While deciding to stay in the city was easy, choosing a specific dwelling wasn’t.  Realizing that if we lived apart, we’d only see each other once a week at best, I pushed hard for us to move in together.  Of course the fact that Michael’s medical school had student housing on the Upper East Side didn’t hurt either.  Standing up to my wishes was never his strong suite and soon he was in the Housing Office picking up an application.  Reading it we realized that prior to securing a coveted subsidized apartment, we were required to provide proof of our commitment to each other (my college roommates had a ball making fun of our Domestic Partnership).  After all the paperwork was finally collected and submitted we were given a choice of a few apartments.  In the end we picked the most expensive apartment but one with all the appliances and plumbing intact, not to mention a 24-hour doorman.

Although paying rent and other living expenses was a shock to the system at first, I loved remaining in my favorite city.  While Michael didn’t see much outside of the library walls, we still tried to have as much of a social life as possible.  I did all the planning and he did his best not falling asleep at the opera, ballet, the theater, museums, restaurants and various other parties.  I felt that my party had been cut short when we learned that Michael matched in Brooklyn for the prelim year and in the Bronx for the remainder of the residency.

After learning that we did not quality for resident housing we once again got lucky and found a great rent stabilized apartment in Brooklyn, However, the program did provide us with a several hundred dollar monthly housing supplement.  We also bought our first car and I finally got my driver’s license (growing up in New York I didn’t have an opportunity to get one until I turned 25).  Michael wasn’t too crazy about this at first because I practiced my driving between two shopping districts.  I was giddy with two incomes and much cheaper housing.  We also discovered the new gentrified areas in downtown Brooklyn where many restaurants and boutiques have migrated to avoid high Manhattan rents.  I’m still not sure if it was all the new restaurants, buying the car or getting married that prompted both of us to gain weight during the first year of residency.

At first we were both a little apprehensive about moving to the Bronx.  Neither of us knew much about this borough but we soon grew to love it.  While we did get approved for resident housing, I found the kitchen and closets (only 2) to be cramping to my style and decided we need to look for a bigger space.  We ended up with another great rent stabilized place, which also included a balcony.  After only a few months in our new home, we completely fell in love with the Bronx.  The housing was half the price of other boroughs (and probably 3 times less than Manhattan), our neighborhood was very safe and friendly and there were tons of parks around.  Whenever we missed Manhattan, we hopped in our car and drove a few miles south and our favorite Brooklyn hangout places were still only 30-40 minutes away.  Plus I was closer than ever to the shopping mecca of the tri-state area – New Jersey malls.

As we get older and our friends are slowly moving out to the suburbs, we see our lives slowing down as well.  We are finally ready to make a similar move and try a smaller city, while remaining safely close to New York.  Neither one of use regrets remaining in New York for the past eight years.  We were both too young to settle down with a house and a family and needed to have fun for a few more years.  But we’re also proof that it’s possible to live in and enjoy New York (or any other big city) while struggling with a medical lifestyle and one salary.  It just takes a little planning and budgeting.  In the past eight years I learned how to live in one of the most expensive cities on a very limited budget and expensive taste.  Remember there are bargains to be found everywhere, even in the New York City real estate market.

Your choice: Feel sorry for yourself and wallow in your misery or take the opportunity to tell yourself that you deserve to celebrate yourself.

Here are a few suggestions for giving yourself the Valentine’s Day you deserve.

One of the first things that the commercials remind you about for Valentine’s Day is jewelry:  Diamonds, pearls, precious stones, gold, silver, platinum.  Sure you deserve a fabulous piece of jewelry or a new watch. The reality of the medical lifestyle says that it’s not likely to happen given the typical income of the medical student, resident or fellow though.

The Dawkter’s Wife plan to solve this one:

Appreciate the jewelry or watches that you already own. Take your favorite pieces and go to a reputable jeweler. Ask to have any precious metals and stones cleaned. Ask the jeweler to check any prongs that hold your stones. If you have pearls (or other pieces of jewelry that are strung) have your jeweler test the strand.   It’s well worth the cost to have any valuable or sentimental pieces restrung. Most pearls should be strung with individual knots between each pearl so that they don’t rub against each other. Have your watches cleaned and batteries replaced. This is the day to replace any watch bands and have metal watch bands sized. (Make sure you get the links back in case the band needs to be resized or you need damaged links replaced at a later time.)

