Residency Expectations?

Hi everyone,

Since today marks the start of a new journey for some of us, does anyone have any tips/words of wisdom & survival for residency? What can we expect? And what can we do to be supportive of our partners?

My boyfriend's going into internal med (hoping eventually to do a GI fellowship). I haven't posted much here, but I think I'll be around more now.

-Esther

Welcome to the group, Esther!

I'll second everything Lunatic said, especially about making a life for yourself outside your spouse's career, and add a few things:

1. Be future-focused. Make "It DOES get better" your mantra--there is real life and real money at the end of the tunnel. I can prove it.

2. Do what works for you and your relationship, even if it seems crazy to people who don't understand. For many months during the first year I drove 40 minutes each way to bring in take-out food and have dinner with my husband in the call room when he was on IM call. Sometimes I'd sit and read for a couple of hours until he could get free, but it was worth it to me, and I don't regret a minute of it.

3. Watch out for jealousy, insecurity, anger and feeling like a martyr because he's never around and you're doing everything yourself. Talk to friends, a therapist, us on this board (we love to hear people vent), but don't suffer in silence and let it damage your relationship. Remind yourself often why you're with him and what you love and admire about him.

4. Be kind to yourself. Find some little things that cheer you up and you love to do and do them. There were lots of moments where it was like the best parts of being single again. I watched foreign films and scary movies on DVD, went out with the girls, spent hours in the bathtub, read piles of books, wandered art museums, got acquainted with my cousin's children, and taught English as a Second Language in the evenings.

Good luck! Enjoy the journey, and remember it only lasts so long!

[Sheherezade]

Here are the main things I wish I knew in PGY-1 or 2 that I only figured out around PGY-6.....

1. The residency/fellowship/hospital is like a "need machine" there is no end to how much it will demand of your spouse, so it is up to him/her to place limits. You could always do more, and you will always feel like you should. It took my DH ages to figure this out. He still struggles with it, because at some institutions you feel judged if you don't give it all you got. Now, 7 years out he is a little infuriated that the "slacker" residents are doing just fine in their post training employment when he gave up so much of his life. ENCOURAGE YOUR SPOUSE TO SET REASONABLE LIMITS.

2. People say it gets better, but that really depends on your particular situation. Every hospital is different, every specialty is different, and every class year is different. There has not been a year of fellowship where the resident class my husband works with didn't complain, readjust, and generally b***h and moan about how bad they have it.....of course now that's my husband's headache since he is responsible for getting all the work on the floor done/patients cared for with fewer work hours and the same number of people on staff. When he complains though, I point out that in residency we had 2 resident meetings at our house to discuss their terrible lot in life and how unfair everything was to them too. Point is, residency is tough and unfair on EVERY class but in different ways---particularly now that the system seems to change every year with new regulations and medical structures. I can not tell you how many fights my husband and I had based on the idea that "next year will be better". We got along much better after I accepted that this was it and decided if I was ok with that or not. In our case, second year was not better than first, chief year got socked with tons of difficult rotations due to reorganizations, and fellowship got slaughtered by the new 80 hour work week (doesn't apply to fellows-they pick up the slack). BE FLEXIBLE --AND DON"T WHINE WHEN IT DOESN"T GET BETTER NEXT YEAR.

3. As has been said before, get your own life. Don't wait around to do things until your spouse is available, because you will grow to resent them. However, balance this with staying connected---it is easy to grow apart if you are both busy in your separate lives. I honestly don't know how to do this very well --I ping back and forth between the two extremes. Balance is not my strong point---you should see me in yoga class

4. Keeping in mind number two----it DOES get better ever so sloooooowly. A vet medical wife here says every year at their fellowship "grad" dinner that med training is like raising children---THE DAYS ARE LONG, BUT THE YEARS ARE SHORT. This I do believe. Time passes quickly if you take it one day at a time.

Angie

[Flynn]

I've been thinking about how to respond to your post since early this morning. What would I have liked to know when we were starting out? What would have helped? I am not so familiar with IM -- the specific residency can vary quite a bit but here are some things I've learned in SEVEN years of residency (with two more to go)....

1.) Being married to a resident is so different from most people's lives --- if you haven't lived it, you don't get it. It's like being married or having a child. You can intellectualize what it's like and you know people who are married and have children -- but until you take the plunge in either capacity...you don't TRULY know how it is. That's how it is being married to a resident. Your family and friends will try and support you which is great, but forgive them when they just don't get it. Make friends or try to with other resident spouse's. These are people who truly "understand" the challenges you will go through.

2.) Does the program have a free counselling service? Many do and I can tell you it might save your marriage someday. Look into what the program provides.

3.) BUILD YOUR OWN LIFE!!!!!! Have friends in medicine but have them outside of the field too. Otherwise every conversation you will have with a beer in your hand will be with people talking about who died and who didn't. I was shocked at first as to what was talked about in social situations. It was nice to hang out with non-medical people to balance "the life."

