Issue deciding ROL with significant other

[amberkre]

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I'm currently applying for Internal Medicine residency, and have been lucky enough to get a decent number of interviews with some programs I considered to be extreme reaches. I applied very broadly. My fiancé is currently working in the city of my med school and loves his current job, does very well financially. With his job he has the ability to either stay in our current city or move to Boston. He has also turned down living in various other cities to which I have gotten interviews at "dream" programs. For example, he refuses to live in Chicago, Baltimore or Philadelphia as he says he "hates philly" and also says it will be a huge issue for his career.

We have had this conversation many many times, but it seems that location is a huge issue for him. I want him to be happy where we are for the next 3 years, and do want to take his opinion into account when I create my match list. However, we have both decided that I would rather match in a less desirable location than not to match at all, by turning down programs not in one of the 2 target cities.

I'm worried that if I create my match list based mostly on location, I will be very disappointed on match day if I put my career options on the back burner. I do not have a specific fellowship in mind, but do want to keep my options open as I have interests in cardiology. I know that I am better off at an academic center with fellowships, rather than a smaller community hospital and am happy to have landed interviews at some great programs. However, it seems most of the community hospitals are a better location for us.

Any advice for others who are going or have gone through the match process while keeping a significant other's preferences in mind?

 

[BigRedBeta]

Unfortunately this is only going to continue to be an issue - if not for residency, then for fellowship, and if not for either of them, then when you get that first attending position. At some point, it's very likely that location will be an insurmountable issue in some way or fashion in which one of you will have to sacrifice. One of the best pieces of advice my wife got from her bosses when we were looking for my first attending job was "it's the first time that Dr. Bigredbeta gets to actually use his training and create a career, you [Mrs. BRB] got to spend the last 10 years building your career in to what you want it to be". While it may not be as impactful as it was for her, it made her realize that it was going to be rare situation in which one of us was not making a sacrifice in some form or fashion. And for you, being just out of medical school, are younger than my wife and I were when we were facing this dilemma, so it may be more challenging for y'all as you each need time to build a CV.

Now the options you have vary. You can certainly just go all out and pick your dream programs, knowing that you'll be apart for 3 years, doing some form of long distance. You could pick some places that are within 2 hours of your fiance's location and then live 1/2 way between his office and your hospital - I've had friends at each stage of training and even now where this is their solution. You sacrifice your commute and perhaps your ideal home environment to keep your relationship and careers intact. The other end of the spectrum is that one of you sacrifices more by ending up in a less desirable location.

There is likely an element of who will be providing for whom that may color your decision making and when you are the big, bad, attending, may be able to drive the decision making process towards your ideal location. But he may be feeling that for the time being that while you're making peanuts, and his career is supporting you two that he should get the better options. How much of that is robbing future amberkre is impossible to say.

If you can, try to take him on your interviews, give him a chance to see the locations up close. And when you love one place that doesn't fit his preferred scenario, maybe he'll see it's not so bad. And if you're fairly equivocal about some locations, then make his opinion the deciding factor. When I finally got my job offers after fellowship, I had pluses and minuses for all three options, and could have been okay at any of the choices. My first choice job was my wife's #3 location, and we ended up at her #1 choice which was my #2 option, which has totally worked out, though not without it's challenges.

Lastly, if all else fails, just remind him: happy life = happy wife (my apologies if I wrongly assumed your gender)

 

[rokshana]

I'm currently applying for Internal Medicine residency, and have been lucky enough to get a decent number of interviews with some programs I considered to be extreme reaches. I applied very broadly. My fiancé is currently working in the city of my med school and loves his current job, does very well financially. With his job he has the ability to either stay in our current city or move to Boston. He has also turned down living in various other cities to which I have gotten interviews at "dream" programs. For example, he refuses to live in Chicago, Baltimore or Philadelphia as he says he "hates philly" and also says it will be a huge issue for his career.

We have had this conversation many many times, but it seems that location is a huge issue for him. I want him to be happy where we are for the next 3 years, and do want to take his opinion into account when I create my match list. However, we have both decided that I would rather match in a less desirable location than not to match at all, by turning down programs not in one of the 2 target cities.

I'm worried that if I create my match list based mostly on location, I will be very disappointed on match day if I put my career options on the back burner. I do not have a specific fellowship in mind, but do want to keep my options open as I have interests in cardiology. I know that I am better off at an academic center with fellowships, rather than a smaller community hospital and am happy to have landed interviews at some great programs. However, it seems most of the community hospitals are a better location for us.

