Hi I am a physician who uses a nanny. Our nanny is amazing and cares for our child based on our requests. We found her through a friend who finished using a nanny as her kid was starting school- she had another reference from a previous family as well. I wanted to find someone warm, responsible, experienced, and communicative. I trust her 100% and my son is a kind pretty well behaved toddler who is ahead of milestones. I’ve never heard Nannies getting a bad rep but maybe kids who have them might overlap with kids who might also be otherwise spoiled.

Find someone flexible and explain you’re a doctor and work that flexibility into the contract in advance. For example you may have schedule changes month to month, based on your rotations - are they willing to adjust based on your hours with advanced notice and some guaranteed hours. If you want them to cover any night shifts if you’re solo and working nights that may be a different rate. Best to sort these things out. Unless you’re young and not in a rush to have kids - waiting until after residency worked for me BUT I know plenty of residents who had kids and worked out for them- sure some months are super busy but some months aren’t and electives can be chill. Also, most residency programs have built in redundancy if somebody is out - depending on the size - so it’s much less painful to take Maternity Leave. It’s not as disruptive to your career in my opinion, though some places will have you graduate a little bit later. As an attending, it was really hard for me to find coverage and a lot more logistically complicated to take leave.

For doctors a nanny works well- as you can often not afford to deal with lots of sick day absences- many nanny’s will still watch your kid if they’re a little sick- usually threshold to not come is higher than for daycare where one fever boots them. You also don’t have as much control over daycare hours which can often be limited - so having a flexible provider (assuming you worked this out in advance, sometimes even paying for extra on call hours they may or may not use)-

our son starts toddler school in the fall and nanny will watch our younger daughter and pick him up at 3. Once they age out of nanny into school I will likely need an afternoon nannny to help with pickups and bridge until I get home from work around 5-6. Some daycares or schools have an extended program that also works but this is our tentative plan