Hello Textbook, Goodbye Spouse? by Angela DeBernardo

I bet many of you are breathing a sigh of relief right now.  You’ve gotten in to medical school.  Finally!  You are done with MCATs, application essays and interviews.  No more prep work.  Sure, the work ahead will be tough, but it’s what you’ve dreamed about doing for a long time.  It will be fun to finally learn about “real” medicine instead of memorizing reaction pathways for organic chemistry.  Surely, this stress will be different because of the underlying satisfaction in the work.

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.