Fellowship and marriage

[ordersol7]

Hello everyone.

Hopefully this isnt too personal a topic for a forum like this but as it pertains to fellowship I thought Id give it a shot. I am a graduating pulmonary fellow applying for a 1 year critical care fellowship position to start next summer. I failed to match last year in part due to casting too small a net and will apply much more broadly this time around. Im actually fairly optimistic about my chances as I have a few more publications and already 2 interviews lined up with outside of the match programs. Im working a pulm only job in the interim.
The problem is that this situation is causing a lot of friction with my wife. We have been married for 6 years and have had a happy marriage including a 1 year old and a 13 year old niece we are poised to adopt but me going to critical care fellowship as been a point of contention. She didnt want me to apply initially due to anxiety of moving, financial concerns, concerns with our baby and the uncertain situation with adopting our niece which is close to resolved now, and was relieved when I didnt match first time around since we wouldnt have to move. I dont necessarily begrudge her this but today we got in an argument where ahe said ahe didnt understand why I was still pursuing an additional fellowship and she doesnt see why i cant just wait it out a few years and then apply so we can have some stability as a family. Ive tried explaining to her that this is a competitive fellowship match and that waiting a few years is just not a realistic option and that Im very passionate about critical care and wont feel fulfilled in my career without it, and that its just one more year and after that Im happy to move and settle wherever she wants but shes not really having any of it. I also offered to go myself and come back to visit with my pto for that year but she didnt like that suggestion either. My wife has been very patient with me throughout residency and pulmonary fellowship, and I understand the burden all this is placing on her, but unless I decide to give up on critical care entirely I dont think theres a way around applying this year, and I dont have the luxury of picking any state I want. Any advice would be appreciated.

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[Entadus]

Can we get more details about what the potential options could be? I.e. what are the chances that you could match in a location that would be (semi)desirable for her?

Also, what is your current income with this pulmonary job? Is your wife concerned about finances or purely the hassle of moving to a new location/uprooting again?

Or is this a time commitment issue, where you will be too busy during the fellowship with additional call/long hours/night shifts, etc?

I think a lot of this will depend on really listening to her and hearing all of her concerns, getting every emotion and fear out in the open, and making a decision together.

EDIT: also, what challenges has your family already overcome with your 2 year pulmonology fellowship? Be specific about the concerns your wife had then and the strategies you had to overcome, plus the outcomes (in terms of location, finances, hours, emotions, etc)

 

[ordersol7]

Critical care fellowships generally don't exist outside of large metro areas with few exceptions so its less the location and more the stress of moving. Odds are better than not we match somewhere that is at least semi desirable since her only preference is to live near a large city but its unlikely we would stay in the same state as there are only 3 critical care fellowships in our state here though more are supposed to be opening up.

My current income with this pulmonary job is 360k not including rvus. My wife is a CPA who owns her own small firm which has picked up a lot of clients this year so she'll likely earn ~100k or so this year. We plan on being frugal this year to save up money so financially we are less concerned.

Time commitment will be a big issue. Critical care fellowship involves call, long hours, and night shifts even though its only 1 year. We plan on hiring a nanny to help but it will still be a strain.

For context my wife's main stress is the hassle of uprooting but she also says she feels like her life has been dictated by forces she has no control over and not just me (a lot of controlling family members she has been slowly distancing herself from) and that she was happy to have some stability and that it feels like its being taken from her, even if it will only be for a bit.

With the pulmonary fellowship we already had to adjust to me taking a relative income hit and occasionally rough schedule as well as balancing raising a newborn in the middle of it.

We have talked more about it since the initial blowup and things are getting better but still a bit awkward

 

[that redhead]

I definitely see both sides here, but especially your wife’s. I think you want us all to say “meh it’s one more year, just suck it up!” Which isn’t wrong necessarily, but it is also short-sighted. Where will you go after fellowship? Presumably you’ll job hunt and have to move again, right? The housing market is really tough right now. Moving sucks, let alone with a one year old. She’ll be on her own a lot with a baby and a new teenager in a new place with presumably zero support system. How with this affect her business?

People on the physician path ask a lot of their spouses, both time-wise but also in relation to care of children, home and other matters. You work hard of course, and the idea is that the pay in the end makes it worth it. But you are a part of a partnership and it’s clear that you are not appreciating your wife’s concerns because it looks to you like “just” one more year. But a year is a long time without help from your spouse (or without dependable help) we specially with kids and a new location with no support.

