Question regarding first year residency experience

hello! I'm curious to get feedback from whoever can share their experience watching loved one in their first year of residency...I'm sort of in a interesting situation as I'm doing long distance with my boyfriend who is on the west coast doing family residency program. I see him once a month...we're taking it day by day but it's hard. anyway-- he's struggling...pretty anxious and depressed and of course, exhausted. I've tried to do some research and know that it's common to a certain extent to feel that way at the beginning... I think his being a perfectionist makes it a bit harder for him. any suggestions, on how I can support him, other than obviously being there for him (even if it is just on the phone) to talk, to let out his frustrations...and just tell him to hang on and that things will get better eventually? Perhaps this is a silly question as I'm sure most residents go through this...but I'm worried and feel a little helpless and I want to be as supportive as possible. I'd appreciate feedback y'all may have. thanks!

[DCJenn]

Hi-

Residency sucks and the first year sucks most of all. It was about this time during PGY1 that my husband nearly threw in the towel. I think he would have preferred to get run over by a truck.

We have plenty of information and suggestions for how to make it through in the archives. It's not that no one cares, it's just so hard to think about how awful it really was!!

See what we have there and if there's anything we haven't covered, ask away. There's always someone here in the same shoes as you so hopefully those who are in the trenches will jump in with some suggestions for you.

Jenn

[Flynn]

The first year is horrible any way you slice it. There honestly isn't a whole lot you can do other than sending cards and leaving messages (because he's probably not home a lot anyway) when you can to let him know you are thinking of him.

Being as supportive as possible sometimes means letting him have his space to figure things out for himself. The minute calling you or filling you in on how he is feeling becomes an obligation (one of many he is dealing with right now) that's when things get even tougher. Let him call you sometimes and try not to make the conversation all about him and what he is going through. After all, your relationship is NOT all about him. He needs to recognize this despite him struggling right now.

Hang in there. I hate to sound negetive BUT (big sigh here) it will get worse before it gets better. He's lucky to have you.

I don't have any advice, as I am married to a 4th year med student. But if I may piggyback on your question... for those who have been through this, does it get significantly "better" once PGY1 is over? Like is the second year of residency noticeably easier? My DH is interviewing for ENT residencies, in case that makes any difference. I know the first year (general surgery) is going to be brutal. And like the original poster, my DH is also a total perfectionist and goes above and beyond the call of duty.

[Flynn]

Gee let me think......NO NO NO NO NO NO NO!!!!! Clear enough for you?? (I wish for your sake I was being dramatic here.)

I have found that the minute you think things "will be better" you get horribly disappointed and resentments GROW.

The bummer with every different year is that you are so tapped from the previous year, even great rotations where the hours aren't horrible are temporary -- so there is NO consistency which gets harder the longer you deal with it. You may be doing great in building your own life as the spouse BUT you and your Doc partner are living like roomates OR you guys are spending a ton of time together in a great rotation and then SNAP -- you don't see him for more than a couple of hours PER WEEK for TWO MONTHS or MORE. Any other surgery spouses out there want to chime in that I am not a freakish wacko??? It really is THIS bad sometimes!!!!

I think the docs feel much better being R2s and "knowing" what to expect so that's a plus for them and may translate to more good times when he is home. Also, General Surgery is brutal so maybe the R2 year for ENTs is better because they are doing what they want to do so the mental aspect is better....it varies.

I hate to be the angel of death here but thinking things would be "better next year" never really works because for every plus in being a year further into training, there were new minuses. Pace yourself if you can.

Other than giving birth to a 10 pound baby and raising children, residency is one of the hardest things to embark on and survive. It's like boot camp for YEARS. The good news is that people come out just fine in the end despite the difficulties and my DH and I are in a really good place right now and have been for a while. If we can do it, so can you!!!

Good luck and I encourage you to read some previous topics on this site. The more you know about how hard this life is, the better prepared you might be to deal with the ups and downs and give yourself a break.

Oy vay. Well thanks for being honest, Flynn. I definitely prefer reality over false hope!

My DH is currently doing an away rotation right now, far away, so we aren't seeing each other for an entire month right now (aside from a quick visit that I and DS flew in for this past weekend). I am playing single mommy too. Single FT working mommy. Not easy. Perhaps I am in denial, but based on DH's past record with studying and such, I really am wondering how different it will be for us when he has a resident's schedule. There have been many stretches (months) already when I didn't see him for more than a couple hours per week (awake) at a time. Particularly during all of 1st and 2nd year, and also during his surgical rotations last year. Of course the irony is that the away rotation he's doing right now, aside from being on call at least once a week, he seems to be making it home for dinner almost every night... but he's staying with my parents!!!!!! (Mom is treating him well with nice dinners)

So anyway, part of me feels that if we've already overcome the struggles of his self-imposed study schedule, prehaps residency won't be *as* bad as everyone makes it out to be? Since he's had that type of schedule already?

