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Arguments with spouse about residency locale?

Discussion in 'Medical Students - MD' started by tiedyeddog, Sep 7, 2014.

  1. 194342

    Physician 7+ Year Member

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    Anyone else in a dedicated relationship, married or not, and having problems trying to decide residency locales with your partner? I just want to know how other people are planning to address these problems.

    Info on me: M4 now, spouse is non-medical, grew up around where I am in medical school. We are trying to decide how far away we should be applying. I live in the midwest and there are a few programs in the south/southwest I am really interested in shooting for. However, these programs are >18 hour drives from her parents back home. I know the right thing to do is to rank higher the places near her parents but it kills me to skip out on programs I might really fit into.

    Is this process really a sore point for any other couples? How are you figuring this all out?
     
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  3. sb247

    sb247 Doer of things
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    (ms1 who already went through these talks with my wife)

    I think you owe it to them to prioritize residency locations that fit with them. You'll basically be absent from the family for a number of years and a location where they have a support network to fill the gap you are leaving is really helpful to them. They made a big sacrifice by jumping into this process with you and you can repay the favor by making it as easy on them as possible
     
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  4. jdh71

    jdh71 epiphany at nine thousand six hundred feet
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    I completely disagree. You only get one shot at training. And you need to prioritize your skill set learning objectives WAY above location. Training is really only a short time. Also I think of benefit is that one finds a lot of personal growth when one has to move away from "comfort zones".

    I told my wife to deal with it. She'd get to basically pick where we eventually ended up living. And She did. She wasn't "happy" with my attitude but at some point you just can't really have discussion when two people don't agree and you've made a command decision. Interestingly enough . . . My wife ended up liking BOTH spots I went for residency and then fellowship. People don't know, what they don't know.

    All things otherwise being equal training-wise . . . Probably no good reason not to stay closer to "home".
     
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  5. WaylonS

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    Easy, I made a list of all the programs in the country, I told my significant other to look at the list and that I needed to apply to X number of programs. I later chose the programs I was interested in, then we sat down and went one-by-one of all of the programs in the country (I'm applying for a small, competitive field, so it didn't take too long), and we each had the opportunity to say why we did or did not want to live in that area. In the end, after our talk, I removed a few and added a few. There are also a few program that the SO was on the fence about, so if I get an interview at one of those program, they will come along too so they can see if they like the city/area.

    Based on the advice of my friends who have gone through this process, it is impossible to over-communicate with your partner
     
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  6. PL198

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    the right thing to do is live near her parents? This argument is used by countless amounts of women that don't even spend that much time with their families. How often does she actually see them? Getting into the program you want and feel comfortable with is 1000x more important than her staying close to home... Forms of transportation exist for a reason.

    The fact that you haven't mentioned her employment makes me assume that isn't going to be working. If that's the case and you base your job decision on her wanting to be closer to home while she isn't working, good luck. If she is/will work, I'd think that aspect of the situation would be much more important than staying close to home.
     
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  7. Cytarabine

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    My personal view is career driven. I'm in a long term (but unengaged) relationship. I'm going where I want for residency. I'll consider her input, but ultimately it won't steer me away from where I want to go, and if it costs the relationship, it costs the relationship. I think if you're already married or prioritize your relationship ahead of your career, you should take a more tactful softer approach. Discuss the impact the difference in residency programs can have on your quality of life, education, and ability to ultimately accomplish what you want in medicine. Emphasize the transient nature of residency, but also how you understand it means her uprooting her life, etc, and that you'll solicit her input as you go and include her in the discussion
     
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  8. DrBowtie

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    Apply broad. You may not interview at those programs or you'll come to find out they don't live up to their fancy website billing.

    Worry about that stuff after you have completed interviews.
     
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  9. compstomper

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    I've had a similar talk with the missus about location for medical school and
    I've had a similar talk with the missus about where to attend medical school. Just a week ago, we had a talk about residency as well. In both cases, we decided to do what was best for our family. I could've gone to a school closer to home on the east coast, but I received a substantial scholarship package from a school in the midwest. I decided to go to the midwest school because it'll be easier for our family financially, especially when it comes time to repay the loan and when a little one is on the way.