If you haven’t yet done so, make an appointment to have your jewelry appraised and add the replacement value to a rider on your home-owner’s or renter’s insurance policies. Pat yourself on the back for taking care of yourself and your precious pieces.

The next thing the commercials and magazines throw at you incessantly:   Flowers.

If your honey remembers or is awake enough to remember that it’s Valentine’s Day, you’ll want to do what you can to prolong the life of your flowers. According to the flower experts (aka a woman I heard interviewed on the Diane Rehm show on NPR) the best way to keep your flowers looking fresh is to replace the water in the vase every day. When you have the flowers out of the vase, cut off about a half inch from each stem. This will do more to prolong the life of a flower arrangement than using sugar, salt, vinegar or preservatives in the water.

So, your honey didn’t remember to send you flowers? Well, you have a few choices to take care of yourself the Dawkter’s Wife way. Solution #1. Send yourself some flowers. Who better to celebrate your fabulousness than you? Order a dozen roses, an orchid, a cactus- doesn’t matter. Order a card with it. Sign it- “to me, YOU ROCK! Love, me.” Or if you know any other languages- sign it in a foreign language. Enjoy your little moment all day. Solution #2. Go to your local botanical garden. Appreciate the warmth and the beauty of the plants and flowers without actually having to attempt to take care of them. Mentally plot your dream garden when the training is DONE. (or if training is done, mentally plot the garden of your dreams when you have time/energy/money to do it!) Solution #3- have a plant or tree planted in your name. Lots of towns and cities have parks or forests that are for memorials or remembrances of loved ones. Why not have a tree planted for yourself? There are reforestation projects in the rainforests, in parts of the Middle East and in some of America’s parklands. I once donated trees planted in Israel for as a wedding gift for a couple that already had everything.

The next over-marketed Valentine’s Day gift? Lingerie. The Dawkter’s Wife way to celebrate the Valentine’s Day Lingerie Onslaught. If you’re a female medical spouse, swallow your pride and your nervousness and go to a real lingerie shop. If you have a Nordstrom nearby, they pride themselves on their lingerie departments; otherwise find a lingerie store habited by ladies of a certain age. Have yourself measured and try on as many bras and panties as you can. You will discover that you have been wearing the wrong sized bra. The Oprah Winfrey show did a show and 94% of her studio audience was wearing the wrong-sized bra. I went to a lingerie shop in Washington, DC and discovered that I was off by TWO cup sizes. Clothes fit much better and bras are much more comfortable when you’re wearing the correct size. I also learned that you really do need to take the time to try them on. My days of grabbing the ‘right size’ off the rack at the PX or Target are sadly over. I may buy them from those stores but I definitely try them on first.

If you’re a male Dawkter’s spouse- go buy yourself some new underwear. Really. Your medical spouse won’t notice but hey, you deserve it. Buy yourself something fun if you want. Throw in some new undershirts and live large ! Throw away the undershirts that are torn, holey or have stained pits. You’ll feel so much better. I’ll feel so much better knowing that you did. You wife will thank you.

Finally, if you drink wine, pour yourself a glass of something that YOU like. Or make yourself a cup of herbal tea or a cup of hot chocolate. Light a candle or two. Take a bath- add in those bath salts that have been sitting on the counter for years. Take a steaming hot shower. Listen to the music that your beloved can’t stand. Or listen to the music that reminds you of your hard-working beloved. Read a book. Watch the TV shows that your honey can’t stand. Put clean sheets on your bed. Sleep in the middle of the bed. You are important. Sleep well iMSN friend.

Obviously, our expectations were a little high. Because we also are poor managers of
money, we haven’t saved a dime. If our retirement money wasn’t automatically deducted
each month, we might be looking at a cardboard box in our future. We are still living
paycheck to paycheck despite the best of intentions. It seems that now our wants and
*needs* have just become more expensive.

Each month we have set out with a new budget plan….and each month, we have failed
ourselves. I, of course, blame him. (But I’m guessing that he is secretly blaming me!).
We each sneak $20 here and there believing that neither of us will miss that small
amount. With two people dipping into the family funds, it’s no wonder that at the end of
the month we can’t figure out where the money has gone.

