A Shock to the System: Welcome to Intern Year by Jenny Hampton

Intern year was harder than I thought it would be. I can’t say that about too many things in my life. Prior to our intern year, I was pretty realistic about challenges and how to gauge them. I looked at our intern year like anything else – a challenge that needed to be managed. I was in love with a medical student who wanted to be a heart surgeon. Okay. Sure, there will be some sacrifice but it’s a noble goal. Let’s come up with a game plan and implement…right? No problem.

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.