4.) Be realistic. Your spouse will miss weddings, funerals, your birthday, and all other important events more often than not. This is the life of a resident. You will go to most important events alone. Be flexible but do what's best for you when you can. Celebrate your birthday even if he can't be there. MY DH has missed two important funerals, three weddings and made two other weddings post-call and brain dead so in other words, he really wasn't there at all. It's hard. I had to miss my grandfather's funeral because it didn't fit in with my DH's schedule and I didn't want to bring my toddler across the country for 48 hours. At that moment I wished my DH was ANYTHING BUT a doc.

5.) The R1 year is hell. It's just awful. Batten down the hatches and do what you can to get through it! Take one day at a time and don't look too far ahead unless you have to. Find things in each day to look forward to. At the beginning of our R2 year, we got married and 6 months later we got a puppy. For me it was the perfect solution to being alone at night all the time. I began to look forward to our walks, dinners together and having him (my dog) keep me company. He is a forever friend to me -- even closer than some human friends I have.

6.) Think very seriously about WHEN to start a family. There is no "best time" in residency to have kids. Financially it's very tough for most couples and that's just the tip of the iceberg. Residency takes on a whole new "look" after you have kids. I found it much harder in the beginning of my daughter's life to deal with the long hours -- now it's better but I am looking forward to being done. As a married couple without kids prior to the birth of my daughter, I felt we were in a very good place. I was dealing with the hours just fine. After our daughter was born, my resentment of the long hours was at an all time high. It was a tough transition for us.

7.) Keep in mind that medicine is a "calling." Only an idiot would put themselves through residency if it wasn't a calling and I mean that in a positive sense.

8.) Do things for yourself you enjoy. I have movie nights with myself, pizza, beer and a game on the tube when I can. Take baths, write in a journal, call your friends and family long distance. Stay connected to who YOU are.

9.) When you have time with your DH -- eat out sometimes (so the TV and the phone can't distract either of you) and make a deal that if he isn't on call, he can't return ANY pages until after your dinner is finished. Figure out what you think is reasonable when you are having QT with your spouse. There is a dream I have where I flush my DH's pager down the toilet! I always wake up happy after that one!

10.) Finally, your DH's ambition is good. It is horrible however when it overshadows EVERYTHING else. The rat race of "better, faster, smarter" is extremely rampant in this profession. Encourage your DH to keep this at bay.

During our seven years my husband and I have learned so much about the medical profession and us as married people. Talk to your husband. Tell him how you feel when you can. There is a fine line between great communication and nagging. If you get into "super wife mode" where "everythings' fine" all the time, you may be doing serious harm to your marriage because your discontent will come out eventually. After seven years we have finally learned how to voice our troubles and concerns to each other in a timely manner so our resentments don't grow through lack of communication.

I respect my husband and what he's accomplished but never more so then after we had our daughter and he realized how much WE as a couple were sacrificing during residency....this experience is NOT all about the DH. He misses his daughter so much when he can't see her for days at a time. Somehow all the time he is at the hospital became tangible after she was born.


Well I'm babbling now...sorry.
Do your best to take one day at a time. You'll learn through trial and error what works for you!!! Also, USE THIS SITE!!!! It's been great for me and I just discovered it recently!!


Good luck.

Thanks for your responses. It's great to have this resource and new friends who understand.

We're not married; we've been together for 1 year and are thinking hard about a future together. I'm a big reason he chose to stay in Chicago. What I fear most is that I'll want to give up on our relationship when things get difficult with his job. I don't know if I'll be able to pick out what's our problem vs what's the situation- does that make sense?

A few of the comments really hit home, especially setting limits. I have a feeling that he'll be one of those people who won't be able to say no. Even now, so close to graduation, he hasn't slacked off. Being hardworking is a great quality, but I hope someone is able to convince him to set limits (I don't think he'll listen to me on this).

Socially-- it's funny because this has been a topic of argument forever!-- most of his friends are dating other med students, so I always feel out of place (and bored since hospital stories are only fun for so long...). I have my own friends, but he doesn't make as much of an effort to spend time with them (even though my coworkers have never talked shop around him!). I feel sometimes it's unfair that we spend so much time around his hospital campus with his friends because he gets lazy about leaving his comfort zone. I think that will continue, since he matched at his med school hospital (McGaw med center--Northwestern memorial) and several of his friends will be here as well. I'm really happy that he'll keep his friends and that he already knows a lot of the attendings and residents and that he can continue his research project. I just hope he'll be able to find some time away from all of it!

I guess my main concern is that while I'm good at having a life by myself (and Chicago's a great place for that), I might start to wonder what the point of having a relationship is if I'm effectively single.

Thanks again for your suggestions. I don't think he's been entirely open with me on this for fear of scaring me, so I appreciate the honest responses on what to expect.

Esther

[DCJenn]

Hello!

First, welcome aboard!

We have lots of archived articles from previous newsletter all about residency. It's a long, hard road but we did fine. I kept busy and when things got crazy- I went home to visit family and friends. I also worked full time and took up some new hobbies- like yoga.