My New Year’s Resolution this year is to get this under control once and for all. I have
decided that the only person I can control is me, and so between you and I…and the
computer between us, I’ll let you in on my secret.

I opened up a secret savings account.

In 18 days, I have managed to save $107.45 by following a few easy steps:

Second-Hand Ka-Ching

I began sorting baby clothes and toys for sale at our local second hand shop. I deposited
the even dollar amount and change ($20.45) into my new account and pocketed the
remaining $4.00. If I had kept the money in my wallet, I would have spent it without
even thinking twice. Now, it is tucked away earning a little interest.

Pay in Cash and Plan Ahead

One of the biggest fixed costs in our monthly budget is groceries. With a family of seven
(and one still in diapers) it isn’t hard to imagine that our trips to Coborn’s can become
very expensive. I went back through our checking account and determined how much
money I was spending each week. By doing strict meal planning and heading to the store
with cash (instead of the check card) and a detailed shopping list, I was able to shave $50
off of the bill each week. I deposited $40 each week into savings and kept the $20 to buy
stocking stuffers at the Dollar Store.

Pay Yourself

Instead of withdrawing money every few days, I decided to give myself a $40/weekly
allowance. From that money, I also automatically deposited $7 into savings. After the
holidays are over, I plan on depositing 10% each week into the new account.
I am amazed that I have been able to save over $100 in less than a month. I am
motivated by imagining the look on my husband’s face next year when we begin to
discuss the family vacation and I offer to pay for it. Hopefully, when he sees how much
money I have been able to save by simply cutting back and putting the extra money into
savings instead of spending it, he will be motivated to do the same.

Look out Disney, here we come!

If I have to hear that conversation one more time when meeting a residents’ wife that I don’t
know I might just have to hurt someone. Neurosurgery gets such a bad rap. “The hours are
horrid”, “The doctors are all full of themselves” or “They have terrible bedside manners”. The
things I’ve heard which are negative about my husband’s chosen specialty could fill a book the
size of the latest Harry Potter novel.

Neurosurgery isn’t the most family friendly specialty; I’ll be the first to admit it. However I
don’t feel it is the worst. My husband is a resident at one of the top programs in the country
based on completed surgical cases. They are exempt to 88 hours versus the regular 80. I feel the
difference is that my husband’s program truly sticks to the 88 hour rule. In the last year my
husband has averaged 71.4 hours in an ACGME four week period. He has worked a week of 101
hours, but he has also worked a week of 47 hours in a non-vacation week. They have been able
to stick to the 88 hours because the program has aggressively implemented scheduling changes
which do not sacrifice patient care and continuity.

The program has brought in two PA’s and is trying to hire a third to assist the Chiefs. The Chiefs
have a Chief junior (PGY-2) on their team at all times. The Chief and his or her team handle all
cases that come in through the ER. The 11, soon to be 12, attendings each have their own
practice. Some of their interests overlap but for the most part they individually cover all of the
neurosurgical specialties. Each attending gets a resident. That resident covers 1-2 attendings for
the quarter. That resident rounds on their patients each morning and evening while operating
with one attending per day. At the same time that resident is assigned to an OR. That OR is
usually staffed by their attending but if their attending finishes early for the day another
attending could take over the room. Therefore another resident’s load is lightened and all
residents finish at similar times for the day. This ensures that, most of the time, one resident
doesn’t work for three hours while another works for 12. Work hour violations are also reviewed
monthly in a conference attended by all residents and attendings so that solutions can be found.
One aspect of my husband’s program that some people see as a drawback is that he carries his
pager at all times. He is the first point of contact for the nurses if they have a question on one of
his patients. If one of his attendings’ previous patients has a question they call the operator which
calls my husband. Since this call is taken from home and is not excessive it does not violate the
ACGME duty rules. Some spouses prefer that when their husband is home, they’re home – no
pager, no intrusions. In my opinion that isn’t a reality in this profession regardless of where you
are in the training program. There are nights when my husband gets paged once an hour but that
is a rarity, not the norm. My husband is on night call, in the hospital, seven nights this quarter
and on weekend day or night call, in the hospital, four weekends this quarter. As the residents
become more senior their call nights and weekends decrease until Chief year when all bets are
off.

So what is my point? My point is that there are programs in this profession that have taken the
steps to ensure that their residents get the education they need while having a life.

How do you find them?

