester, Minnesota at Mayo Clinic. But my wife is a corporate business professional, and she works in Irvine, California where she and my sons live. And so I work four or five days in the week in Minnesota, and I fly to the West Coast and hang out with my family over the weekend and then fly back on Sunday night. Balancing life. So this is what I was alluding to when we were talking about building your brand and your career and so forth. All kinds of things are serendipitous in life, and you have to be flexible enough to know when to take those opportunities and how to flex up to deal with them. When you have two careers in your family and they're equally important, sometimes you have to take turns. There's nothing in Rochester for a corporate person to do. And I have a successful spouse, and to make that work, this is her turn. And she is happy as a lark doing what she's doing and is being very successful doing it. But it also means that she's a single mom four or five days during the week. So the deal is, whenever I'm there, I take over everything with the kids. Obviously, when I'm not there, she has to do it all, and she usually doesn't finish work till seven. So the way that we control it is the following. We set boundaries. I never, ever, well, I probably shouldn't say never, very rarely, ever take work home. I get it done on the nights that I'm alone in Minnesota or on the plane. There's no desk for me in the house for that reason, to keep me from getting tempted to write papers and edit stuff and things like that on the weekend. The second thing is we just plan things ahead in terms of family calendar for things that we're going to do together. Otherwise we get lazy and things don't happen because we're all tired by the end of the week because everybody's busy. Kids have homework, they get home late, and it's still got to get done. And then finally, we surround ourselves with friends, social friends. Many of them have nothing to do with work for either one of us. They just happen to, because of our kids' age, it has a lot to do with who their friends are and which friends' parents we like to hang out with socially, right? But we make sure that we're surrounded by people who have similar stresses in their lives, not to commiserate, but actually to celebrate that, hey, we can actually have it all and we can actually celebrate the fact that we are successful despite having these impossible responsibilities, schedules, and so forth. We have a good time. Furthermore, the kids take care of themselves because they're doing their own thing within eyesight, but then we get to hang out and drink together and watch the band and listen to them or whatever. So those are my things. All right. So my schedule is a little bit different actually. My wife, and I guess I'm going to start with my wife because she does bring a lot of work at home. She brings a lot of work home. So for me, actually, working at home and working at night is almost like sitting next to my wife and being on the computer next to her. I mean, this is not all our time together, obviously, but it is kind of time that we just kind of sit and the kids are kind of like, hey, we don't want to go be in the work room. So we kind of have time. We talk about other stuff randomly too, but it's kind of a little bit of time spent together. And I do do some of my work. I'll write my notes afterwards. I'll come home a little early and then write my notes afterwards. My normal schedule during the week, a couple of hours, at least two hours or so where we're going to kind of spend time with the kids and help them with their homework, to play with them, whether it's even video games or playing ping pong or doing homework with them if they have some kind of project, help them. And then at night, I might do a little bit more work just to kind of catch up. And my wife's doing a little bit of work as well. I try to split into the type of weekend you have. You have the weekends where you're on a call, you're halfway there, you're kind of there, but sometimes you just can't predict it. And so my wife knows that. But by the evenings, you're usually home and you're doing stuff with the kids. You have weekends like this weekend where you're traveling and you're completely away and your wife is taking care of everything and the kids are being pretty much self-sufficient. And then there are all the other weekends and they're kind of split into sometimes when my wife has to work and I'll spend time with the kids and do things. Other times, my wife, we'll just kind of hang out with as a family and we'll go places, we'll travel. It's really important to travel. And I got that advice early on. You really need to kind of put these big travel events in your schedule and go with your kids and just kind of disconnect and go and do things because it's that your kids will remember it and you guys will look back and be like, that was great. You need to do that again. And then there are some, there are about three to four weekends a year that I really just take for myself and my own hobbies. I like to take my car to a racetrack. And so that weekend, I'll just be gone and I'll be at the track pretty much both days. Nothing crazy. I'm not doing any races. You're not going to see me