Relationship vs residency

[Crystal8]

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I'm a 4th year med student nearing the end of my interview trail. I've been fortunate in that I've interviewed at some really strong, well-known programs that I loved and also at programs that I like, though are definitely a tier lower.

My question lies in the fact that I'm a 27 year old female who was in a 3 year relationship (my former SO is non-medical) that ended in the summer. We were long distance throughout all of med school and our relationship actually held up really well. However, toward the end things started falling apart and I found myself falling a little out of love, most likely secondary to the issues we were having. Even though my ex and I have broken up, we've remained good friends, and he's been an amazing support throughout the application and interview process.

Now that some time has elapsed between our break up, and I'm nearing the end of my interview trail and beginning to think of rank order lists, I've hit a wall: my ex and I have remained very good friends after our break up and he swears he sees the problems we'd had and will work hard to change. I've seen some evidence of change, but of course, can't be sure unless we date again. I still care a lot for him, though I'm not sure that he's "the one," and he knows this. At one point we both saw ourselves getting married and he admits he still holds out hope that we will. What he thinks is that I should try to be on the East Coast (he's in Manhattan) so that we can give our relationship another try, and in the case it doesn't work out, then I'll still be at a good (though not one of my top choices) residency program. His argument is, I'll have completed my residency and be a board-certified licensed doctor no matter where I go, so why not give us another try?

He will not commit to another 4 years of long distance unless we are at least a train ride away (he's in an industry that only flourishes in Manhattan, so he doesn't have the option to leave without taking a significant career set-back). I can't say I disagree, because by the time I finish residency we'll both be in our early 30s, have had essentially a 7 year relationship and still haven't even lived together. Problem is, my top 2 or 3 programs are not anywhere near the East Coast. There are 2 programs that I plan to rank that are on the East Coast, but they are definitely a tier lower.

I've always hoped that I'd be married with children by the time I'm in my late 20s, early 30s. At the very least in a serious, long term committed relationship. I also figured I'd prioritize my personal life before my career, but at this point I'm confused because I don't know if I should prioritize my former relationship (that might have potential) or my residency/career during which I don't even know if I'll meet anyone. Everyone in residency already seems to be attached in some capacity.

If I choose to prioritize my personal life, will I always wonder what could've been at my first choice residency? Conversely, if I choose to prioritize my residency (and especially if I don't meet anyone else), will I forever regret losing someone who could've been "the one?"

Any advice out there? Thanks in advance--especially thanks for making it this far down in the post!
I'm posting this in the resident forum, because presumably most of you have "been there, seen that," and might be able to give me more insight. Sorry for the long background, but I thought it was necessary to give so people would have a more or less complete story when giving advice.

 

[jdh71]

I'm a 4th year med student nearing the end of my interview trail. I've been fortunate in that I've interviewed at some really strong, well-known programs that I loved and also at programs that I like, though are definitely a tier lower.

My question lies in the fact that I'm a 27 year old female who was in a 3 year relationship (my former SO is non-medical) that ended in the summer. We were long distance throughout all of med school and our relationship actually held up really well. However, toward the end things started falling apart and I found myself falling a little out of love, most likely secondary to the issues we were having. Even though my ex and I have broken up, we've remained good friends, and he's been an amazing support throughout the application and interview process.

Now that some time has elapsed between our break up, and I'm nearing the end of my interview trail and beginning to think of rank order lists, I've hit a wall: my ex and I have remained very good friends after our break up and he swears he sees the problems we'd had and will work hard to change. I've seen some evidence of change, but of course, can't be sure unless we date again. I still care a lot for him, though I'm not sure that he's "the one," and he knows this. At one point we both saw ourselves getting married and he admits he still holds out hope that we will. What he thinks is that I should try to be on the East Coast (he's in Manhattan) so that we can give our relationship another try, and in the case it doesn't work out, then I'll still be at a good (though not one of my top choices) residency program. His argument is, I'll have completed my residency and be a board-certified licensed doctor no matter where I go, so why not give us another try?

He will not commit to another 4 years of long distance unless we are at least a train ride away (he's in an industry that only flourishes in Manhattan, so he doesn't have the option to leave without taking a significant career set-back). I can't say I disagree, because by the time I finish residency we'll both be in our early 30s, have had essentially a 7 year relationship and still haven't even lived together. Problem is, my top 2 or 3 programs are not anywhere near the East Coast. There are 2 programs that I plan to rank that are on the East Coast, but they are definitely a tier lower.

I've always hoped that I'd be married with children by the time I'm in my late 20s, early 30s. At the very least in a serious, long term committed relationship. I also figured I'd prioritize my personal life before my career, but at this point I'm confused because I don't know if I should prioritize my former relationship (that might have potential) or my residency/career during which I don't even know if I'll meet anyone. Everyone in residency already seems to be attached in some capacity.

If I choose to prioritize my personal life, will I always wonder what could've been at my first choice residency? Conversely, if I choose to prioritize my residency (and especially if I don't meet anyone else), will I forever regret losing someone who could've been "the one?"