Ask questions!

When you’re interviewing for residency ask the program coordinator to put you in contact with
an upper level spouse or a resident spouse. The programs that want their residents to have a life
outside of the hospital will not have a problem giving you that information. Many programs even
arrange for applicants to meet with other residents for an informational lunch.

Don’t be afraid to ask questions about the cost of living, local school districts, cultural activities
and the residency program itself. It is perfectly acceptable to inquire about what other resident’s
and their spouses like most and least about the program. In addition, find out about any spouse
support group and how to contact them.

If one of the top neurosurgery programs, based on completed cases, can keep their residents
under the 80 hour rules, every other specialty should be able to do the same.

There I was, sitting on a cramped plane holding my son, then two and a half months old. My husband and I were talking excitedly. We couldn’t wait to get there. What would it be like? How hot is it going to be? Will the locals embrace us? Are we going to survive the journey?

We had been up for 38 hours or more the day before. I lost track eventually. My mom picked all of us up, dog included at the hotel in Vermont. We drove for a few hours packed to the gills in our car. As soon as we got there I started crying. We were leaving all of our family behind to embark on a journey to a country we hardly knew anything about.

We were to leave the airport in Boston at 7am. The plane had mechanical problems, so
we left a few hours late. We arrived in Puerto Rico as our connecting flight left – without
us. We were exhausted…and dressed in our winter clothes with a new baby, an 80- lb
Golden Retriever and ridiculous amounts of luggage.
Stranded.
The airline put us up at the Marriot Hotel, but they didn’t accept pets. After much
arguing, a car was sent and we were taken to the most beautiful, expensive hotel I have
ever seen. I couldn’t imagine that they took pets. I think someone must have bribed them.
I have never slept so well. For the first time, our son slept through the night. It was
wonderful!
The next morning, we finally boarded our flight. All three of us, the dog in the cargo, 6
large suitcases, 3 carry-on’s and a laptop. The flight was short to the island. We were
flying so low; the other islands and an occasional volcano were visible.
The airplane swooped through the trees, weaving in and out. We could almost touch the
tree tops because they were so close. Before I knew it, we were ready to land. There
were houses made of plywood cinderblocks and sheet metal, banana trees everywhere,
mountains, and the most beautiful lush rainforest I have ever seen. We had arrived on the
island of Dominica, the West Indies. Our closest mainland was now Venezuela. “Wow!”
was my only thought. “We’re finally here.” Finally, we are living my husband’s dream
of going to medical school.
As we got off the plane, my thoughts changed from “Wow!” to ”Wow! It is so hot
here!” How am I going to survive this heat?” “When we left Vermont, it was 28 degrees
Fahrenheit. Now, here I stood in a pair of brand new shorts, a tank top, and flip-flops
(with the whitest legs ever) and I was ready to pass out from the heat.
We went through customs at the airport. This proved a little difficult. It was difficult to
understand the local dialect, but we managed to do okay with lots of “What? I’m sorry, I
didn’t understand the question”. The airport was not your average airport. It was very,
very small and lacking in so much that we consider normal. It was hot, all luggage was
moved by hand and the only business was one little stand that sold things to eat and
bottled water. Later, when we left the island, I found out they don’t even scan your
checked luggage. They just ask you what is in it. It took about two minutes to get from
customs to the exit. In that short walk, many of the locals tried to hustle us. Thankfully,
my husband has no problem telling people to back off. If it had been only me, I would
have had nothing left at the door. We picked up our luggage and were asked some
standard questions about what we were bringing in to the country. Since we were
students and had a child, they were quick to let us pass.
Outside, we found a driver that we came to know as Alexis. He was a nice guy – one of
the most reliable, honest people we met while we lived there. He had a fleet of transport
vehicles. He had many drivers that would pick up locals and students. Because he was a
hard worker -and trustworthy -he also had a contract with the university. Driving through
the winding roads and mountains almost made me sick. Thankfully, we sat with parents
from India coming to visit their daughter. They were veterans of visiting the island.
Talking with them kept me from getting car sick. After an hour-long, horn-beeping,
brake-slamming insanely fast weaving ride, we made it to our new home.
Because of our dog, we had to pre-rent a house. We had never even seen pictures. We
just knew it had two bedrooms and a yard. We pulled up to a small white house with
shutters, a small porch and a fenced-in yard. We found out that it did have hot water…in
the shower…when you flipped a switch. My first thought was laundry, believe it or not. I
ended up doing it by hand for months…. king sized sheets and bath towels included.
You can imagine my complete joy when an American woman walked out of the
neighboring house to greet us. We shared a yard and she had a German shepherd. We
were so excited! Our dog was happy to have a friend, too. Our landlord came to greet us
and give us the keys. She was a very kind woman and every now and then she would
bring us the most delicious pineapple.
The woman next door was in her 50’s, a lay mid-wife, mom of 6 and a mother figure to
me. Me, with a new baby, thousands of miles from home and any one I could count on.
She was going back to school to get her MD.
Many people refer to Dominica as a third world country. They don’t have a lot there, but
it is far from third world. They have phones, cable, internet, banks, and even a pizza
place! The university seems to be what keeps the island running. The country is very
poor. They used to be ruled by England, but gained their independence. We heard that
once that happened, combined with a catastrophic hurricane, the island was never the
same.
Dominica has the most delicious bananas, pineapple and mango I have ever tasted. The
fruits and vegetables will never compare anywhere else. They are rated in the top five in
the world for scuba diving. They have the most beautiful rain forest, waterfalls, boiling
lake, Emerald pool, and colorful birds and parrots. There are iguanas hanging around the
campus, coconuts, mangos and guava always falling to the ground. With a baby, I really
did not get to do too much on the island. But, if you don’t have children (or if they are
older) there are many things to do. You can island hop, snorkel, scuba dive, hike, day
trips to the capitol of Roseau, and – of course – hang out at the beach.
Although life on the island may have looked like a tropical fantasy, it often felt more like
a nightmare! We were there for 16 months. It was a long 16 months. There were
constant power outages. And then there was the heat, the lack of reliability from the local
community, goats, cows and bulls tied up on the side walks, stray dogs, starving children,
roosters crowing in your windows at all hours of the day and night, dirty drinking water
after the rains, mosquitoes that could carry you away, centipedes that can leave a nasty
welt, my favorite….”advice” from the locals on how to raise my son (and in the end, my
daughter too) and the constant wonder if we were going to make it out of there.
Looking back, I’m not sure if we would have done it all over again. The cost of travel,
the extra certification to do residency in the states, the stigma of being a foreign grad, and
being away from family, friends, and what I consider a comfortable lifestyle was hard. It
was an adventure, but going this route is not for the faint of heart. In the end, it did give
my husband the chance to become a doctor.
_________________
Sylvia Siegel is currently the very busy parent of three toddlers. She is married to a PGY-
1 resident in obstetric and gynecology.