on TV or anything, split in my car, but. You're my hero. But I just, it's, I'm a car person. I do projects with the kids, with the cars, and then we'll fix things up and we'll do things and that's just something to keep me busy and getting your kids and getting people around you to kind of do some of the hobbies that you're interested in is always going to be useful. But you just need, I feel like you need, so I guess that goes to the first step tip is that you do need a hobby. And actually Isaac Reichman was the first one who told me, it's like, Hey, you just came to Baylor St. Luke's, you know, you're going to, you're going to be really good with your career. You're going to work hard, but always have some kind of a hobby. And he does a lot of art. He's one of the attendings. He's one of the, one of the attendings in Houston, he does a lot of ERCP, a lot of spyglass, but have some kind of a hobby for yourself, something that you really like. Now don't be too stressed. If it's not something that you really can find as a hobby, that's okay. You know, maybe your work and you really do enjoy working on, on papers and reading papers and doing things that that's fine. I mean, endoscopy for me is kind of work, but not really. It's almost like playing a video game for me because you're just kind of going through little areas and you navigate. So, so for me, that is a lot of fun. Um, but, and you have to figure out where your level of work balances, like your level of work balance is going to be different from your fellows work balance where they're like, dude, I got to get out of here because I have to spend, go do that social event and go out with this. And I want to go out to the bar and this and that, and you're like, do my work, go home, just kind of relax and I'm done and I want to go back to work the next day and just forget everything done. So your, and that's goes to the second tip is that where you are, it's very personalized. Your work balance relationship is going to be very personalized. Um, third tip, um, I don't remember what I would have thought about before. I'll think of something later and I'll just randomly blurb it out. So why don't you let you go? So my situation, um, uh, my spouse is not in medicine. Um, he's also, um, kind of the corporate professional side of things, um, which we've had to try to balance that in different parts throughout our career. Um, and I have a five year old son who is not self-sufficient, we're, we're getting there. Um, so I, I think kind of to echo your point, like work life balance is going to mean something very different to every person. It's incredibly subjective and it's probably going to change throughout your lifetime too. And I think that you need to be honest with yourself about that. So for me, I can, when I was trying to think about this, when I'm like, how in the heck did Lisa and Doug decide who was going to be on this panel, I was a terrible choice. Um, so I, I really have thought a lot about this. Um, I wholeheartedly agree that like, well, so one, one of the first pieces of advice I got from one of my best friends from med school, um, she's, she's like, I had to think about it. And I asked myself this question, do I work to live or do I live to work? And I don't think there's a right answer or like that answer is going to be different for different people. And, and it's kind of been different in different stages of my career. Um, and I kind of know what that answer is for me. And once I figured that out, it's like, okay, well, who am I outside of work? What is important to me? My family is clearly important to me. We love to travel. My husband and I love to ski. So far we've managed to brainwash our five year old into believing that he loves to ski as well. Um, and so I love to cook and knowing what that is and like these things are important to me. And then the second piece of advice that I got relative to work life balance kind of came from my husband. Um, the first time that we had a yard, he came to me and he was like, do you know what my billable rate is? And so when I was in fellowship, he was a consultant and so he very much knew what his billable rate was. And he said to me, this is my billable rate. And if you can find somebody to take care of the yard for less than that, which the obvious answer was, yes, I can very easily do that. Then that's what you need to do. And so kind of the context that I think that the concept there is understanding what's important to you and if it's not important to you, what is the value of your time? And is this something, cause you will likely be in a situation where you can outsource a lot and so you can outsource almost anything, but if it's something you like to do, like could I outsource my cooking? Absolutely. But I love to cook. And so I choose not to do that because that's important to me and helps provide some balance for me in my life. Um, so those were two pieces of advice I think that I got to that have helped me kind of try to on most days feel like I'm balancing that. Yes. I'll just briefly talk about me. So, um, I, um, uh, I have a physician husband. He does poem critical care, um, and does, um, translational research. So he, um, luckily has a relatively flexible schedule except the