Medical students often ask me if it is possible to balance having a family and succeeding in medicine. They must think I have the answer because I have a large family in addition to being a physician. But most days I feel like I am barely staying afloat. I do believe work-life balance is possible and rewarding, but it is the hardest thing I have ever done.

Years ago, as a second-year medical student, I went to the Dominican Republic on a medical mission trip and treated orphans in a clinic we set up. That's when I felt led to pursue a career in family medicine, as well as to help children who might not have anyone advocating for them. A few years later, when my husband and I wanted to start a family, we decided that, in addition to having biological children, we wanted to adopt. We also became foster parents, and at one point went from having two children to six children in a six-month period.

Today, we have five children under the age of five. I teach at a medical school part time, practice part time at a Federally Qualified Health Center (FQHC), and work a couple shifts per month as a hospitalist. My husband teaches high school. It is busy to say the least, and COVID-19 has made it seem even busier. Here's what I tell students who ask about work-life balance.

1. It takes a village. I live near my parents and in-laws, and have several babysitters who help watch the kids when my husband and I are at work or need some time together. Not everyone can (or wants to) live near family, so other options include building support through community groups, church groups, or other physicians and families in your area.

2. It helps to have as much financial freedom as possible. My husband and I chose to pay off medical school debt prior to starting a family, which allowed us to choose jobs that fit our family. It is not possible for everyone to do that these days, but there are other options: loan repayment for working in underserved or rural areas, military stipends during or after residency, private scholarships, and other innovative options to allow flexibility and decrease financial stress.

3. Choose your specialty for the right reasons. I advise students not to choose their specialty just because it is competitive, has good work-life balance, or pays the most. Your specialty should remind you of why you went into medicine in the first place. If it does that, then work won't always feel like work, and you will feel more satisfied and fulfilled.

4. Take care of yourself. Burnout is prevalent in health care, as the system asks us to give more time and effort with fewer resources and more liability. Physicians feel the burden of taking care of patients and running a practice while trying to manage their home life. Self-care can easily get pushed to the back burner, and physicians and their families suffer. We have to take time to care for ourselves and our mental health. Make time for hobbies and fun, not just work.

5. Create your own niche. Family medicine offers a variety of practice options, so if one setting isn't working for you, don't feel stuck there. I worked for a few years at a large multispecialty group where I had a high patient load and not enough time to spend with each patient. When I had my first child, I decided to leave that job and work part time at a private group. Soon, I was given the opportunity to teach, which felt engaging. I also channeled my passion for helping the underserved into working at an FQHC. To keep up my hospital skills, I joined a group looking for per diem coverage. With these three jobs, I finally found my niche.

6. Be forgiving of others and yourself. We all will make mistakes, both in life and in medicine. This is difficult for physicians, as it has been ingrained in our minds that we must be perfect, prove we are competent, and be everything to everyone. But we are human. Work-life balance is trial and error. I know I have made mistakes and have some regrets. But I also know that, as a result of my decisions, my family unit is the best it can be at this moment. I will forever strive to improve and be there for my family, patients, and students. To me, that is work-life balance.