If only we could all keep that feeling strong through training.  Going to medical school is hard on both the student and the family.  Schools are traditionally designed for single people. Professors do not imagine that a student might have to feed the baby or cut the lawn after class.  Even if they do, many would expect ordinary household chores to take a back seat to studying.  You  will be juggling the demands of classwork with the demands of home – and every outside message you hear will tell you the classwork must come first.

Many families start out strong, with the philosophy that they’ll just hunker down and get through. If medical school lasted for a year or two, this might be manageable.  In reality, medical training can last from 7 to greater than 12 years.  That’s a long time to ignore the home front.  Many a medical family has hit the wall a few years in and decided they can’t take a backseat to the books any longer.  It’s better to set some guidelines from the start about study time at home.

Strategy One:  Don’t Bring the Work Home

Wouldn’t that be great?  Student at class, husband and father at home?    Unfortunately, this strategy is completely unrealistic.  It’s impossible to avoid any reading during your time “off” from school or even during residency.  In the first two years of medical school, there will be standard classes and exams.  During clerkship in the final two years, there will be concerns over board exams as well as reading for cases and journal clubs.  In residency, practicing patient care takes the foreground – but this can make the demands on home time even more obvious since there is limited time at “work” to read. Since residency hours are already bad, it came seem almost cruel when your spouse walks in from a 36-hour shift, grabs a bite to eat and settles in to study.  It’s possible to minimize the study at home by establishing an off site study spot – like the library, hospital cafeteria or the local coffee house.  If you’re like me though, you’d rather have them home reading than off somewhere else for hours on end.