times he's on ICU service. Um, and we have three children, 10, six and four, and it is chaos. Every day is chaos. Um, but it's okay. We manage. Um, and, um, so, um, the, every like three years or so we both have the same, um, our, our GI and pulmonary conference lineup on the exact same weekend. It's fantastic. Um, so I'm being sarcastic there. So, um, so we, every three years we have to find like some help, right? Cause I do a lot of like training and teaching. And so I go to DDW and, um, he does a lot of research, so he needs to present at his pulmonary conference. So we, um, every three years we like recruit a family, like either his parents or my parents to come and take care of our three chaotic children. Um, so it's a, it's an interesting, um, dynamic and I think that, um, both of us spend a lot of time talking about how we can work together to make both of our things work. Um, and so, um, when I applied for advanced fellowship, he took a year and put off his research, um, for a year. And then when we were looking around for jobs, we had, you know, I was one of those things that we need to find a place where this will work for you. So, um, one of my tips is to actually like, you know, find a nice balance where you both can, you, your spouse, your significant other, um, where you can potentially, you know, come together and have balance from that perspective, um, and kind of talk to each other. I'm fully, uh, agree with throwing money at things, um, that you don't want to do. You will have a lot of, a lot more disposable or expendable income. Um, and so, um, if you don't want to do it, like the lawn thing, just get someone else to do it. Um, so, um, so that's really, um, a great tip. Um, and then, uh, the last thing I'll say is that, um, your institution, um, will not love you. So, um, if you, um, you might feel like you're indebted to doing things that a lot of people are asking you to do and, you know, but it's okay to, um, to say, you know, I'm not sure that this is something that I want to do. And just take a second to think back about it. Now, as a, like an initial attending, you're probably going to have to say yes to more things that you didn't know. Um, but eventually at times you can pick and choose, um, what it is that's going to be beneficial for you. And just because someone asks you to do it doesn't mean it's the right choice to advance your career. I wanted to add it, well, just one other thing that I think is really important is, um, we're talking, I think, and everyone's talking about sort of their mental health, but, um, your physical health is something also that you should not be ignoring. Um, and it's hard. Our schedules are terrible. I mean, I can't, during the week I cannot get any exercise out. My exercise is essentially not taking the elevator and going up eight flights of stairs rather than, and going up and down eight flights of stairs and, but otherwise I have no time during the week, but then the weekend I'll go biking or doing something or we'll go hiking. And so just your physical health, exercise, don't ignore it. It will help with everything. And I think that's, that's something that's important. I also really struggle with getting physical exercise in. Um, so I totally agree with that. I definitely need this work on that. That's definitely something I need to work on. So yeah. Is there anything else? Anyone have any like questions or, you know, things that you want to ask about as you get started or? You know, I think much as with your career, you know, you, you have to plan what a lot of things that get done successfully get planned, but, you know, if something better comes up, you need to be able to pivot to that. Right. So, uh, but yeah, you don't, your, your personal time is precious and I think you need to plan that. Um, and that will help you make sure that your exercise gets in there or that your social time decompressing with friends actually happens. Um, the other thing is there is a right way and a less right way to say no. Um, and I don't know, Melinda might back me up on this. Um, business people, the people from the business world are very good at giving the negative. They never say no. They don't do that. They, they say, well, you know, um, this isn't the best time or this isn't a great time. Um, but let's talk about it next week or whatever. They don't just say no. And that's actually, that can be a good way to give the negative for now, but let people know that, uh, it's just, I can't do it right now, but I'd love it if you would think of me next time. Um, that's a much more positive spin on the no than saying no. Uh, it's a good way to keep your foot in the door. So just want to offer you that the way that you communicate things, uh, can, um, help. I do agree with that. And I think that in addition to saying like, hey, you know, now's not a good time with me. If it is something you're interested, check back in with me at this date, or if it's something you're truly not interested in, suggest an alternative, like, oh, I know my colleague might have an interest in this. And it's, it's just a much more gentler way of saying no, it's kind of like complaining about something. If you're going to complain about something, have a potential solution, um, so