ROL, residency and spouses

[gdbaby]

I really think the whole match process is for single people. Is anyone handling this better than I am? My husband is a public school administrator and has been looking/applying for jobs in the places I am going to rank highly, but we still really haven't talked about whether we would be wiling to move regardless of his employment situation. I think he wants to wait to see if he gets any interest in his CV from some of these places. Of course, it is so important that we are all happy, but this looming question is so anxiety-provoking.

Anyone out there with spouses (or Trophyhusband!) have examples of how you have approached this topic? Compromises? Lowering your current standard of living if he/she can't find a job? Any help would be greatly appreciated.

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[pingumd]

This process is very difficult indeed. My spouse is looking at transferring residency positions or else we go long distance for who knows how long. You can imagine the fun we are having.

I really don't want to do the long distance thing especially during PGY1-2 when there will be little free time to travel and visit. It seems like most of the call is now on the weekend since most places have a night float system.

The thing that concerns me is that this feels like a very big decision and yet my ROL is changing dramatically from day to day based on rumors of what programs might have openings. Yesterday my #8 program shot to the #1 position because my spouse got an encouraging email from a PD. Every day of the last week I have had a different #1. Ihave pretty much given up the notion that i will find the perfect fit and that we can still be together.

I just want the ROL to be due so that this madness is over and then we will just have to deal with the fallout on March 18th.

 

[digitlnoize]

This process is very difficult indeed. My spouse is looking at transferring residency positions or else we go long distance for who knows how long. You can imagine the fun we are having.

I really don't want to do the long distance thing especially during PGY1-2 when there will be little free time to travel and visit. It seems like most of the call is now on the weekend since most places have a night float system.

The thing that concerns me is that this feels like a very big decision and yet my ROL is changing dramatically from day to day based on rumors of what programs might have openings. Yesterday my #8 program shot to the #1 position because my spouse got an encouraging email from a PD. Every day of the last week I have had a different #1. Ihave pretty much given up the notion that i will find the perfect fit and that we can still be together.

I just want the ROL to be due so that this madness is over and then we will just have to deal with the fallout on March 18th.

Disclaimer: I'm a 2nd year, so still a bit far off from this whole process. That being said, my wife and I talk about it, and I think it depends somewhat on your spouses job.

My wife is a dental hygienist. We're reasonably sure that she'll be able to get some type of job no matter where we move. So, while we're going to take her job market into consideration, it's not a primary concern. What is of more concern, to us, is how happy we will be in that area. I'm a DO student and there's lots of DO residencies in the Northern Midwest (for example). We're currently in Florida and hate the cold. I'm not sure how we'd handle that type of transition. We also have an 8yo daughter, so the quality of the local schools and the safety of the area is also a concern.

I agree though, that the whole process of medical education is MUCH easier, logistically at least, for the single crowd. I do think I have the advantage of having someone to support me, of not needing to "date," of a second (or first!) income, etc. In the end, the advantages might outweigh the disadvantages, if your spouse is supportive.

 

[trophyhusband]

I really think the whole match process is for single people. Is anyone handling this better than I am? My husband is a public school administrator and has been looking/applying for jobs in the places I am going to rank highly, but we still really haven't talked about whether we would be wiling to move regardless of his employment situation. I think he wants to wait to see if he gets any interest in his CV from some of these places. Of course, it is so important that we are all happy, but this looming question is so anxiety-provoking.

Anyone out there with spouses (or Trophyhusband!) have examples of how you have approached this topic? Compromises? Lowering your current standard of living if he/she can't find a job? Any help would be greatly appreciated.

Alas gdbaby, I don't know that I'm going to be that much of a help. I took a job early in my wife's medical school career that would allow for us to move anywhere in the US as long as I was within 45 min of an airport. I have since changed jobs but I took a position that has a virtual office (aka I work from home). So my wife can choose whatever program is best for her training without regard to my working situation (without regard to her family's wishes is another story entirely ). I made these career choices with residency and the match in mind so we have been planning for this for a long time.