Strategy Two:  Set Aside Special Study Times

If you can’t avoid study and work invading your home, you can work to control it.  Set limits based on the situation. In low demand times, set aside a house study hour.  This has worked for us on many occasions.  When my husband was studying for boards (part II), he would study every morning from 5:30 am – 6:30 am before leaving the house.  He would also study each night for an hour while I put our kids to bed.  This consistent study time helped him do well on the test.  It also helped us preserve time together.   Having a set end to study time gave us time to catch up on each other’s days and enjoy a few moments stress-free.  It let me know when he’d be busy so that I could plan my life accordingly.

Strategy Three:  Set Aside Special Family Times

Alternately, in periods before big exams or during hard rotations, you might schedule sacred family times with the understanding that all other time would be given over to the books.  A Sunday afternoon free to play with the kids?  Movie night on Friday with you?  Try to establish a few times when you can request the full attention of your med student partner– regardless of the pressure he may be facing in training.  Setting this rule up front will keep you from feeling neglected – and give you a clear complaint if your partner doesn’t hold up his end of the bargain.   We are actually in this mode now – my husband is preparing for his oral boards.  I feel much less neglected knowing what to expect.   I have checked out a stack of books and I’m indulging my love of mysteries.   I think my husband feels less guilt knowing that I will speak up about his family participation if necessary.   Eventually, this phase will be over and we’ll have more time for fun and less for the books.

Making a place for  reading and studying within  normal home life is a challenge.  It’s worth discussing as you start in medical school.  I know I thought that eventually the outside reading demands on my husband would decrease, but I’ve found that they have not.  Board exams seem to go on forever – and there is always a new article to read when a patient comes in with something unusual.  It is part of the job in medicine, so start incorporating it in to your home routine as soon as possible.  You’ll be happy you did it early.

We’ve had a lot of chatter on the boards lately about feeling “invisible” to outsiders. Once others learn that we’ve landed the golden “DOCTOR” as a spouse, our work, interests … basically our lives become beside the point. “You’re so lucky!” or “It must be nice” or, my personal favorite “It will all be worth it in the end.” are refrains we’ve all heard over and over again. Usually I chalk this up to ignorance. If all you’ve seen is the Hollywood version of being married to a doctor, then you’re bound to have misperceptions. My neighbors are all learning, though. They never see my husband’s car here, and I pay the 12-year old neighbor to handle most things my husband would do for us.

I have a harder time dealing with it when the invisibility happens within the marriage. My husband is so used to me handling all of the family details that he never thinks twice about his plans, often clueing me in at the last minute. Calendar? What calendar? Why would he bother to write his events or commitments on our family calendar? In his mind all he needs to do is tell me the morning of (or, if I’m really lucky, the night before) and he’s done his part. And it has taken a lot of work from me to get him this far.

It’s always strange for me to hear people mention conversations they’ve had with their spouse mid-day. As in “My husband called to see what we were doing.” or “I just got off the phone with my husband.” My husband doesn’t call. I know this is not purely a medical marriage thing. I know medical spouses who are very good about calling. Truth be told, I’m not a “check in” kind of girl. A daily “what are you and the kids up too?” would grate on my nerves.

What does bother me is when he’s out of town, or we’re out of town, and he doesn’t call to see that everyone is okay — or to talk with the kids. He writes it off. “I know you’ve got it handled. I don’t want to bother you. I don’t want to get the kids upset.” Very considerate. But let me tell you: he’s called more in the past two days while waiting for his new laptop to be delivered than he has in the past month. Today he even called to let me know he was heading from one office to another, just in case the laptop was delivered. I pointed out to him that he makes this journey daily, yet doesn’t call to let me know where he’ll be in case one of the children is injured, and gee, do you see why this might be insulting?? And while I said I realize this isn’t purely a medical marriage issue, I choose to believe its part of the intrinsic narcissistic character that dawkters seem to have. Otherwise my husband is just self-centered – right?

Match lists. Fellowship interviews. Specialty choices. Job offers. These are all areas where the non-medical spouse can become “invisible” if we’re not careful. It’s all about their career, their opportunities. Hazard, Kentucky? My husband was honestly considering an offer from a hospital (let’s be serious … “the” hospital) in Hazard, Kentucky, but for me stomping my foot down and reminding him about our children’s education.
“I’m sure there are private schools, Jenn.” he says, optimistically.
“What? The Academy of Hazard? I don’t think so.”