Any advice for others who are going or have gone through the match process while keeping a significant other's preferences in mind?

sorry, but it sounds like that this is not a "we" decision, but a "he" decision...

you two need to sit down and discuss the cold hard facts of the residency match and what it means for your career...and you need to sit down with yourself and decide what you truly need in a residency and whether geographically limiting yourself will have an adverse effect (i.e. not matching) on your career.

there was a thread last year that dealt with a similar theme (wife initially was ok with moving, then decided she didn't want to because of family and loss of friends reason)...it may help you with ideas of how to talk to your fiancé and question you need to ask yourself.

as for "hating philly" well, maybe he needs to spend a little more time in philly...it grows on you.

 

[coffeeclothesaddict]

.

 

[amberkre]

Unfortunately this is only going to continue to be an issue - if not for residency, then for fellowship, and if not for either of them, then when you get that first attending position. At some point, it's very likely that location will be an insurmountable issue in some way or fashion in which one of you will have to sacrifice. One of the best pieces of advice my wife got from her bosses when we were looking for my first attending job was "it's the first time that Dr. Bigredbeta gets to actually use his training and create a career, you [Mrs. BRB] got to spend the last 10 years building your career in to what you want it to be". While it may not be as impactful as it was for her, it made her realize that it was going to be rare situation in which one of us was not making a sacrifice in some form or fashion. And for you, being just out of medical school, are younger than my wife and I were when we were facing this dilemma, so it may be more challenging for y'all as you each need time to build a CV.

Now the options you have vary. You can certainly just go all out and pick your dream programs, knowing that you'll be apart for 3 years, doing some form of long distance. You could pick some places that are within 2 hours of your fiance's location and then live 1/2 way between his office and your hospital - I've had friends at each stage of training and even now where this is their solution. You sacrifice your commute and perhaps your ideal home environment to keep your relationship and careers intact. The other end of the spectrum is that one of you sacrifices more by ending up in a less desirable location.

There is likely an element of who will be providing for whom that may color your decision making and when you are the big, bad, attending, may be able to drive the decision making process towards your ideal location. But he may be feeling that for the time being that while you're making peanuts, and his career is supporting you two that he should get the better options. How much of that is robbing future amberkre is impossible to say.

If you can, try to take him on your interviews, give him a chance to see the locations up close. And when you love one place that doesn't fit his preferred scenario, maybe he'll see it's not so bad. And if you're fairly equivocal about some locations, then make his opinion the deciding factor. When I finally got my job offers after fellowship, I had pluses and minuses for all three options, and could have been okay at any of the choices. My first choice job was my wife's #3 location, and we ended up at her #1 choice which was my #2 option, which has totally worked out, though not without it's challenges.

Lastly, if all else fails, just remind him: happy life = happy wife (my apologies if I wrongly assumed your gender)

Thanks so much for the very thoughtful response Dr. BigRedBeta. I guess this isn't so much a residency issue but more of a life/career problem that will continue. Its good to hear that your #2 choice has worked out well and that you don't have regrets. I'm hopeful that we can come to some sort of compromise / that it works out for both of us. For the time being he is the financial supporter. I appreciate that while these next 3 years seem to me to be the most important for my career, they are also a turning point for his as well. The 1 hour commute wouldn't be the worst in the world so that definitely increases the options! Thanks again, its good to hear that other people have gone through this location / career dilemma. Haha and you assumed the correct gender, ill have to remind him of that quote.

 

[amberkre]

sorry, but it sounds like that this is not a "we" decision, but a "he" decision...

you two need to sit down and discuss the cold hard facts of the residency match and what it means for your career...and you need to sit down with yourself and decide what you truly need in a residency and whether geographically limiting yourself will have an adverse effect (i.e. not matching) on your career.

there was a thread last year that dealt with a similar theme (wife initially was ok with moving, then decided she didn't want to because of family and loss of friends reason)...it may help you with ideas of how to talk to your fiancé and question you need to ask yourself.

as for "hating philly" well, maybe he needs to spend a little more time in philly...it grows on you.