    We also agreed that residency is as much a job as it is training. My philosophy has always been that family comes first, partly because I didn't grow up in the best circumstances. So for me, any job, no matter how fulfilling, how gratifying, always comes second to family.

    It's a tough position to be in, so I wish you and your spouse the best of luck.
     
  10. Brain Bucket

    Brain Bucket Oh man, I forgot to bring the marshmallows.
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    Nope

    The only people who should be making a decision are those who're qualified/educated to make one. Besides, 'we' aren't applying. You are.


    You have GOT to be kidding me.

    The right thing to do is what is best for both of you. Your (and in turn, your SO's) happiness is half of the equation. Your education is the other half. Her parents don't fit in.

    "Hon, I think this is best because..." "You sure?" "Yep" "OK"

    Rank where you want to go highest. It's just a question of a few years. If your wife is giving you attitude over this...you might want to consider moving on before you start earning.
     
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  11. operaman

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    MS4, married, having similar discussions now.

    I don't think we've totally resolved this issue yet either. So many factors come into play: proximity of family, whether or not you want children, childcare, spouse's job, etc. Lots of things to think about and no one thing clearly takes priority; they each vary depending on the people involved.

    For us, I think our basic plan is to apply fairly broadly and begin to be more selective as interview offers come in. There's no point to argue about training in X state if you don't even get interviews there, so that part has to come first. Plus, each additional program app is peanuts compared to the rest of the expenses this season.

    Deciding on interviews will be a bit tougher. It will probably work out such that I will only take interviews in less desirable locations if they are with truly top programs (how you define 'top' is again a very personal decision). Conversely, I will probably interview with almost any program that will have me in areas that are more desirable for us. Hopefully the end result will be a rank list with some (maybe even many?!) dream programs at the top followed by a number of solid more-realistic choices that are also regionally fitting for our plans.

    There's also the issue of actually interviewing and seeing how you fit and what you think of the program itself when you get there. Our current plan if I find my perfect fit somewhere less desirable is to take my wife out there for a weekend trip, see the city, the neighborhoods, the schools, etc. If she visits and hates it and can't imagine living there, well then it probably won't make the list.

    Other things to think about that may play in to your rank list:
    1) Where do you want to practice after training?
    2) Academics vs private? --if your ultimate goal is private practice closer to family, you may have less need of a more competitive program and find great training along with local connections a little closer to home. If it's academics, you would probably benefit from the connections of a more elite academic center.
    3) Opportunities for your spouse? -- does she work? will there be good career options for her wherever you go?
    4) Children? If you're planning to start a family, having relatives close by can be a big help
    5) If you're planning to have children, will your wife continue to work? If not, then cost of living may need to be considered as your salary would be the only income and a resident salary goes farther in some areas.
    6) How competitive an applicant are you?

    Personally, I want my wife signed on 100% to our final rank list because when things get tough, I want us both to own the choices we make.
     
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  12. Mass Effect

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    This. You haven't even been invited for an interview yet. Why argue about it when it could turn out that you don't get an interview or that you do get an interview and visit the place and decide you hate it? Just make a deal with her that you're going to apply and see what happens. After interview season, then sit down as a couple and decide.

    I totally disagree with those who say you should train wherever you want. I also think she should be open to other places away from home. You need to compromise. That's the only way to avoid one of you resenting the other for the next 3-7 years. Also, I think it's important to ask if you have kids. If so, she might want to be close to home so her parents can help out with the baby/kids or babysit if she works. What field you're interested in is also relevant. If you're interested in something like neurosurgery, which pretty much guarantees she'll never see you, then I can appreciate her case a bit more, especially if you have kids.
     
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  13. SoyMilk

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    [​IMG]
     
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  14. Robotman

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  15. maxxor

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    Apply broadly and deal with this at the end of January when you have finished interviewing.

    Some programs invites SOs to interview dinners and had events planned out for them.

    When it came time to rank, I ultimately chose, but our lists were very similar.
     
  16. PL198

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    lol if he's the only one working and he has to compromise where he's going to work so she can be closer to her family, that's one hell of a compromise on her part. if they resent you for 3-7 years for a logical decision that they just didn't emotionally agree with, then it's a marriage doomed to fail. that's about the most petty thing possible to be upset about.
     