Or maybe I am nuts and in for a reality check.

We had been thinking about trying for baby #2 to come around the beginning of his PGY2, but perhaps we need to rethink that plan.

[SueC]

I don't know, I guess I thought 2nd year was better than 1st year. Then again, maybe I was better at dealing with him being gone. He was on call just as often, but as his confidence grew, his stress level went down. 1st year of fellowship sucked, but each year after that he had fewer ICU months which was a drastic improvement.

Ok-- I am thinking about (make that dreading) intern year. Is it that bad for ALL specialties? Are some way better than others after intern year? Sorry! Might be a dumb question but you all know the truth and that is what I am after

[Flynn]

One plus all spouses (and residents) will have that previous couples did not is the mandatory 80 hour work week in place now.

When looking into programs I would be curious as to how many are actually following this new rule -- I've heard that some are horrible about it but the UW did do an above average job keeping my DH's hours at 80 hours when he was a clinical R5. That's the only year we could take advantage of it but it was a HUGE difference in my book.

Some of my (less than ideal) memories have my DH working 110 - 120 hours a week in his early years R1 - R4 so that's a plus for all of you going into the system now!!!

Unless they want to risk suspension, all programs should be 80 hours or under per week (averaged over the month). Your DH may have a 95 hour week but then somewhere he has to work less in order to abide by the standard.

Never expect less than 75 hours in a surgery residency however. It just doesn't happen.

Since you guys have one child already, you have had to "juggle" more than the average med student for sure!! Don't put off having baby #2 because residency WILL be harder than med school (trust me here) but you guys will make it work for you as you have been doing.

Interesting fact about our experience:
Out of about 35 couples we know in surgery (various specialities) NOBODY had kids in med. school and we were the only couple we know who had one in my DH's PGY6 year (3 years GS and 2 years in the lab at that point).

Now that we are in a fellowship we know a bunch of couples with young children but that means that none of them started having kids until 5-8 years into their training post med. school.

While most of these couples did not know each other in med. school -- all of them married early on in residency and waited (in large part due to the residency hours) over 4 years in their marriage to have kids.

I just find this interesting. It's only my experience and I have no idea what it means but it might give you an idea about "life" during a surgery residency.

[SueC]

My dh was med-peds so if he was on the medicine side he was Q5 and on the peds side he was Q4. He had clinic rotations sprinkled in there which were like office hours so I really dug those months. I think a lot of it depends on how often they are on call. Correct me if I'm wrong, but I was thinking general surgery was Q3 which would be an absolute nightmare.

[Flynn]

Surgery (and all that this implies) is the worst as far as lifestyle during residency bar none.

Within surgery, Neurosurgery, and General Surgery are the absolute worst with a few others being only slightly better after their intern year which is spent in General Surgery the whole time.


This is just my opinion but non-surgical residencies are much more family friendly.

[Flynn]

Sue -- Yes you are right, my DH was Q3 for three years straight when he was in his General Surgery residency. It was HORRIBLE.

When my DH was finally an R4 he had a few rotations that were Q4 (it seemed like heaven) AND some were "home call" and not "in house." That made a huge difference too!

[samssugarmomma]

Flynn,
Even though I didn't ask the question - thanks for the honest responses. My DH is also looking at surgical subspeciality and it's nice to see what life will really be like. Even though I *hate* it here in Houston, I'm kinda of hoping that he gets in here b/c the general surgery call is Q6 (and home call!).

Kate

[Flynn]

Kate,

Q6 is totally reasonable~!!! What a great schedule!!!

Fill us in when your DH decides what he wants to go in to. I am always curious how people choose what they do and wonder if I knew then what I know now.... Hmmmmm. Would we have made the same choices??? We'll never know.

My DH LOVES CT so General Surgery was a stepping stone to where we are now. A LONG, BELABORED, PAINFUL stepping stone but things are going well now.

Hopefully in a little less than two years I will say it was all worth it. When we are done it will have been 5 years of GS, 2 years in the lab and 2 years of a fellowship. I must say that having kids makes things harder in some respects but much easier in others because it's impossible to be self-involved and the days fly by!!! I feel like this past year was on fast forward!

[DCJenn]

I have to agree that the 80 week has got to help. My husband was pulled over for drunk driving but was really falling asleep at the wheel- after working close to 48 hours straight. (and that was peds)

Second year was marginally better than internship year, thrid year was great. and then we started fellowship which was in many ways as bad as internship year BUT we had just come off third year so that made it all that much worse.

Training sucks ass and anyone who thinks this is a glamourous lifestyle is either the second wife/husband or is an outsider....

Jenn