How can I support my anxiety prone partner?

[marciaquezada]

My fiance will be taking step I this July. He is a foreign medical student at UQ in Brisbane, Australia. He is currently doing his clinical rotations at Oschner Medical Center in New Orleans, Louisiana. Anywho, I am currently not with him due to job constrains but decided it be best to move to NOLA after step 1 and hopefully he'll be done with step 2 by the fall early/winter. FI, is stressed with step 1.. and I understand everyone gets stressed, but he seems more since, he hasn't been getting the grade he'd like from his practice exams.. He scares me and tells me we will never match into residency.. Anyone else go through this? Will we have a light at the end of the tunnel?

[MrsK]

I think you'd be hard pressed to find someone partnered with a resident who has NOT gone through this. It's the nature of the beast. Our partners wouldn't be going into medicine if they weren't a driven and a little neurotic. I don't think there is anyone here whose partner walked into Step 1 (or Step 2 or the boards or residency interviews or job interviews) thinking, "No worries. I've got this." And I don't think anybody actually feels like they are getting the scores they want on their practice exams or otherwise. There is a light at the end of the tunnel - I hope. But first there is a very long and twisting tunnel with many hazards. For some of us (my dh and I), medical training has been a matter of pure endurance.

Hang in there. Be supportive but don't be afraid to be firm sometimes either. Don't let him become irrational or sink into a pit of despair because that won't help him to his goal. For instance, my dh becomes obsessive and angry about bureaucratic irritants which I feel is about as useful as blaming the ice burg when the Titanic was sinking. I frequently have to remind him that the ice burg doesn't care so he'd better swim.

[marciaquezada]

MrsK, thank you so much for the advice. It always feels reassuring to hear advice from someone who has gone through this process. My FI, can be a little of a pessamist sometimes (undersandably so). I put off my move in big part for both step 1 and step 2 so, that he can have all the time and space to get through and pass. I noticed that you guys are PGY-4 in Psychiatry.. My FI went into medical school to become a psychiatrist and his passion for research in the field. Was the match difficult into this speciality? Was Psych the first choice for your DH? Were you guys international med students as well? (sorry for all the questions)

Also, funny fact when I marry FI, I too will be MrsK. Thank You for the reassurance.. I always feel anxiety when he feels anxiety and it feels good to know that other people understand!

[Meenah]

MrsK gives great advice!!! I think part of the "medical personality" is to be anxious and worry. When they get to Attendinghood they still get anxious and worry, just about different things. Why did the patient pick Dr X instead of me? Why did the ER give that patient to Dr.X and not me, and on and on and on and on!!!!!!!

[MrsK]

MrsK, thank you so much for the advice. It always feels reassuring to hear advice from someone who has gone through this process. My FI, can be a little of a pessamist sometimes (undersandably so). I put off my move in big part for both step 1 and step 2 so, that he can have all the time and space to get through and pass. I noticed that you guys are PGY-4 in Psychiatry.. My FI went into medical school to become a psychiatrist and his passion for research in the field. Was the match difficult into this speciality? Was Psych the first choice for your DH? Were you guys international med students as well? (sorry for all the questions)

Also, funny fact when I marry FI, I too will be MrsK. Thank You for the reassurance.. I always feel anxiety when he feels anxiety and it feels good to know that other people understand!

I met my dh when he was in med school. He had wanted to be a trauma surgeon but was not enjoying his surgical rotations. At one point he was telling me about his plans and explaining the Match to me. I asked him what would happen if he didn't match in surgery. His reaction surprised both of us; he became really excited about the possibility of doing something other than surgery (a clear indicator that he should not have been pursuing surgery). About a week later, he told me that he'd decided he wanted to do psych. That was a total reversal his prior assertions that he liked trauma surgery because there is an immediate problem that he can fix. In psych, there are usually a lot of problems that are hard to get to and cannot be fixed. So, the short answer is that by the time we entered the Match, psych was his first choice. For us, matching was not easy. However, it really depends on your SO's qualifications, the number of candidates/positions available that year, and the program in which he wants to match. Traditionally, psych is one of the less competitive programs and in the last couple years (subsequent to our Match) there has been an increased interest in mental health and probably more demand.

No, he is not a FMG.

[metroguy]

for FMG, step 1,2 are critical. He must score high otherwise, there's very little chance of matching. i would suggest taking 2 month off and just dedicated study time (aka kaplan, usmle world, etc)--somewhere around 12 hrs a day just for the test - 7 days a week. basically, for 2 months, it's just studying, and body functions and nothing else (no tv, internet, phone calls, etc).