We’ve got trailing spouse lawyers who have to continue taking Bar Exams as training takes their family from state to state. We’ve got teachers and nurses who need to keep getting licensed as they relocate for the “best program”. And we’ve got young families who move thousands of miles away from their extended family, help, support, lifelong friends … all to feed the Medical Beast.

When I was a kid I thought invisibility would be cool — but it’s really not.

The majority of retailers, especially large chains, rotate their merchandise several times a season. Each holiday brings on a new wave of sales. So remember when you find yourself absolutely loving an item from the new collection, chances are it will be on sale in a few months or even weeks. The key to this rule is to check your favorite stores often enough, so you don’t miss the point at which the beautiful sweater or comforter that caught your eye becomes reduced while still in stock.

This strategy also allows you to evaluate how much you want or need the item in the first place. Were you drawn to the sweater because you saw it in a glossy magazine on a model a foot taller and 3 sizes smaller than you ? Or was it because it would be a perfect thing to wear to an upcoming party and goes perfectly with a skirt you already have? Will that comforter that looked great in Martha Stewart Living totally clash with the color scheme in your guest bedroom? A successful bargain shopper is one who always makes thoughtful purchases.

Stock up on staples during sales

While browsing the sales racks , always look for items that you may need to replace soon or will need in the near future. For instance, if you have received a wedding invitation in the mail and happen to see a great outfit while looking for new work clothes, don’t necessarily overlook it just because the event is 2 months away. Even if that killer diet works and you miraculously lose 10 pounds, almost any garment can be taken in. If you wait to lose the weight or count on last minute shopping, you may find yourself paying full price the day before the event. Stocking up on wardrobe staples when they’re on sale is another great way to save. Even one annual trip to Victoria Secret during the last two days of their semi-annual sales can save time and money all in one shot. Collect your favorites in every color and proudly wear snowflake bikinis through the summer heat. Just remember to establish what your wardrobe staples are prior to finding yourself mesmerized by a display of embroidered velvet suits.

Buy seasonal items at the end of the season.

The best deals on most items are found towards the end of the season. Air conditioners and shorts are cheapest in August while the prices for ski equipment and cashmere sweaters are lowest in February. Although your mind may have already moved on to the next season’s items, your bargain shopper instinct should keep you planted among the clearance merchandise. As long as you choose classic cuts and patterns that flatter your figure and complexion, the items will never go out of style and look amazing for years to come. However, this rule can also lead to a big pitfall – acquiring a useless article simply because of the bargain price. A new fancy kitchen gadget won’t turn you into Emeril if you detest cooking – at any price.

Shop at outlets

Any self-respecting bargain hunter should know the location of the nearest outlet shopping center, its directory of stores and operating hours. Before each visit, think of stores you’d like to visit. This way you’ll have a plan of action and won’t aimlessly wander from store to store. Often, it helps to download the mall directory and park close to the cluster of your favorite stores. Outlet centers usually have sales at times similar to traditional stores but the savings can be more significant. Additional promotional savings are common early in the day, so it pays to arrive in the morning. You’ll also score a great parking spot and avoid the crowds.

Take advantage of special online offers

Store charge cards are a great way to rack in extra benefits. The savings may include free gift wrap, advance sale notice, additional coupons, 10% off every first Tuesday of the month, free shipping, birthday discount and so on. However, be aware that they tend to carry a higher APR than bank-issued cards. If you don’t need or can’t obtain another credit card, signing up on the store’s website can often bring just as many benefits without any hidden costs. By just providing your email address, you will be barraged with weekly and monthly sale offers, enough to max out the cards you already own. Sign up for announcements and you’ll also be the first to know when the new wave of reductions has hit the store.

Happy Shopping!

Julie Muchnik (aka Vishenka) has become the iMSN’s often -sought fashion advisor. She is writing a special series for MDFamily in the hopes of improving us all, one outfit at a time.