On the flip side, this is a time sensitive issue and it’s your path to following your ultimate career satisfaction. Her concerns are valid, but I would hope she might come around to a compromise. What are you giving back to her to make this upheaval worth it?

 

[HemeOncHopeful19]

I definitely see both sides here, but especially your wife’s. I think you want us all to say “meh it’s one more year, just suck it up!” Which isn’t wrong necessarily, but it is also short-sighted. Where will you go after fellowship? Presumably you’ll job hunt and have to move again, right? The housing market is really tough right now. Moving sucks, let alone with a one year old. She’ll be on her own a lot with a baby and a new teenager in a new place with presumably zero support system. How with this affect her business?

People on the physician path ask a lot of their spouses, both time-wise but also in relation to care of children, home and other matters. You work hard of course, and the idea is that the pay in the end makes it worth it. But you are a part of a partnership and it’s clear that you are not appreciating your wife’s concerns because it looks to you like “just” one more year. But a year is a long time without help from your spouse (or without dependable help) we specially with kids and a new location with no support.

On the flip side, this is a time sensitive issue and it’s your path to following your ultimate career satisfaction. Her concerns are valid, but I would hope she might come around to a compromise. What are you giving back to her to make this upheaval worth it?

I disagree a bit but I may be reading a bit too much between the lines and bringing in experiences with a few colleagues. It almost sounds like the real stressor is moving away from these “controlling relatives” (aka the inlaws) and everything else is just extra fluff. OP already mentioned he is bring 360k to the table and offering to hire a nanny, etc.

When my wife and I get frustrated with each other’s careers we remind ourselves that we knew the plan going in together.

 

[that redhead]

OP already mentioned he is bring 360k to the table and offering to hire a nanny, etc.

When my wife and I get frustrated with each other’s careers we remind ourselves that we knew the plan going in together.

Yeah, $360k a year is great. But income isn’t everything to everyone, especially with kids and other careers involved. If they were childless and she had a flexible job situation, sure, suck it up another year. But maybe she doesn’t want to have to use a nanny (I’ll give OP a point on this one though, it’s fair to offer outside help at least some of the time, but that doesn’t cover random call ins). Or maybe she wants to devote time to her career too, after years of having him take priority.

As for your second point, it sounds like the fellowship interest is more recent and not necessarily something she knew she’d be getting in to. Obviously harder to predict that far out in medicine but it doesn’t sound like she knew this all would happen and is suddenly balking.

 

[dpmd]

I disagree a bit but I may be reading a bit too much between the lines and bringing in experiences with a few colleagues. It almost sounds like the real stressor is moving away from these “controlling relatives” (aka the inlaws) and everything else is just extra fluff. OP already mentioned he is bring 360k to the table and offering to hire a nanny, etc.

When my wife and I get frustrated with each other’s careers we remind ourselves that we knew the plan going in together.

Did she really know the plan going in though? sounds like the decision to pursue critical care wasn't one reached together, but rather unilaterally. 360k is the income from the job but that isn't what fellowship will bring in. She already suffered through one fellowship after dealing with residency and now is looking at having to suffer through another when she has already said she doesn't want to. I see nothing fluff about it.

 

[deleted1079620]

Did she really know the plan going in though? sounds like the decision to pursue critical care wasn't one reached together, but rather unilaterally. 360k is the income from the job but that isn't what fellowship will bring in. She already suffered through one fellowship after dealing with residency and now is looking at having to suffer through another when she has already said she doesn't want to. I see nothing fluff about it.

This is what I was getting also...that critical care wasn't part of the original plan but OP realized he really wanted to do it during his Pulm fellowship, and his wife who was maybe just starting to feel like she was getting a handle on things (young baby, adopting a teenager and building a business at all once is a lot!) would like to have a few years of peace and stability before uprooting it all and starting over in a new city, just to have to move again in a year. OP's offer to move and do the fellowship alone also leaves her alone to run a business and raise two children with very little support from him, and it seems like there are other stressful family issues going on as well.

OP, I'm only a medical student, so I have no idea what fellowship and all that entails yet, but I'm a nontrad and I've been married over 2 decades, with many compromises on both sides & many tough decisions along the way. If your wife is "blowing up" over this issue, it's because you two haven't been communicating for a while (or haven't been communicating effectively) and she feels unheard and unseen. You two need to sit down and calmly discuss all of your family's options, one of which has to be to give up this fellowship right now. I'm not saying that has to be your ultimate decision, but it at least needs to be on the list to show that you're considering the impact that another year of fellowship will have on her, your relationship, and your family.