[PrincessFiona]

DH went through this too. (We are now 11 years OUT of fellowship, so there is hope). Basically, he set up a daily study schedule and I honored it. There wasn't any way around it. I agree with MrsK about not letting him sink into a pit of despair (love that!). I tried to be encouraging and we looked together to find the right study guides, etc.

Hang in there. Once StepII is behind him things will get much easier!

Kris

[houseelf]

I'm the anxiety prone partner in our relationship, so my gut instinct is to shout, "YOU LEAVE HIM THE HELL ALONE!!"

Then I realize, it isn't ALL about me. LOL.

Good luck. FWIW, this sounds normal.

[Cinderella]

Anyone else go through this? Will we have a light at the end of the tunnel?

We've been going through it for several years and I've found there is light at the end of the tunnel.

I learned some of my husband's tells when he gets stressed and has high anxiety like shaving all his hair off because it bothers him while studying for a Step he's got a set exam date for. LOL! I blame it on summer time but really that's just the short acceptable answer for what's going on. He has curls and saves money using a home electric shaver to do most his hair and then he'll ask me to trim the back. This last time I showed the slightest doubt about the job I did and the next thing I know he comes out of the bathroom with a bald head again! He did this with Step 1 just when he was getting serious about his studying and having high stress and anxiety and now he's done it again with Step 2 CK. Thankfully he was feeling confident about his ability to pass Step 2 CS, because he's practiced medicine in his home country in a private clinic that services tourists. So we didn't have any shaved head incidences before he flew to LA to take the exam.

I've been asking myself the same question, "What can you do to help the anxiety prone partner?", for the last few years. Part of it is truly leaving them alone to deal with it themselves at their own pace whether you are living with them or doing it long distance. Be their support. Always reassure them that they are capable. That they have come this far and have the ability within them. Encourage them to keep the momentum. Avoid indulging in the negative discussions of what ifs, self destructive, downward spiral stuff. Worrying together about it doesn't help either of you.

When living together again give them the space they need to study. I've read several times from others and heard it from my husband also that they need absolute quiet to focus. That it's like filling their brain up to over flow capacity and they're trying to keep the information from spilling out of their ears. Keep yourself occupied and keep the environment supportive. Offer to go on hour walks together. They may complain at first about not having the time, but you're both getting your fitness together and after a regular amount of time the benefits show. They will tell you they're grateful for it and the benefit it brings and that they look forward to the routine break. Something funny we also do together is have a snack time. I make something and we have some thing to drink and eat like tea and cookies. We sit on the couch in front of the living room window and just chat about what's going on for the day for around 30 minutes. Then it's back to study. Most meals he'll eat at his desk in front of the books and computer. Sometimes I make them and sometimes he makes them. Mostly from sunrise to well past sunset he's at that desk. I do everything else now that I'm home - like the laundry and the cleaning and the cooking. When I worked and he was home studying all the time he'd help around the house with these things, but I'm home now so I let him have as much time for himself as possible for what he needs to accomplish.

Also they gain more confidence in their ability with each Step they complete and can put behind them. For several years we struggled just getting past Step 1. Once we got past it though things seemed a lot better and huge burden was taken off of us. Then we finished another exam with Step 2 CS and now it's just the CK left for the ECFMG certification in order to apply for the match.

I think it's a little bit more stressful right now because he's on a deadline with meeting the upcoming match. It feels like we will be hitting the ground running after he's finished that last Step. We immediately apply for the match. Move. Finish immigration for US Citizenship. Go through the interview period for residency. Then ROL and finally Match. We get a small break between the match and when (hopefully) residency starts. This is after three years of immigration to the US and him not going back to his home country that long while studying for the USMLE's. Adjusting to a new culture and country entirely different from yours while attempting to continue to practice medicine in that foreign country is like a double whammy for stress factors and anxiety.

I can see the light at the end of the tunnel now. It's exciting and scary too! On the bright side we know if he doesn't match this round we can apply another round but it's not all lost. He can also take his American board certification and use that in other countries because it means something more to have passed these Steps and become certified. We can go work in the Gulf Arab States and make a nice standard of living compared to his home country. It won't be either of our homes but we'll be together and it will be living like first world standards in some places like in the UAE. I'm hopeful it works out and he matches here. I'll be holding my breath until next March however because I don't know which way our life and future will go.

Sorry this is such a long response. You guys that are FMG/IMG should get your post count up to 100 so we can get to know you more, and then you can access the private forums where we can talk more about this in depth in the Foreign Medical Graduate forum on here. I'd love to have more people to talk to who are going through this in there to share this process with.