that it's not just a completely negative communication. Subtext of this being is say no in a nice way to opportunities, to things, because whenever you do one thing, like being here, you're saying no to other stuff by definition. So for your own wellness, and maybe in the beginning, yes, you're going to say a lot of yeses to everything because you're like, oh, another opportunity. Let me try it. Let me do it. Great. Eventually you start realizing you have to start saying no, otherwise, it's just in a nice way. Otherwise, it's not going to work. I almost, go ahead, John. I was just going to say, it's just a product of the fact that you're a very talented individual and a very likable person. It's a positive thing that you have more opportunities, whether they're career-related, social, whatever, than you have time to answer to. That's a really good thing. But you need to pick and choose well, because your time is so limited. And your other opportunities are also so great. And you need to set boundaries, because your first commitment has to be to yourself and to your loved ones, no matter what. Those are commitments that are indelible, let me put it that way. So you have to meet those commitments. So you have to set boundaries. I like Mel's comment, I think, about the no's could be opportunities for your mentees. That's a good stepping stone early on, even for now as senior fellows, junior faculty. You have med students, residents that can take on some of those things. Now I'm at a point where I don't say yes or no to every other thing, but I kind of think about it in that way. But it's almost like the opposite of imposter syndrome, which I've also experienced, that I worry if I say no to something, I might not get asked to do it again. There's a trip once a year somewhere, and the one time I say no, I don't get asked the next time. So there is that balance, too. But I think traveling is so important, and again, being able to spend time with your family. And even if you're not somewhere, making sure that you're checking in. I left because of my son's baseball game. I wanted to make sure I talked to him beforehand. Those are the kind of things that you have to have a window and make time, even if you're not there. Do we have time for another question? OK. So can you speak a little bit to family planning, and what would be your advice to both the men and the women in the audience, in terms of is there ever an optimal time to start a family or to grow your family? What sort of things are you thinking about, in terms of if you delay having a family, versus if you have a family during fellowship, or advanced fellowship of whatever type, or early faculty? How does the decision to delay a family, what kind of implications could that potentially have? Thank you. I'll start. So I was always told there's no perfect time. So when I would talk to people who had been doing this longer, had family, and it was something that we were considering in our lives, there's no perfect time. But there may be something as a more optimal time, or a less optimal time. That was definitely something that I encountered along my path. So I think the biggest thing that you have to think about is the time element of it. Kids require a lot of time. And so we were in a situation where my husband really enjoyed his career. We're both very career driven. It's very important to us. We prioritize that. Where he was at, in order to get to where he thought he needed to go, he was in a largely travel-dependent situation while I was in the high work volume of residency and fellowship. And so we didn't feel like we would be able to give the time that we would want to to a small child. And so then we're like, OK, well, maybe now we're getting to this place where we could do this. And he had stopped traveling as much, and I was applying for my fourth year fellowships. And I remember making this phone call to him from the lobby of a hotel being like, we can't do this right now. I just had my first interview. I'm going to be on call every night. There's tons of radiation exposure. And you're the only fellow, most scenarios. That's not true at every institution. Where I went, I would have been the only fellow. Maternity leave was not an option. That would have been a really negative thing to do to my program. And it wasn't something that I chose to do. And so I do think you have to be very thoughtful about it, I would say. And if you're in a situation where you're choosing to family plan with a partner, significant other, whatever that may be, making sure that you've had a lot of conversation about it, understand what expectations are, and have a plan for care. So my kid's five. He's full-time school. I still have a full-time nanny. I'm not sure how I'm not going to have a full-time nanny until he's 16. We'll figure that out. But it's really interesting. He goes to school. She drops him off at 8. I'm already at work. She picks him up at 3.30 and covers that time until we get home. And then also just takes care of everything around the house so that when I get home, I can spend that time from 5.30 until he's asleep at 8 o'clock with him and doing things that I want to do. And so by delaying having a child until I was post-training, I do feel like