This isn't as easy a decision as choosing a residency when you didn't have any kids yet or maybe weren't even married, because now you have to consider where your niece will go to school, how will you get her back & forth to school & activities, how will a move affect your wife's business, childcare for the baby, where you will live, etc. Often showing the other person that you care about the impact your decisions have on their life is enough to facilitate meaningful conversation instead of awkward silences and stalemates. Good luck, OP!

 

[HemeOncHopeful19]

If you look at OPs post history I suspect he originally applied Pulm/Crit and matched to Pulm only (apologies OP if that isn't the case). It's clearly been something he's been pursuing for years, although maybe not when he first got married.

 

[NITRAS]

Did she really know the plan going in though? sounds like the decision to pursue critical care wasn't one reached together, but rather unilaterally. 360k is the income from the job but that isn't what fellowship will bring in. She already suffered through one fellowship after dealing with residency and now is looking at having to suffer through another when she has already said she doesn't want to. I see nothing fluff about it.

I would say that people’s plans and lives are never what they think they are. Life with a 1 y/o and a newly acquired 13 y/o, (and do yall want to have another kid before you are completely geriatric) can be very different than you think is going to be. Fellowship will require a significant drop in income for a couple years and likely 2 moves. And many of those CC jobs have lots of suckage with them (nights of at least being on call). It isn’t unreasonable for your wife to not want to go through that.

I would just say that you aren’t in a bad place, and as a marriage you should make these decisions together. It is ok to change plans. It is a really bad idea to go into fellowship without the support of your wife.

Hope you guys figure it out. Good luck.

 

[VenusinFurs]

Hello everyone.

Hopefully this isnt too personal a topic for a forum like this but as it pertains to fellowship I thought Id give it a shot. I am a graduating pulmonary fellow applying for a 1 year critical care fellowship position to start next summer. I failed to match last year in part due to casting too small a net and will apply much more broadly this time around. Im actually fairly optimistic about my chances as I have a few more publications and already 2 interviews lined up with outside of the match programs. Im working a pulm only job in the interim.
The problem is that this situation is causing a lot of friction with my wife. We have been married for 6 years and have had a happy marriage including a 1 year old and a 13 year old niece we are poised to adopt but me going to critical care fellowship as been a point of contention. She didnt want me to apply initially due to anxiety of moving, financial concerns, concerns with our baby and the uncertain situation with adopting our niece which is close to resolved now, and was relieved when I didnt match first time around since we wouldnt have to move. I dont necessarily begrudge her this but today we got in an argument where ahe said ahe didnt understand why I was still pursuing an additional fellowship and she doesnt see why i cant just wait it out a few years and then apply so we can have some stability as a family. Ive tried explaining to her that this is a competitive fellowship match and that waiting a few years is just not a realistic option and that Im very passionate about critical care and wont feel fulfilled in my career without it, and that its just one more year and after that Im happy to move and settle wherever she wants but shes not really having any of it. I also offered to go myself and come back to visit with my pto for that year but she didnt like that suggestion either. My wife has been very patient with me throughout residency and pulmonary fellowship, and I understand the burden all this is placing on her, but unless I decide to give up on critical care entirely I dont think theres a way around applying this year, and I dont have the luxury of picking any state I want. Any advice would be appreciated.

Unfortunately, it may come down to fellowship or marriage at this point. And what about the kids? I assume the 13 year old goes to school? Have you considered what it might be like for a newly adopted 13 year old to have to move schools and then possibly move again a year later? Does she have local friends you will be taking her away from?

I think you really need to think about the well-being of your entire family here. We are not our careers, our careers can be taken away at any minute and our careers will never love us back.

 

[Trefoil]

Hello everyone.

