What do you need?

[WolfpackWife]

we knew we could be anywhere for three years if it would open up more opportunities over a lifetime. .

This is exactly the thinking I have adopted over the past year, and am becoming more and more accepting of every day. Especially because our long-term location goal is a popular one with many reputable health systems.

[niener]

The only thing I needed was for him to match. Anything beyond that was bonus. Residency is 3-5 years; I can do just about anything for 3-5 years if it means getting him the best possible connections and the best possible training so that when we do start looking for *the* job we have more options available for where we're going to settle down. We were vying for an extremely competitive specialty though (which he didn't end up in but is still in a pretty competitive one), so our strategy likely would have been different if his chances of matching were higher. In the next phase of life I'll have more needs, namely some semblance of a city -- a professional sports team, a decent grocery store chain, good shopping, quality restaurants -- and ideally near some close friends and a major body of water.

[Pollyanna]

Totally makes sense to me. I just found the whole exercise of thinking about what I really needed, what he really needed and what our family really needed to be fascinating and valuable - and the match forced that conversation in a different way than I'd ever experienced.

The process truly is eye opening. Interestingly dh and I had very different rank lists. His was based on family priorities and mine was based on his priorities. In the end, the real priority is matching

[KlynK]

We are nowhere near this point yet but we've already talked about where we want to end up. Really, we just came from a job where he had no say in where we lived so that taught me that we can make it work anywhere. We would have to be somewhere where I can find a job but everywhere has schools so that isn't too limiting. Otherwise, we enjoy the experience of different places. Wherever ends up being best for him will be where we end up! I think things will be very different once he's looking for a job because we do want to end up West, in Colorado ideally but I don't think he would turn down a good opportunity if it was in a place that we weren't thrilled about. Heck, I was really mad when we found out we were moving to KS. But it didn't end up being near as bad as I thought. We make it work!

[MAPPLEBUM]

So I'm not sure I agree with this as a sweeping statement - DH got a great fellowship training in a densely populate metro area. BUT someone asked him the other day if he thought the "Mayo way" could be duplicated in big cities. They were talking about the expense of health care, the ability of people to shop around, etc. And he said no (he trained at Mayo and is now in a big metro area) - he said he sees specialties that are tied to each other (like neurology and neurosurgery and oncology) doing a better job of working together but the Mayo way works at Mayo in a large part because of WHERE its located and because its always been the same Mayo way since the day it was started/created.

Anyway, not sure where I'm going with this and sorry for the hijack but I thought it was an interesting conversation because we hear people talk about outcomes based medicine as a better gauge for healthcare and Mayo does that but its probably not sustainable, recreate-able in big cities.

Yea I'm pretty sure his opinion is based on just a negative bias for big cities. It's one of those arguments that can be flipped however you want. "So many people, therefore training not as good, don't get to see as many good cases." or "So many people, which means great training and lots of cases!" He likes to throw the word "saturated" around too. The only thing I do know is true is of course difference in cost of living.

[rainbabies]

We ranked on his fitting in with the attendings, program, reputation, and cost of living. We had three young kids and not a lot of cash. (Isn't that always the way?)
When we looked for THE job, it was in upstate ny and New England. We wanted to be back home. We've been home for just about 4 years now. We're about an hour from most friends and family. THE job didn't work out. So dh travels every other week for the new *it* job.

[Cleave]

Everyone sounds like they have found ways to be really flexible. Sometimes I think we get 1 or 2 things that we really want/need (I need swimming for stress release; I need whatever) and that everything has to be adaptable. And those things change over time. And I mean this more broadly than residency.