  17. Mass Effect

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    It's petty to be upset that your spouse isn't willing to take your feelings into consideration when choosing where to live for 3-7 years? You have no idea if the OP's reasons are logical. All you know is that the OP is interested in programs far away and his/her spouse wants to stay closer to her family. You have no idea what her reasons are. What if her parents are ill and she wants to be close to them for that reason? What if they help with child care while she works? What if she has a sibling with some kind of handicap and she helps her parents care for that sibling? Until we know more details, it's impossible for any of us to say either spouse is being unreasonable or illogical. Nevertheless, your marriage will get nowhere really fast if you're not willing to find a compromise. The "it's my way or the highway" motto will only work in a marriage where one is subservient to the other.
     
  18. SouthernSurgeon

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    Every relationship is different. Every partner, and what they want and need from a relationship, is different.

    I think it is promising, and important, that you are having these conversations now.

    I would agree with some of the points of advice that have come up above:
    1. Training is temporary - often as short as three years. Training is also crucially important. It's a very difficult period in your life and you need a program where you will be a good fit both in terms of career goals and socially. It's also important though, that your spouse has a strong support system in place, since you will often be too stressed to be that support for her.
    2. I would agree to apply broadly. You shouldn't artificially restrict your options now. Wait til the interview offers come in and then let things shake out. You should try as much as possible to bring your spouse with you. She will get to go to some of the interview dinners with you, and see the cities for herself.
    3. Do you have kids? Honestly if you are DINKS, it's a great time to move somewhere new. Try taking the attitude with her that it is a (temporary) adventure. something you can do now before you settle down.
     
  19. PL198

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    A compromise doesn't have to be 50/50. None of the reasons you listed would be valid reasons for taking a doctor and having them train somewhere else instead of where they wanted. If we were being logical and any of those concerns were real and I was OP's spouse, I'd want them to train at the programs they want, as he said they are higher ranked and thus he would be a more competitive applicant when it comes time to be an attending.
     
  20. operaman

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    I think all of those reasons are pretty valid.

    The OP -- and all of us really -- must do some serious soul searching with regards to what we want and what we value. Depending on what you want to do, the "rank" of the program may not matter very much. From a purely financial standpoint, you can make a lot more $$$ coming out of the lowest-ranked program going into private practice than you can coming out of a top 5 going into academics. What matters are your own personal goals. A program's ranking only matters insofar as it helps achieve those goals.

    OP will need to decide, as offers come in, whether the difference in training in these locations is truly worth the move and the inconvenience to his spouse. Obviously, if the only opportunities he gets are in these far away places, well that's better than not matching and I'm almost positive his wife would understand. I think she would have a harder time understanding why they need to go so far for him to become an XYZ doctor when he could just as easily do the same thing closer to home.
     
  21. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    Having a similar situation with the gf right now too. We basically just went through a bunch of programs on FREIDA, I told her the ones I was planning on applying to and she agreed with basically all of them. I agree that having the discussion post-interview is much more important as you''ll know which programs you liked by then and you'll both know which ones you actually have a shot at.

    However, I will throw in that it likely depends on what specialty you're applying to. If you're applying to something hyper-competitive like plastics, uro, ortho, ENT, derm, etc. it's only going to hurt you to take programs off your application list. Apply everywhere and tell her it's such a crapshoot that you're just looking for interviews. No need to compromise applications when you're in that situation.

    On a different note, does anyone know how accurate all the numbers on FREIDA actually are (esp. in relation to call schedule, avg hours per week, avg days off per week, etc)? I feel like it's all self-reported so it'd be pretty susceptible to manipulation by programs...
     
    #20 calvnandhobbs68, Sep 7, 2014
    Last edited: Oct 2, 2014
  22. PL198

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    lol you act like if he can match somewhere home he should just do that automatically. whipped so hard I can't even imagine
     
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  23. Mass Effect

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    I sometimes forget that most med students are in their 20s, single, without kids or other commitments. Different priorities, different way of thinking. I think every reason listed is more than valid, especially the one about an ill parent. Some things in life are more important than your "dream program." And by the way, no one said the compromise has to be 50/50. No one even said the OP should only agree to apply near home. All anyone said was that as a married person, he should probably take his wife's opinion into consideration. He's not just making decisions for himself anymore.
     