I was so naïve. In hindsight that served me well to a point. Ignorance IS bliss with regard to intern year. I was tough and extremely independent. “We” weren’t like other couples who were needy and dependent on each other in unhealthy ways. I chalked up people who had trouble with their relationships during intern year as “weak.” I knew despite the long hours “we” would work on our marriage. What I hadn’t anticipated was how little time there was to do anything together. It was difficult for my husband to make a three minute phone call during his standard sixteen hour day, let alone time to “be together and work on our marriage.” All new interns have the 80 hour work week now in their favor. It’s a HUGE improvement from the abusive hours of old – yet it’s still WAY TOO MANY HOURS to function like real people do. So how can you survive intern year as a spouse and live to tell about it?

Perspective. It’s an annoying burden to shoulder for the spouse BUT it’s a necessary evil. What will the intern more than likely experience in one form or another on this journey? Being an intern is somewhat like being lower than pond scum on the scale that is medical hierarchy. An intern is cheap labor — plain and simple. The residency system benefits the system, not the individual. Further, your spouse will be working with people who are smarter, better read, and have more endurance than they do. They will be required to do things at the hospital nobody wants to do. It’s humbling to say the least. There is also the prominent issue of sleep deprivation. It’s hard to be even 75% when you are sleep deprived, let alone on top of your game. During intern year, the quality of life at home is one of many sacrifices. Regardless of how many challenges the intern faces however, it’s not all about the doc.

There are a few concrete steps to make intern year bearable. The first is to make sure you, the spouse, are legally able to make all necessary decisions pertaining to loans, bank account, credit card, and medical insurance BEFORE intern year starts. Fill out the paperwork beforehand. Discuss with your spouse how the checking account should be managed and where your “fun money” will go. Your doc spouse will be unavailable and/or brain dead due to exhaustion frequently during intern year. They may have no idea when loans or forbearance paperwork is due and have trouble participating in seemingly mundane household duties. Yet, the bills must be paid and the trash doesn’t take itself out. Your roll at home has changed. It’s now YOUR job to make sure things run how they should. Hopefully your doc will help out when available, but his/her participation will be unpredictable at best, completely absent at worst.

Socially, make an effort to embrace this new independent persona you now have, and be realistic. Develop your own support system with family or friends who are sympathetic to your situation. It’s likely these people will be there for you more than your spouse can. Keep in mind that it is extremely likely that all weddings, funerals, showers and holidays you will attend alone. If that’s not the case and your spouse can be by your side –GREAT – but why set yourself up for being disappointed every time there is something important to attend? Having low expectations is not negative; rather, it’s a realistically cautious way to embrace your new roll — as the spouse of an intern.

Choosing your battles is also imperative to surviving intern year. Your spouse’s time is going to be severely limited. The “quality time” you have together during intern year will be complicated by the doc’s lack of sleep, stress at work, necessary financial or family conversations you need to have with each other, the intern needing to read and answer pages, and very often the doc’s inability to “connect” at home . Being married to an intern is a thankless, lonely existence at times. However, your needs as spouse must be addressed in order for this relationship to survive. WHEN you choose to have a conversation about your needs is extremely important. After a 36 hour stretch at the hospital is probably NOT the best time! Waiting is difficult but if your goal is to have a fulfilling discussion, timing is paramount to your goal. One of the easiest ways for resentments to build while navigating intern year is for communication between the couple to be stagnant or one sided. Like I said, it’s NOT all about the doc.

Emotionally, intern year is comparable to a marathon rather than a sprint. Pacing yourself can be a helpful survival skill to getting through it with your relationship intact. Try not to look too far ahead and make sure you celebrate minor victories. Put things on the calendar specifically so you can look forward to them. If you sense that you are off the tracks and heading for relationship disaster call on professional help. Many programs offer free counseling for a period of time. A professional is trained to be objective, see all sides of an issue, and can really help a couple learn how to work together during challenging circumstances. Because time is so limited during the first year of residency, professional help can not only be a great comfort but an immeasurable resource.

Surviving intern year is doable. I’m living proof. We made it and you can too. Our intern year was nine years ago. Now we are days away from signing a contract for a “real job,” and have added (in this order) a charming Labrador and two fantastic, healthy kids to our family. I am looking forward to making up for lost time and co-parenting. Yesterday we talked to the drafter in charge of the plans for our dream home scheduled to be finished this September. We have four months left of residency. Life is good.

Jenny Hampton is the wife to a PGY-9 senior CT fellow, mom to two great kids ages 3 and 1, and a true survivor of the medical training system. Her family will be happily out of training next year. She offers her wisdom for MDFamily in a featured article this month.