Medical How to go about separation from my wife during the first years of med school?

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tantacles

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Hi All,

I know I am posting this a little early given that I haven’t even received an interview invitation for this cycle, but I fear that I may have to make a tough decision regarding where I attend medical school.

My fiancee, whom I will be marrying before I start medical school, will be attending graduate school at University X from January 2021 to December 2023. University X also has an MD program, and I would like to attend this program for obvious personal reasons, but I fear that doing so may limit my career options. University X’s MD program is ranked outside the top 100, and they have limited research opportunities available for their students. They don’t generally have a problem matching graduates into good IM programs, but surgical subspecialties are a different story. University X lacks many departments in smaller specialties (no neurology, neurosurgery, orthopedics, plastics, etc. departments). I do NOT have an interest in academic medicine, so I don’t need prestige, but I’m not yet sure where my interests lie in terms of specialty.

There are a number of schools to which I have applied that do not present any of these issues, some of them as close as 3 to 4 hours from University X. In fact, four of these nearby schools are T20. So, my question is, would it be wiser of me to attend one of these other schools that are 3-4 hours away (assuming I get accepted to one of them) instead of University X, with its limited resources? What if I get accepted to a different T20 school that is 10 hours away? Or even a T10 school that’s 10 hours away?

If this post is too hypothetical, I understand. If I do end up being faced with this dilemma, I’ll post again in several months with more specifics. I just wanted to hear some expert opinions now because the idea of having to make this decision has been weighing on me pretty heavily.

Unfortunately, this isn't really a question we can answer in any concrete capacity, even with specifics. Students from MD programs have the option to go into any specialty they choose, and their performance generally dictates which specialties are open to them. The change of USMLE Step 1 to p/f changes that a bit as many programs used that as their initial screening tool.

So the overall answer: Your school choice may affect your career path, but no one can say for sure how much. In addition, only you can determine the priorities that dictate how you choose a medical school. Family struggles and location preferences, for many, weigh far more than prestige of school and breadth of potential career options. I've even known applicants who applied to only 3-4 schools because their family was of a higher priority than their schooling.

Ultimately, the choices you make need to be based on your priorities. So for now, apply broadly, and make the decision when you have more information.

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Hi All,

I know I am posting this a little early given that I haven’t even received an interview invitation for this cycle, but I fear that I may have to make a tough decision regarding where I attend medical school.

My fiancee, whom I will be marrying before I start medical school, will be attending graduate school at University X from January 2021 to December 2023. University X also has an MD program, and I would like to attend this program for obvious personal reasons, but I fear that doing so may limit my career options. University X’s MD program is ranked outside the top 100, and they have limited research opportunities available for their students. They don’t generally have a problem matching graduates into good IM programs, but surgical subspecialties are a different story. University X lacks many departments in smaller specialties (no neurology, neurosurgery, orthopedics, plastics, etc. departments). I do NOT have an interest in academic medicine, so I don’t need prestige, but I’m not yet sure where my interests lie in terms of specialty.

There are a number of schools to which I have applied that do not present any of these issues, some of them as close as 3 to 4 hours from University X. In fact, four of these nearby schools are T20. So, my question is, would it be wiser of me to attend one of these other schools that are 3-4 hours away (assuming I get accepted to one of them) instead of University X, with its limited resources? What if I get accepted to a different T20 school that is 10 hours away? Or even a T10 school that’s 10 hours away?

If this post is too hypothetical, I understand. If I do end up being faced with this dilemma, I’ll post again in several months with more specifics. I just wanted to hear some expert opinions now because the idea of having to make this decision has been weighing on me pretty heavily.
I can't tell you what to do, but I personally would give up being a surgeon if it meant I could have another two years with my wife.

Saying "top 100" is the same as saying "any US medical school."

Saying "not in the top 100" is a meaningless bar. Even Drexel, Albany, Mercer and MCG send people to good residencies.
 
No offense, you picked medicine as a profession, and there is a clear implication that you will prioritize work, even above family during duty time. If you pick a high duty/low flexibility residency like surgery, that is a lifestyle as well as an occupation. You are going to have to make your priorities clear.

That said, I also would warn you that I have been jaded to see how many marriages break up in medical school under the circumstances you are in. I honestly say this in a position of ignorance referencing @tantacles 's comment about our inability even with specific knowledge would have problems predicting, that people really should really have a self-examination of shared values before marrying before medical school but that standards are more flexible than 20 years ago, but there is still a major expectation that work is prioritized. Any decision you make cause regret in this area and it usually works out as resentment (which is unfair but all too human) when family matters interfere with career aspirations. Divorce really happens toward the end of residency to the point of being a stereotype at many academic institutions with a clear resource for professional marriage counseling on retainer if not employed for these scenarios.

You want a happy, balanced life and marriage in medicine, you're going to have to work at it and against the easy, unconscious route which always leads to not prioritizing one at a critical time. It is extremely possible to have both a good family and a good practice, but many are not willing to compromise the right choices at the right times. Happy, balanced lives in medicine are to me the exception rather than the rule, and that definitely goes for the surgical schedule such that you do pick work if you pick surgery as your career. Even surgeons who works 16 hours or less a week went through periods of their lives when they worked 80+ hours.

But remember, it's no longer your decision once you get married, it's your household's decision. You don't get to make this decision independently if you have a good marriage, it must be done in consideration with your spouse. If your spouse wants you close, then what do you prioritize? If your spouse is supportive about any choice works, you still have to consider that long-distance marriages are riskier and harder on the relationship for obvious reasons.
Thank you for your input. My finacee is very supportive of my career choices, and she has made it clear that she will support me in whatever decision I make. Additionally, we have maintained (and strengthened) our relationship while being separated by about 1.5-2 hours during the last four years of undergrad, so we are not strangers to this. Of course, the options for med school which I am considering are about double the distance, so that would make it more difficult.

I’m also concerned about having less time to devote to my fiancee on the weekends when we would visit one another. This hasn’t been an issue for me in undergrad, and I usually spend 50-60 hours per week working on school/extracurriculars. How many hours per week do medical students typically spend working in their first two years?
 
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