We do worry a bit about us moving to a smaller town (for example Temple, TX) and me losing my job. But I have a professional certification that is easily transferrable state to state and allows me to find jobs easily (relative to most people). So while I wouldn't likely be making as much as I do now I would still be able to support us.

If we were in your position I think we would still put her comfort with the program 1st and I would wait until match to begin my job search. We would be able to subsist off of her residency salary (though it obviously wouldn't be an opulent lifestyle) until I could find something. Of course we are not looking at programs in high cost of living areas, if we were that would change the equation substantially.

Sorry I couldn't be of more help.

 

[BerlinNeuro]

Well, I'm in a similar situation right now with my husband. I wrote about it on another forum because we are having a hard time trying figure out how to maximize opportunities for both of us. I love a few programs in places he is less excited about, and he loves a location (a lot) where there's a program that would be a lot lower on my own list but great job opportunities for him.

My solution (as much as this is a solution) is trying to get a feel for job availability in his field in all the locations I interviewed. I got in touch with the programs to see if they had any ideas, but nobody can actually promise a job of course and to be honest I really haven't gotten a lot of feedback. If a PD from one of my favorite programs got back to me and said - hey, we know someone with a position that sounds perfect for your husband and tried to help facilitate an interview - my husband would be very open for that possibility. But right now, I'm trying to keep an open mind regardless, because maybe we end up somewhere less ideal for both of us.

So, that's not really an answer, but I can commiserate with you about how hard a decision this is when you're not single and only have to make decisions for yourself.

 

[whopper]

Hard to give an answer on this one because one's happiness is very different depending upon the person.

My wife and I had a long distance relationship for 5 years before we married my PGY-3 year. During the MATCH, I knew where I wanted to be, and did not want to do residency in the NYC (where she lived at the time). After the wedding she moved to the south NJ area where she was not happy. She made friends, got a job she enjoyed, and loved where we lived, but she's an opera singer, and there's no opera scene in South NJ. Her love of opera was to the point where she felt like a part of her died. It was too much of a hassle to for her to travel to NYC or even Philadelphia several times a week (spending over 20 hrs a week just travelling).

We moved to the Cincinnait area and she's back in the music scene. She's so happy she occasionally remarked that if we moved back to South NJ she's divorce me. She as pseudo-serious. I know she wouldn't divorce me, but I also know she'd be very unhappy if we moved back.

 

[Fermata]

I have no advice to give being that I'm a year away from the match but it is already a source of conflict in my marriage. Best of luck to you.

 

[OldPsychDoc]

Residency is 4 years.
Marriage is hopefully the rest of your life.

Happy Marriage = Happy Resident = Happy spouse.

It really is OK to put the marriage first.

 

[MDchouette]

My SO and I talked a lot at the beginning of fourth year, and I didn't apply to any programs where he wouldn't be willing to move. I also made an extra effort to learn all I could about the programs near my SO (away rotations, second looks, etc). When possible, my SO accompanied me to interviews in other cities.

While that didn't mean that my SO was/is super excited to move, I think it significantly decreased the stress for both of us and has allowed us to have better-informed discussions about my rank list.

But, I agree with the original poster: the match process is for single people. Perhaps more accurately, it's for men with stay-at-home wives. We should submit our rank lists two weeks after interview season is over and then get the results the next week, like Urology does.

 

[Sophie]

I only applied to programs in locations my fiance would be willing to live in and that are good for his occupation, although he liked some of the cities a lot more than others. The 2 programs I'm ranking highest are ones I fell in love with, but in probably his least favorite of the cities I applied to. He said it's worth it, though, and he can put up with it for 3 or 4 years. My 3rd spot is going to a program I was so-so about (I can make it work, it'll just take more effort on my part) but that's in his favorite city, and 4th is going to a program I'm okay with, in his 2nd favorite city. The rest of the list is the same - a balance between programs I like and cities he likes. This whole process involved a lot of give and take, but we're both happy with the list.