it's I only had one child because I was very of advanced maternal age. But it has allowed me to have more control over my involvement in his life by doing that at this time. But that's the trade-off, is I traded those years for having the time. So I also think that there really is no good time, which means that every time is perfect. There's going to be difficulties. I mean, there probably are times that are going to be a little bit more ideal than others. But my first son was born two weeks into internship. He wasn't planned. So it is what it is. But it was fine. It worked out. We did what we needed to do. My wife was working more on administrative jobs. But still, it was 9 to 5. We had family around. You do what you need to do, and you get it done. Second one, we said, OK, we're going to have it. And I did it when I was a second-year fellow. And we thought it would work out. Meanwhile, for the next year, we were bleeding about $1,000 a month in terms of child care and everything, and just kind of getting it out of ourselves just so that we couldn't. You got cheated on. No, that's, yeah, I mean, that was negative income, essentially. All our income was gone towards expenses. And we were spending $1,000 a month. And both of us did not have a lot of money at that point, and a lot of savings at that point in time. And we didn't want to rely on parents. We were kind of trying to be things. So it wasn't very easy for us to be doing that. But it worked. It worked out eventually. And we had it planned out to the point that we were able to do it and get ourselves to the next step and stage. It's all so circumstantial, isn't it? I mean, every life decision has so many inputs. We were faced with the advanced maternal age issue, too. And my wife had also had breast cancer in her 20s. And she had gotten Adria. So we weren't sure about what her ability to have kids, much less healthy ones, was. And on top of that, her oncologist was not keen about her getting pregnant. But we both really deeply desired a family. And so it was a, what the hell? We went for it. And actually chose my insurance instead of hers because we had better fertility coverage if we needed it, which, knock on wood, we didn't. But yeah, we took a chance. And the follow-up to this story is actually a few years after our second one, she had a recurrence. She's well now after having a bilateral mastectomy. But you've got to live up to the goals in your life, right? And stuff happens. But a lot of times, everything works out well. You just have to be true to yourself. And you have to be true to yourselves as a couple. And damn the torpedoes, right? So and hope that it works out. And it usually does. So you're going to have a lot of inputs, too. It just kind of depends. But that's also what makes life sweet because it depends. But when it works out, you've just kicked ass. And you own it. So live life and love it. I have one more thing to add about the whole parental planning. I had one, my first kid, when I was a second-year fellow, my program director was female during the time of my fellowship. So after first year, it was essentially all like ward service. We sat down, beginning of second year. We talked about research plans. She's like, OK, let's talk about your family planning now. And so I was in a program that was super supportive because they realized that we were in our prime childbearing years. And I swear, we had the highest rates of fertility in a fellowship program. There's always somebody pregnant during an NGI fellowship. Then I had my second baby during my associate year. So I knew at some point my plan was to have a second child. And so I made sure that leave, maternal leave, parental leave was in my contract. So when I got my contract, there was some type of leave in there. It was a little bit vague. So I brought it to a lawyer. And I was like, hey, my plan is to have a baby. I need to get protected time. And I want some paid time. And we worked it into my contract. So even though I worked for a private practice, lots of private practices will not pay you or may not pay you for maternity leave. I got a lot of it paid. And I didn't have to pay that call. I didn't have to exchange my calls. And if family planning is on your radar, but you haven't found that partner yet, I have a lot of friends who egg retrieval, freezing your eggs, preserve your fertility. That is super-duper important. We heard about how high infertility rates are. So like Tian, I actually also had my first. And like Wasif, it was oops. I started GI fellowship first year with a three-month-old. So if you ask me now, I actually don't remember my first year of fellowship very much. My husband at that time was also in surgical fellowship. They had just did duty hours. So neither of us remember anything that is not in a picture, to be real. But we got through it. We were shelling up the wazoo for nanny. I think we lived on less than half of fellow's take-home pay that year because that's how expensive child care is. And then my second one I had after my interventional fellowship. And that's a tough one because it's only one year. You only have one year to be trained for that. So like going to Mel's point, that's a harder time to have a child and be pregnant and all of