  24. DermViser

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    Agree. The machinations on where to live is only AFTER you have completed the interview and when you're coming up with a rank list.
     
  25. PL198

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    Not saying to ignore the wife at all, just think in terms of weighing in on this situation, it's not 50/50. Also I pondered a few questions in my first post so until those are answered or more info is given I don't really know where that split should be.
     
  26. 194342

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    I did the same thing you did, haha. I am intend applying to something pretty competitive with very limited spots each year, so I can't really be very selective with my applications.

    I agree the major decision will be after interviews once I am making a rank list. However, it is never too early to communicate. She IS matching with me. She needs some say in this, I don't plan on getting divorced during residency and I want her to be as happy as possible.

    BTW, the FREIDA numbers seem to be useless. The places I have done aways at are far off from what FRIEDA says. I plan on never being home, so it doesn't matter to me, but I wouldn't use those numbers if it matters to you.
     
  27. 194342

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    Yes, I understand this, but it doesn't hurt to talk about how we each feel about large geographical areas.
     
  28. 194342

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    I will be applying broadly but my field has only about 100 programs. Many of them are over 16 hours away from her parents so it can't hurt to discuss this in generalities right now.

    She will go wherever I go, we've been together since before medical school and she knew this was a possibility. Just trying to do what is best for the family in all senses of it.
     
    #27 194342, Sep 7, 2014
    Last edited: Sep 7, 2014
  29. Gunninforpeds

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    Jesus what's with all this "whipped" and "beta" talk? OP is asking a totally reasonable question. I am honestly flummoxed that he's getting blowback here.

    You better believe I'm going to consider my wife and kid's wants/needs heavily when making my rank list. Probably at the expense of going to the most ideal place for me, career-wise. That doesn't make me whipped it makes me a grown up.
     
  30. sb247

    sb247 Doer of things
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    Every family is different. But my >10yrs of marriage says every residency that accepts me will train me enough to get board certified. My residency schedule is a sacrifice for my wife, I choose to sacrifice ranking priority in ways that might make her life better.

    As you get older, kids being near extended fam means more than program reputation
     
  31. SouthernSurgeon

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    There is a subset of the allo forum consisting of immature young men who have confused this site with a TRP subreddit
     
  32. oldbearprofessor

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    This is an issue that you will face in medicine throughout your career and thus figuring out how to communicate about it needs to happen now as this isn't a one-time issue in many if not most medical careers. Heck, even really old folks have to make decisions about leaving long-time locales for opportunities elsewhere. You should look broadly, but ultimately you must also give your spouse a real say in the final ROL. Hopefully if your favorite spot is far away, she'll understand your passion and agree. If not, well, move it down the list or off of it. Consider talking with her about the idea that if you move to train, you'll come back afterwards. Of course, you will either make do on that commitment or plan on paying alimony/child support.
     
  33. 194342

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    Eh, don't worry about it. I have been around SDN long enough to know to ignore these arm-chair tough guys. Most of them are just nerds who have a hard time relating to women with an IQ above 70, just ignore it.
     
  34. 194342

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    I agree with you. I have met far too many residents who divorced during residency. I really don't want to be one of those people.
     
  35. BobbyB

    BobbyB ayy lmao
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    we're going to need an update in 5 years
     
  36. 194342

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    I'll let you know.
     
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  37. maxxor

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  38. FutureInternist

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    An unnamed classmate of mine changed the rank list w/o her knowing (after she had "approved" it)..Guess I can blackmail him once he starts raking in the dough :)
     
  39. Robotman

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  40. SouthernSurgeon

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    It is basically worthless.

    It's self-reported 100%.

    It's also almost always filled out by the program's residency coordinator.

    So not only is it self-reported and susceptible to manipulation, it's being filled out by someone who is often a glorified secretary who wouldn't even know the accurate answers.
     
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  41. DermViser

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    The person you're responding to is also 21 years old.
     