One caveat: I feel I would be happy at just about all of the programs I interviewed at - more so at some, less so at others - so I don't feel like I am sacrificing my happiness for his. And, likewise, I only applied to cities he likes, so I don't think he is sacrificing too terribly either. I think this is the key to no one ending up resentful.

 

[notdeadyet]

Residency is 4 years.
Marriage is hopefully the rest of your life.

Happy Marriage = Happy Resident = Happy spouse.

It really is OK to put the marriage first.

Amen to this one. Spouses have already make a lot of sacrifices (of all flavors) to stand by us during medical school, when getting through is sink or swim. When it comes to residency, you're going to be a psychiatrist regardless of program. Put your partner's needs way high on the list.

I wouldn't go to a program that looked god-awful, but if the difference between my #1 and my #5 was four years of my wife's happiness... I'll start packing for #5.

And I agree with OPD's equation of:
Happy Marriage = Happy Resident = Happy spouse
I think I'd find my #5 program a lot more satisfying than my #1 if looked at a content wife across from the dinner table every night, rather than a wife bitter for me putting my job ahead of her happiness for 8 years.

 

[st2205]

if the difference between my #1 and my #5 was four years of my wife's happiness... I'll start packing for #5.

An often undervalued perspective.

 

[billypilgrim37]

My wife is still miserable, mostly because she is married to me.

 

[gdbaby]

Residency is 4 years.
Marriage is hopefully the rest of your life.

Happy Marriage = Happy Resident = Happy spouse.

It really is OK to put the marriage first.

Thank you. I think this what I needed to hear. Will see what happens with this job prospect for him. If it doesn't pan out, it is his decision about what to do. I would be really happy with my top 4, but happier staying married to my SO.

 

[whopper]

It really is OK to put the marriage first.

Yes, yes, yes, yes, yes.

 

[psychotrope]

We do worry a bit about us moving to a smaller town (for example Temple, TX)

are you guys really going to rank scott and white in a position where you could match there? IIRC you're wife had interviews pretty much everywhere, and while I do think scott and white is a nice program, it's hardly the equal in many/most respects at some of the other programs your wife has been to.....

 

[trophyhusband]

are you guys really going to rank scott and white in a position where you could match there? IIRC you're wife had interviews pretty much everywhere, and while I do think scott and white is a nice program, it's hardly the equal in many/most respects at some of the other programs your wife has been to.....

Yep, it's actually #2 on the current draft ROL. Like I said in the post, as I work from home for us it's all about where she feels comfortable. She really liked the residents and the staff at S&W. It's not as prestigious as some of the other programs she's interviewed with but the curriculum fits how she learns pretty well. The program also seems extremely family friendly, which is important to us as we put off having a family until she was done with med school.

So while going to S&W may limit her employment options somewhat vs. going to UTSW-Dallas (not as likely to get an academic position for example). She feels comfortable with the trade-offs due to personal fit.

 

[psychotrope]

Yep, it's actually #2 on the current draft ROL. Like I said in the post, as I work from home for us it's all about where she feels comfortable. She really liked the residents and the staff at S&W. It's not as prestigious as some of the other programs she's interviewed with but the curriculum fits how she learns pretty well. The program also seems extremely family friendly, which is important to us as we put off having a family until she was done with med school.

So while going to S&W may limit her employment options somewhat vs. going to UTSW-Dallas (not as likely to get an academic position for example). She feels comfortable with the trade-offs due to personal fit.

I really liked the residents at S&W too, but the 4th years will be gone next year, and the third years an incoming pgy-1 would be in the program for 6 months with.

In terms of being family friendly, it doesn't have night float, call stretches into midway through the 3rd year, and the call is actually pretty heavy in the sense that when you're on call you're working.