that. There's a lot of considerations that go into that time frame. And then finally, my third baby I had as an attending. A lot easier, a lot harder to have her because I was a geriatric mother. You're a geriatric mother. But it was a little bit easier. I was in a much more supportive place. I had time. I had flexibility. It was easier for me to say no to things because any time you say yes to something, ultimately, you are saying no to something else, like what everybody was saying. But that gets easier the older and long you are in your career. So there's not a good time. Yeah, and child care is expensive, right? Daycare is expensive. Nannies are expensive. I would say depending on where you are, nannies are $20 to $30 an hour. Daycare is some of the Boston-based ones. Infant room starts at like $3,500 a month. So factor that into your budget. I think that's another place where networking is incredibly important and useful. You can trade favors with other working parents, especially if the kids are friends and already know each other. We'll take them this Saturday and you take them next Saturday or whatever. There's all sorts of apps out there, sites like care.com and things like that, where you can find people to do various things to help you run the kids around to their activities and this and that. It's the old, we're not throwing money at the lawn here, but we're throwing money at getting the kids transportation or whatever. It's so much nicer if it's family members you can trust or friends that you know, or at least they come vetted from others. So we've always made use of contact lists from preschool or school to just reach out to people. My wife has more of a social bug than I do, and so she reaches out to any and everyone out there for all sorts of things. And you'd be surprised how many resources come up at the last minute out of nowhere. Somebody is like, oh, I'd love to take your dog for the weekend, or yeah, I'd love to have your kids come over for a play date. There's some serendipity in that, too. You can't plan everything, but don't say no to some opportunity without checking with a couple of friends down the street who may actually have just been looking for friends for their kids to go to the pool with and can take your kids for a little while. So, yeah, networking, not just for career, but for keeping your family integral and keeping you sane. This kind of goes without saying, but we haven't really mentioned it. I don't know if we've mentioned it anywhere in this conference, but when you're taking the next step, your location is going to very much define your work-life balance, your happiness, your things, and your decision to be close to family or close to friends or close to people who can take care of family or things for you to do around that area, it's not a small deal. Yeah, the perfect academic practice that you absolutely love has everything that you want is nowhere near anywhere. Your family is in the middle of nowhere, and you're like, we're just going to drive ourselves insane. It's just not worth it. I mean, you have to consider your happiness as an academic and your career and your happiness as a person and put it all together. You can't just look at one or the other. Great. On that note, I think we might close. So, I want to say thank you to all of the faculty for taking time out of their busy schedules to come. I want to thank all the fellows for coming and participating. I'm really hopeful that in the next year or two, as you go through things, that you're very successful. Please, all of us are willing, ready to help navigate things if you want. We're here, just a little email away or a little phone call away. So, I'm speaking for every faculty member, but I'm almost positive. Just kidding. Everyone is very happy to help if you reach out and need it. Look at CVs, letters, et cetera. I don't want all 90, but I look at 89 of them. You can delegate some. Yeah, so I'll ship some out. And again, look at all the people around. We were all in these courses. And that, I think I mentioned the other day, is kind of like sleepaway camp. We're all friends and you'll see us for the rest of your careers, and some more than others. And so it's kind of fun because you'll see someone in some random meeting or even some international meeting. And it's kind of fun. So, thank you for all your attention and sticking around for some of you for three days. So, it's pretty awesome. And everyone, including Ed back there, would love some feedback about how the course went. I know he'll be sending out, at least I'm pretty sure he's sending out an evaluation. We would love to hear, get feedback, change whatever you guys didn't like, or whatever. Yeah, and again, thank you to our sponsors, Fuji, and Olympus, and Boston, and GI Alliance, and I think Medtronic, and Irby, and I think I left one out. But without those in-kind supports and some other things, it's really hard to do this. And certainly, the ASG faculty, and Ed, and Marilyn, and everybody else. Yes, all the staff out there, say thank you to the staff. They are awesome. So, appreciate it. Thank you.

work-life balance

family activities

supportive friends

personalized balance

outsourcing tasks

communication

strategic boundaries