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  42. Geekchick921

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    I agree with all of this post but since it was long I just kept the last line because I think it's important.

    This is obviously a very important decision or you but you aren't the only person it affects. Your wife is going to make sacrifices while you're in residency as well. Does she particularly care about being close to her parents? Why? I can understand this if you have children or are planning on having children during your residency and she wants to have the support of her parents nearby.

    When I told my husband I wanted to expand my search beyond the Philadelphia/tri-state area, we came up with the expanded list together. I omitted entire states because he wouldn't want to live there because of climate or other reasons. We are usually on the same page with those kind of preferences anyway but if he said, "I really don't want to live there." I cut it. He works from home so he can take his job anywhere but he will be in charge of keeping the house in order and taking care of our kids, especially in the morning. Residency is going to be challenging for both of us so his happiness matters just as much to me as my own.

    We are both equally excited at the prospect of relocating (we've both spent all but 4-6 months of our lives in this area code) and reluctant to move. It is a tough decision. I'm hoping he can come with me for at least some of my interviews (if my mom can watch our kids).
     
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  43. ChiDO

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    Didn't read this thread...but multiple attendings have told me.... happy wife, happy life
     
  44. 194342

    Physician 7+ Year Member

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    She wants her mom to help raise our future children. This is totally reasonable as I am going into a surgical subspecialty and will never be around to help.

    I was hoping to have her fly out with me and visit some of the cities after I get interviews. She has never seen most if the cities I could possibly be matching at.
     
    #43 194342, Sep 8, 2014
    Last edited: Sep 8, 2014
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  45. 194342

    Physician 7+ Year Member

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    This guy goes hard in the paint with useless video responses. Keep up the strong work.
     
  46. Armadillos

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    For my wife and I, I made a list of programs I was thinking of and gave it to her, she crossed out places she absolutely wasn't interested in (apparently her professional license doesn't work in a couple states, good to know). She added a few more cities she was interested in and I looked for more programs there.

    Also, a lot of the posters saying "this is your only chance to train, forget your spouse, go wherever you want" are likely not married or if they are will quickly find out that half of a Hopkins trained docs salary is a lot less than salary of a doc trained at random state University.
     
  47. jdh71

    jdh71 epiphany at nine thousand six hundred feet
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    I'm married. Was then.

    Where is your God now?
     
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  48. sb247

    sb247 Doer of things
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    N=1

    Docs get divorced too and anything that increases odds of being on the wrong side of the statistic is expensive
     
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  49. jdh71

    jdh71 epiphany at nine thousand six hundred feet
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    Not too expensive if you do it soon enough. ;)

    Though you bring up an "interesting point" what is the "N" of everyone giving your sort of advice?? Hmm??

    Bottom line, everyone's gotta negotiate the there way through all of this in whatever way they think is best as there is no "best". I simply don't subscribe to any argument that "compromise" is "better" than training in this instance, especially when logically it's freaking "out of your mind" unreasonable to insist someone not get the best training they can when they can if it's only for a short time. As I said all things otherwise being equal there is no reason not to compromise, but spouses that won't allow some to get the training they need with all the years and hard work we put in are simply short-sighted and selfish in the extreme in my ever so humble opinion. Accuse my position of being "selfish"? Damn right it is. And it should be for the short time that is necessary to get the skills you need.

    You see what so many padawans here in this forum don't realize is that your training will be the BARE MINIMUM necessary to put you out into the work as a competent provider. You NEED to see things and do things, in order to feel comfortable doing the same as an attending. You're not going to re-invent any wheels after training when it's your job, license, home, cars, kid's private school education . . . And you need to be thinking about THAT, and if your spouse is NOT, then you need to have a productive conversation where you give them the facts.

    You all, can, of course do what you like. And good luck.
     
  50. Psai

    Psai Snitches get zero vicryl
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    What's your n? 4?
     
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  51. PL198

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    best way to avoid that? don't get married. I can just give my SO a piece of paper that says I love her and it's the same thing as a marriage except it doesn't f*ck one of us if either of us turn into a baller and make a billion dollars.

    More people single in US now than married, hm I wonder why
     

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