I think it's a good program with a good reputation, and I don't think it will limit future options all that much. I'm ranking it as well and would be happy to match there, so it's not like I don't think highly of the program

 

[trophyhusband]

I really liked the residents at S&W too, but the 4th years will be gone next year, and the third years an incoming pgy-1 would be in the program for 6 months with.

In terms of being family friendly, it doesn't have night float, call stretches into midway through the 3rd year, and the call is actually pretty heavy in the sense that when you're on call you're working.

I think it's a good program with a good reputation, and I don't think it will limit future options all that much. I'm ranking it as well and would be happy to match there, so it's not like I don't think highly of the program

My wife really doesn't see the benefit of night float. In fact she's moved most of the programs that have night float down on our list. She wouldn't want to spend a month working nights and then still have to do weekend call and late call anyway the rest of the time. She'd rather just do her call and go home or in the case of S&W just do home call. Her top programs all have home call of one type or another (home call exclusively or home call + regular call for certain portions of the program) and this seems to be much more of a benefit in her mind. Though of course there is no guarantee that home call won't eventually be replaced with regular call...

 

[hallam]

We have both made compromises. We only applied to programs in locations where we would both be happy living, and then narrowed down our choices based on her job prospects, proximity to family, and a few other factors.

Whopper - My fiancee is also an opera singer. We lived for 1 year someplace without an opera scene, and she was MISERABLE. We won't be making that mistake again!

 

[psychotrope]

My wife really doesn't see the benefit of night float. In fact she's moved most of the programs that have night float down on our list. She wouldn't want to spend a month working nights and then still have to do weekend call and late call anyway the rest of the time. She'd rather just do her call and go home or in the case of S&W just do home call. Her top programs all have home call of one type or another (home call exclusively or home call + regular call for certain portions of the program) and this seems to be much more of a benefit in her mind. Though of course there is no guarantee that home call won't eventually be replaced with regular call...

1) I get the sense that there are two types of "home call". That in which the # of pts seen on any given night is generally small enough that many people do spend significant amounts of time at home, and those programs where there is no rule that the resident has to be in the hospital at 2am, but because the volume is high enough in the ED the residents are better off just staying at the hospital than trying to go home because there is a good chance they will just have to drive right back. I got the sense S&W was the latter type of program, which is good in a lot of ways from a training perspective.

One positive about S&W's call though is that when a resident is post-call, they are done at 7-8(whenever they are off call) and don't have to go to the unit and finish regular stuff up until noonish. That's a big positive, because when you've been up for 25 hours morning rounds from 7am-12noon and doing discharges on inpatients would be hard it seems.

2) the occasional weekend call for programs that have at least 5-6 spots each year and do night float is so rare that it's not a big thing to me. Usually the interns and pgy-2's will take primary call, and most months there are going to be 8-9 weekend coverages......that comes out to around q30 or so for pgy1's and 2's......of course there still is normall q6 or so short call, but you're still out of there by 8 and get a full nights sleep in your own bed and have time to go home and make a late dinner, etc.....

But even as I say this, many of the programs Im ranking fairly high do have a more traditional call schedule without short call or night float, so i guess it's not an overriding factor for me.

 

[Messerschmitts]

Okay...maybe this is a bit immature but can I just say that I am really jealous of what seems to be 90% of the applicants who are in happy, committed relationships? Sure I can match into and go wherever I like, but I'd trade that "freedom" in a heartbeat for someone great to couples match with. I think it's worth the hair-pulling. Okay I'm going to heat up some soup-for-one and wallow in my loneliness now. Rant over, stupid happy couples, grrr...(must be Valentine's Day)

 

[psychotrope]

Okay...maybe this is a bit immature but can I just say that I am really jealous of what seems to be 90% of the applicants who are in happy, committed relationships? Sure I can match into and go wherever I like, but I'd trade that "freedom" in a heartbeat for someone great to couples match with. I think it's worth the hair-pulling. Okay I'm going to heat up some soup-for-one and wallow in my loneliness now. Rant over, stupid happy couples, grrr...(must be Valentine's Day)

it's not just about the freedom to match wherever you want(which is nice)....

it's about the freedom on any random friday night to do whatever you want.

it's about the freedom to play golf on a saturday afternoon....*every* single saturday afternoon(assuming your not working).

it's about the freedom to take the cute 21 year old barista out on saturday night, and then the next saturday night take the cute 22 year old nursing student out

I don't doubt that there are upsides and benefits of being in a long term relationship. But there are upsides to not being in one as well.....