[Agentamer]

I think you'd be hard pressed to find someone partnered with a resident who has NOT gone through this. It's the nature of the beast. Our partners wouldn't be going into medicine if they weren't a driven and a little neurotic. I don't think there is anyone here whose partner walked into Step 1 (or Step 2 or the boards or residency interviews or job interviews) thinking, "No worries. I've got this." And I don't think anybody actually feels like they are getting the scores they want on their practice exams or otherwise. There is a light at the end of the tunnel - I hope. But first there is a very long and twisting tunnel with many hazards. For some of us (my dh and I), medical training has been a matter of pure endurance.

Hang in there. Be supportive but don't be afraid to be firm sometimes either. Don't let him become irrational or sink into a pit of despair because that won't help him to his goal. For instance, my dh becomes obsessive and angry about bureaucratic irritants which I feel is about as useful as blaming the ice burg when the Titanic was sinking. I frequently have to remind him that the ice burg doesn't care so he'd better swim.

Agree with above. My DH is definetly prone to this. He wanted to quit medical school 3rd year (the loans he accrured from years 1-2 kept him from doing this). Then he spent 2 out of 5 years of residency depressed. I mean I almost couldn't stand living with him type of depressed. Then he came home his 1st day of fellowship last summer (we had moved 1 week earlier) and said to me "I think this isn't going to work. You better start thinking of plans for moving..." Needless to say...he never did quit anything and he finished his fellowship. (Thank GOD!!!!!) But the point made above is right on. A friend of mine once told me that these medical people are critical by nature. They need to be in order to be good docs. It's just really hard seeing them on the home front and I always wished he wasn't so critical of himself (and of the rest of us poor souls). The Step exams are a great "break in" to the medical world as they are super important. Just keep up the encouragement for him. And when you do get to be together, I think that in our life at least, the most important thing I could have done for him is to just help out with the little things that he won't have time to do. Good luck on your journey with your soon to be Doctor guy!!!

[marciaquezada]

Ladies,

I am sorry that it took me this LONG to respond. I have been in the midst of my final examinations at school and workin' full-time. PHEW!

I appreciate all of the wonderful responses.. I think that you all are right medical peeps in general.. I think can be overly anxious, because of the level of academic/social stress that they can be to perform. J told me yesterday that he will take his board in about two weeks ago. I have never been more worried/scared... However, I have been trying to keep him motivated to continue his 13-14 study blocks. After the boards are over we are planning to spend a couple days together before his next rotation begins.. After Step I, is ova' and results are back everyone can just relax.. and perhaps J and I can finally plan are wedding

I've realized with all of these exams/rotations it is important to always honor his schedule and the things he needs.. It used to be so hard for me to understand that, perhaps, because I didn't understand the level of dedication that this type of training entailed. As I realized the importance of getting through satisfactorily..for the sake of him.. I have been able to respect his space and needs completely. I have also read extensively on how you guys also have your own lives outside of your marriages/relationships.. I used to feel guilty for wanting that for myself and now-a-days, I realize all of this is a part of the process and will make our marriage better in the long run.

Thank You again for all the responses

[DrBandMe]

All of this was good advice for anyone trying to support their SO through this process. There's no handbook to tell me what to do when SO is freaking out about Step 2 or pacing the living room fretting over that one thing he missed on his last shelf exam. I've learned to simply be available to him and to ask him what he needs - sometimes that's to be alone and other times it is to steal him away to the bedroom to cuddle and be quiet together for a bit. Good luck to you and yours as you navigate your way through it all!

[MAPPLEBUM]

Yep, my husband killed steps 1 and 2 and then for whatever reason sunk into a deep cavernous depression on the 3rd. He was convinced for months that he had failed and we even postponed our honeymoon because he thought he'd have to use that time to study. Needless to say he did fine. It was scary though, his tendency to obsess is usually in the positive --- studying for hours in the evenings after work or researching whatever his newest hobby/obsession is (miniature orchids, birding, whatever), but this was the first negative obsession I'd ever seen. You can only be as supportive as you can and then at a certain point cart them off to a GP and then maybe a therapist. It's a lot of stress, and if they're not careful it does tend to implode (or explode) at a certain point.

[DrBandMe]

It's a lot of stress, and if they're not careful it does tend to implode (or explode) at a certain point.

I've certainly thought about this, too. DrB is freaking out about interview season and it seems there is next to nothing I can do to help him unwind. Crossing my fingers he'll calm down a touch once his first interview invite comes in.

[diggitydot]

I've certainly thought about this, too. DrB is freaking out about interview season and it seems there is next to nothing I can do to help him unwind. Crossing my fingers he'll calm down a touch once his first interview invite comes in.

Unfortunately, he won't really mellow the fuck out until after he finds out where he matches. And then he'll worry about different shit.