Thanks so much for the advice @rokshana . From my first post I may have made it sound like he is very demanding, but I left out the fact that he has lived in our current city because it's my hometown and because I've been in med school here, while sacrificing the fact that he had no family or friends nearby from the start. So he's definitely compromised on location for the past 7 years or so. I do feel like its my turn to compromise on that end, however you're right in that I'm not ready to allow that to have an adverse affect on my career. (whether that is being selfish). I don't understand the philly hate either, he claims theres no career opportunities for him there and would be detrimental to his career (I have a suspicion it honestly has to do with sports). I'll see if I can check out that thread, thanks.

 

[Moose A Moose]

However, we have both decided that I would rather match in a less desirable location than not to match at all, by turning down programs not in one of the 2 target cities.

Create your own match list to programs you want. I can assure you that if he can't flex his work schedule for three years you're only going to have issues down the road. Unless this relationship is going on 8-10 years, I think what you should do is evident.

 

[gutonc]

I have lots of advice to give on the subject of how to make a ROL w/ your non-medical spouse's life/career/happiness in mind.

But I'm divorced now, so you should probably take advice from others.

Let's just say that the phrase "you ruined my life" was a big part of conversations at home for a few years. We can also say that I'm quite a bit happier now...so there's that.

 

[Lccjblu]

It's a tough situation to be in OP. In such relationships there Will always need to be compromise and there will definitely be one person sacrificing more than the other. When my wife and I couples matched during residency I did not rank my second favorite program because she hated the corresponding program for her specialty. My third favorite program was number 15 on our ROL. In the end we made our rank list based on where she could position herself best for a highly competitive fellowship down the line. I too am applying for fellowship but I have slightly more options.

It honestly took me a long time to wrap my head around having to put our future first. We had just gotten married before interview season. But in the end I was willing to trade 3 years of a mediocre program for a future where both of us could reach our professional goals.

 

[Raryn]

I have lots of advice to give on the subject of how to make a ROL w/ your non-medical spouse's life/career/happiness in mind.

But I'm divorced now, so you should probably take advice from others.

Let's just say that the phrase "you ruined my life" was a big part of conversations at home for a few years. We can also say that I'm quite a bit happier now...so there's that.

I'm surprised. You're in one of the most desirable metropolitan areas in the states.

I suppose if you came from NY though, there's some people who love the northeast and never want to leave. Baffles me personally.

 

[Psai]

I'm surprised. You're in one of the most desirable metropolitan areas in the states.

I suppose if you came from NY though, there's some people who love the northeast and never want to leave. Baffles me personally.

There's nothing better than the smugness you get by birthright from being better than the plebs of Boston, Philly and New Jersey. Not to mention those insufferable pricks from upstate.

 

[Perrotfish]

Create your own match list to programs you want. I can assure you that if he can't flex his work schedule for three years you're only going to have issues down the road. Unless this relationship is going on 8-10 years, I think what you should do is evident.

I don't think it's that one sided. It's a tough situation for both of them. OP isn't wrong that this could affect her options for fellowship, and that she's worked very hard to get where she is. Fiance isn't wrong that his career is also important, and that uprooting everything to follow his spouse can be career ending. Physicians may have the ability to pull up stakes on whim but most people who walk away from good job set their careers back by years, and may torpedo it all together. I don't know what the right answer is for them, but its unfair to the fiancé to suggest that he's unreasonable for having his own priorities.

 

[amberkre]

Thanks everyone for all the great responses, some good advice from people who have gone through the process before! Feeling a little jealous of all my single friends going through match! Luckily have some good options in locations that will work, will be sad to say buy to the programs not in those areas but I agree that his career is no less important than mine. We have decided I'll still rank those programs but just further down on the list, and if I match there 3 years of long distance wouldn't be the end of the world for us. Thanks again!

 

[LucidSplash]

Is this fiancé like you have a date set and are getting married within the year or fiancé like you’ve been engaged for 2 years and still don’t have a date set? My perspective on the situation would vary widely depending on the answer.

 

[amberkre]

Is this fiancé like you have a date set and are getting married within the year or fiancé like you’ve been engaged for 2 years and still don’t have a date set? My perspective in the situation would vary widely depending on the answer.

Date set, been together for ~7 years, living together for 6 years, wanted to wait to get married until after graduating.

 

[NotAProgDirector]

There are lots of good programs in Boston, and likely some good programs where you are now. You can probably have whatever career you'd like regardless of the program you attend. If you're getting "reach" invites, you're sure to get "solid" invites in those two cities. Don't become so focused on "name" that you lose focus on what you really need.