Hopefully this isnt too personal a topic for a forum like this but as it pertains to fellowship I thought Id give it a shot. I am a graduating pulmonary fellow applying for a 1 year critical care fellowship position to start next summer. I failed to match last year in part due to casting too small a net and will apply much more broadly this time around. Im actually fairly optimistic about my chances as I have a few more publications and already 2 interviews lined up with outside of the match programs. Im working a pulm only job in the interim.
The problem is that this situation is causing a lot of friction with my wife. We have been married for 6 years and have had a happy marriage including a 1 year old and a 13 year old niece we are poised to adopt but me going to critical care fellowship as been a point of contention. She didnt want me to apply initially due to anxiety of moving, financial concerns, concerns with our baby and the uncertain situation with adopting our niece which is close to resolved now, and was relieved when I didnt match first time around since we wouldnt have to move. I dont necessarily begrudge her this but today we got in an argument where ahe said ahe didnt understand why I was still pursuing an additional fellowship and she doesnt see why i cant just wait it out a few years and then apply so we can have some stability as a family. Ive tried explaining to her that this is a competitive fellowship match and that waiting a few years is just not a realistic option and that Im very passionate about critical care and wont feel fulfilled in my career without it, and that its just one more year and after that Im happy to move and settle wherever she wants but shes not really having any of it. I also offered to go myself and come back to visit with my pto for that year but she didnt like that suggestion either. My wife has been very patient with me throughout residency and pulmonary fellowship, and I understand the burden all this is placing on her, but unless I decide to give up on critical care entirely I dont think theres a way around applying this year, and I dont have the luxury of picking any state I want. Any advice would be appreciated.

I think the thoughts have been echoed multiple times, but I would have to agree with the other posters here that you should have a better conversation with your wife. It sounds like you are making this decision despite her wishes. I think the argument that waiting is not an option is a bit too final. I would imagine that it could be possible, but it’s not what you were planning.

This could permanently change your lifestyle as well, which would also greatly change your relationship. Given the huge impacts this has on both of you, it’s really not an option to go forward without her approval. If you want your marriage to work, you need to respect your wife’s desires.

 

[ordersol7]

I greatly appreciate all of your input.
I ended up sitting down and having a long talk with my wife on this.
The long and short of it was that she felt like I was not hearing her concerns and stresses and that she felt like an accessory in our marriage.
She also said she didn't necessarily want me to give it up because she knows how important it is for me she just isn't sure how she's going to handle all the mental stress.
We ended up agreeing to a compromise where I will withdraw from the programs I applied to that either require a plane flight to move or are too far from any family or friends who could support us and pitch in with child care, and let what happens happen from there.
To clarify an issue with our niece, the plan was always to change schools after 1 year regardless because while the middle schools in our currrent area are decent, the high schools are notoriously bad and rife with academic/crime problems, and this was something we agreed on independent of the fellowship match.
After this year, one way or the other I don't plan on applying for fellowship again so our niece can stay in the same high school all 4 years. We plan on settling near where I end up matching as well.
I don't plan on replying to this thread again but I do appreciate all of you taking the time.

 

[VenusinFurs]

I greatly appreciate all of your input.
I ended up sitting down and having a long talk with my wife on this.
The long and short of it was that she felt like I was not hearing her concerns and stresses and that she felt like an accessory in our marriage.
She also said she didn't necessarily want me to give it up because she knows how important it is for me she just isn't sure how she's going to handle all the mental stress.
We ended up agreeing to a compromise where I will withdraw from the programs I applied to that either require a plane flight to move or are too far from any family or friends who could support us and pitch in with child care, and let what happens happen from there.
To clarify an issue with our niece, the plan was always to change schools after 1 year regardless because while the middle schools in our currrent area are decent, the high schools are notoriously bad and rife with academic/crime problems, and this was something we agreed on independent of the fellowship match.
After this year, one way or the other I don't plan on applying for fellowship again so our niece can stay in the same high school all 4 years. We plan on settling near where I end up matching as well.
I don't plan on replying to this thread again but I do appreciate all of you taking the time.

I really appreciate you thinking about the well-being of your niece here and about compromising further with your wife, and I hope you will feel fulfilled in your career and life regardless of what ends up happening with this fellowship. I’m so relieved you listened to your wife’s concerns and put more emphasis on your marriage and family.

 

[J ROD]

I am so invested now....I wonder if he matched.

 

[ordersol7]

I did. Matched in another state but one where she has a sister and cousin for support so things look good for now.

 

[J ROD]

I did. Matched in another state but one where she has a sister and cousin for support so things look good for now.

A story with an ending. Thanks for the reply. Glad things worked out.

 

[medshousing]

Just to add to the topic: Has your wife joined the group The Flipside Life | Connection. Education. Advocacy. It is a terrific support group for spouses created by a spouse of a fellow, Hayley Harlock. They meet virtually often and any spouse can join in.

"Championing and supporting physician partners and spouses to thrive, not just survive!​

A growing community of those living on the flipside of the white coat."​

Who Are We?

We are the spouses and partners of medical students and physicians. We are the keepers of our families. We are the organizers and executors of details big and small. While being on the flipside of medicine can feel lonely and isolating at times, collectively, we are an inclusive community dedicated to supporting our physician families and each other.

 

[J ROD]