 

[WhoisJohnGalt]

it's not just about the freedom to match wherever you want(which is nice)....

it's about the freedom on any random friday night to do whatever you want.

it's about the freedom to play golf on a saturday afternoon....*every* single saturday afternoon(assuming your not working).

it's about the freedom to take the cute 21 year old barista out on saturday night, and then the next saturday night take the cute 22 year old nursing student out

I don't doubt that there are upsides and benefits of being in a long term relationship. But there are upsides to not being in one as well.....

Believe me, there are tradeoffs both ways... grass is always greener on the other side

 

[Messerschmitts]

it's not just about the freedom to match wherever you want(which is nice)....

it's about the freedom on any random friday night to do whatever you want.

it's about the freedom to play golf on a saturday afternoon....*every* single saturday afternoon(assuming your not working).

it's about the freedom to take the cute 21 year old barista out on saturday night, and then the next saturday night take the cute 22 year old nursing student out

I don't doubt that there are upsides and benefits of being in a long term relationship. But there are upsides to not being in one as well.....

I don't play golf, and there's no cute barista or nursing student who's going out with me. The cute ones are all married or engaged, at least around here.

 

[billypilgrim37]

I woke up at 3AM so that I could spend 1.5 hours assembling my wife's birthday present clandestinely in the attic. Single people at least get to sleep through the night!

 

[Messerschmitts]

I woke up at 3AM so that I could spend 1.5 hours assembling my wife's birthday present clandestinely in the attic. Single people at least get to sleep through the night!

True, but only one of us is gettin' sum tonight

 

[OldPsychDoc]

True, but only one of us is gettin' sum tonight

Do you know any married people???

 

[Messerschmitts]

Do you know any married people???

HA HA HA Ha touche.

 

[trophyhusband]

HA HA HA Ha touche.

Find yourself a nice latin girl and it shouldn't be an issue .

 

[Messerschmitts]

Find yourself a nice latin girl and it shouldn't be an issue .

Hey if you know one, introduce me. Tell her I'm going to be a doctor

 

[billypilgrim37]

Do you know any married people???

Yeah, what is this "gettin' sum" of which he speaks?

 

[psychotrope]

Yeah, what is this "gettin' sum" of which he speaks?

married people tend to have a good bit more sex on average, but then again I'm not the sort of person who would want to be with the same person year in and year out, week after week, etc......

I think the average married person in our age group has sex about 100 or so times a year.....but many of them(if they are faithful at least) with the same person.

So would you rather be with 5 different women for a total of 50 times in a year, or the same woman 100 times in a year?

I prefer the former, but am up front about it. But others may prefer the latter....

 

[Messerschmitts]

So would you rather be with 5 different women for a total of 50 times in a year, or the same woman 100 times in a year?

I prefer the former, but am up front about it. But others may prefer the latter....

In my current situation the choice seems to be no sex vs. sex with one woman. The latter sounds preferrable

 

[billypilgrim37]

I think the average married person in our age group has sex about 100 or so times a year.....but many of them(if they are faithful at least) with the same person.

I am hoping my wife and I have sex 100 times by our sixth anniversary in July.

 

[notdeadyet]

Yeah, what is this "gettin' sum" of which he speaks?

I seem to remember it being a Chinese meal made up of lots of small dishes. My wife and I went a lot while dating when we still went out.

 

[johnhoedack]

I am hoping my wife and I have sex 100 times by our sixth anniversary in July.

That's just sad.