There were moments, the inevitable "who died and made you King of the Universe" discussions. The pinnacle moment was the 800th time I'd cleaned the cat pan and he sat in his underwear killing aliens on the computer becuase he "needed to destress". I nearly killed him. But after my total and complete meltdown, we managed to talk things through, and now three years later, things are much better.

So- the key is communication and patience, in my opinion. Also, just a note, your boyfriend is no doubt like the rest and the reason he hasn't painted a clear picture of residency for you is that he probably thinks 1) It can't be as bad as they say it is or 2) It will be bad, just not for him or 3) Paralyzing fear of just how awful he thinks it will be prevents him-

in reality, it's somewhere in between.

Jenn

Jenn,

Thanks for pointing me to the articles!

Sigh... I can already see the arguments we'll have I guess it'll be a good time for me to work on my patience...

So- the key is communication and patience, in my opinion. Also, just a note, your boyfriend is no doubt like the rest and the reason he hasn't painted a clear picture of residency for you is that he probably thinks 1) It can't be as bad as they say it is or 2) It will be bad, just not for him or 3) Paralyzing fear of just how awful he thinks it will be prevents him-

in reality, it's somewhere in between.

Jenn

I think that is a pretty accurate assessment!

I agree with all of the above comments. I think that one of the harder things for us was the extreme fatigue from being on call. So, I would just add that it is never a good idea to evaluate one's life, relationships, etc while suffering from lack of sleep. Try to table discussions for a time when they (and you, as the case may be) are in a little better frame of mind. I speak from experience. This, of course, can be hard to do because it is just at those moments when they have been on call and absent that your patience for the resident lifes plummets.

There were times that I thought I had traded in my vows of marriage for vows of poverty and celibacy. But we survived and are now going on to a residency with what should be an easier schedule. There are rough spots but if he is who you want to be with, you can both make it work and get through it.

[migirl]

There were times that I thought I had traded in my vows of marriage for vows of poverty and celibacy.

So true...

You said it Nellie!!

[SueC]

Yep, I tend to agree with that statement!

[Flynn]

Setting limits is key...I agree. In our R1 year, we had been together for 3+ years but we weren't married or engaged. My DH turned into a complete asshole as he transitioned from med. student to an R1 General Surgery resident and I dumped him after about 4 months.

I loved him but I refused to live like that. We were apart for a month with no communication, he started calling after that (to my surprise) and I made him take my parents out to dinner without me, to show he was serious about getting me back and not just dinking around. I figured that would scare him off for good but it didn't I am happy to say.

We were engaged 6 months later and while we have our moments (more than I would like to admit) -- breaking up with him was the best thing I ever did while we were dating and he was being completely selfish. He CHOSE to be a resident, not me. He chose the pain and the horrible lifestyle. Taking that out on me was unacceptable in my book. Our life as a couple was not "all about him and his crazy hours" despite how he acted initially.

Knowing what you are willing to handle and take in stride is a HUGE help in setting limits. It's a learning process and sometimes a painful one but you can make it through IF and only IF your significant other (the doctor in the relationship) is as dedicated as he can possibly be with his chosen career to respecting you and the relationship. If he is apathetic when he needs to step up to the plate, give him a few friendly reminders, warnings, whatever you do and then I would seriously consider bailing if he stays self-involved.

The fact that he isn't very receptive to knowing friends outside of medicine would worry me. Be careful and good luck.

[Sheherezade]

Hey--I think its great that your SO decided to stay in Chicago partially for you and because he knew people there. I think that shows he cares about contacts in his life, not just advancing his career. As for having med friends, my DH's med friends got so worn out after awhile they were too tired to be social, and then I got to drag him anywhere I wanted with my friends. Also, he didn't want to see ANYMORE of hospital people after enough hours in that place, so you may just win that argument in time As for wondering if you'd rather just be single after a while, I did that BEFORE he went back to med school!!!! (But we've got 15 years together now, so we must be ok!!!)

Angie

[SueC]

I never thought about the "friends outside of medicine" aspect, but I agree with Flynn that it is important that they maintain their friendships outside of medicine. Over the years, my husband has pretty much abandoned his "non-medicine" friends and the end result is that the people he cares to socialize with during the "off hours" are the same ones he has spent the better part of his day with, leaving me feeling more closed off than I already am! I wish over the years I had encouraged him to keep up with the "non medical" friends more. I'm not sure what the solution is--whether I should be arranging "play-dates" for him just like I do for my children???(Pardon the sarcasm--I'm coming off of a tiresome weekend of him being on call and I am in a piss-poor mood today for various reasons.) He is pretty good about getting together with my friends and their husbands and seems to have a good time with them, but if it were up to him, he'd choose to go out with the group from the ICU.
I haven't really added a reply regarding my thoughts on dealing with residency, but pretty much agree with what everyone else has said.

[Flynn]

Hey Esther,

Another cliff note version of dealing with residency or being with a doc is in the "Cheers and Jeers" (Marriage Matters) section of this site. This post illustrates to a "T" how challenging, yet wonderful in their own way, doc significant others can be.

There are lots of comments about kids -- but as a whole it's a funny but eye-opening read. There are lots of similar themes!!!