Any advice out there? Thanks in advance--especially thanks for making it this far down in the post!
I'm posting this in the resident forum, because presumably most of you have "been there, seen that," and might be able to give me more insight. Sorry for the long background, but I thought it was necessary to give so people would have a more or less complete story when giving advice.

You only get to do residency ONCE, so get the best training that you want. I'll assume you wouldn't have even brought this up if your current rank list number one was somewhere NOT in NYC.

Second google "the working definition of insanity" and honestly assess the situation. People don't largely change. In fact we shouldn't have that expectation. I think 3 years is plenty of time to tell you what you need to know. Plus there are lots of dudes, really.

Via con dios.

 

[peppy]

It already crashed and burned once. It would be iffy to sacrifice your #1 residency for someone you were still dating. It would be totally crazy to sacrifice your desire to be at your #1 residency for a failed relationship that "might" somehow get back on track someday.

This is not a matter of sacrificing your personal life. It's not like you would be forbidden from dating anyone at your new location. If anything, you might be more likely to end up married happily in a few years if you stop wasting time on a guy that there is likely no future with. If you're not sure you want to be with him after this long, it's probably a sign this is just not meant to be. A lot of my peers in residency came into residency single. No, there isn't much time to try to meet people in bars or anything like that, but online dating works pretty well for a lot of them.

Incidentally, my boyfriend threw away a chance to stay in a very good job in another state to follow me to my residency location. Even though it was a big financial loss, he thought it was worth it because he believed in our relationship. Though your guy's situation probably isn't quite the same, perhaps that you know he wouldn't even consider such a thing may be another hint that this relationship isn't meant to be.

 

[TexasPhysician]

I interviewed at some big name programs as well that were far away from family. I strongly considered Duke and Vanderbilt.

I think the program I chose to rank 1st is an excellent program, but it is not a Top 25 name program.

I personally chose to be closer to family and girlfriend at the time. My mother's health isn't excellent, and I am not sure if she will still be with us after I complete residency.

While my training is important, I also know that life is more important. What does your gut say? What is most important to you right now? If you make yourself happy, everything else is easier.

 

[BostonMedicine]

Lots to respond to. Definitely a tough decision, and one I've had to deal with. As other posters have said, what does your gut tell you? As hard as it is to imagine, there are other guys out there who also could be the one. The fact that you guys have been doing long distance for 7 years without living together or taking it to the next level of commitment speaks not only to your dedication to your respective careers, but also to the very real possibility that he isn't the one. Just playing devil's advocate. You're not going to make any major changes to someone. If you love him and see a future with him and think he has a very real chance of being the person you want to spend the rest of your life with, then take that leap. But otherwise, don't give up on your dream program because you're scared of not finding someone. I met plenty of residents at programs where most people seemed attached who had come into residency single. Just a few thoughts. Definitely not easy though. Good luck!

 

[SRK Jerk]

I'll give a bit of a different view, though my situation is different because I'm married with a baby on the way. I was flat out told by my adviser (at a fairly top tier, not top 5 but top 10 school) that top programs within my specialty would be be possible for me (obviously not guaranteed, but chance to interview is at least decent); however, it did not make geographic sense with where I needed to be (especially now that my wife is expecting). While obviously where you do residency matters...what's stopping you from making the most of whatever residency you go to? If someone sees two CVs that are identical, one from a top-tier and one from a mid-tier, yeah, they'll take the mid-tier. So if you go to a mid-tier, you can overcome that handicap by working your ass off and making your CV excellent. It will be a handicap, but not one you can't overcome. This is just food for thought and obviously I gave up my chance at the top-tier because I am going to start a family, not because I might start one. However, just thought you might want a separate point of view as food for thought.

 

[blue2000]

I was in similar shoes 7 years ago; I had an ex-boyfriend that I was enmeshed with who was not the person for me in the long run but whom I dearly loved. He was matching on the East Coast, I had family on the West Coast.

I matched into general surgery at a big university on the West Coast where we worked long hours. I was single, as were several of my co-interns. It became clear to me that my ex, who is a wonderful person, was not the person for me. Once I finally came to that realization (and I'm maybe a little bit embarrassed to admit it took a cross-country move to make that clear) I really moved on with my life. Not to be cliche, but about six weeks after that epiphany, I met the man that I would marry.

Dating as a resident is not easy, but it's totally possible. In my general surgery residency, most people who come in single graduated married, sometimes with kids. If it's a priority to you, you'll make time for it. It won't always be easy but it's not impossible.

I'd be hesitant to tie your future to a person with whom you've already decided things aren't working. I'd also be hesitant to tie your future to someone who is geographically tied to an area that is not desirable for you to train in, especially because this person isn't willing to make major sacrifices for you, such as leaving a good job.

 

[wannabeOBGYN]

If you still aren't sure if he's the one after you dated him for 3 years and then had time apart to assess the situation/relationship from a distance, he's not the one. Move on and go to your #1. You'll meet someone when the timing is right.

 

[notdeadyet]

Any advice you get here is fundamentally worthless, since we don't know you or your boyfriend. But here are two things I can say with total confidence:

Residency is way more important than a doomed relationship.

Your partner for life is way more important than any particular residency program.

Unfortunately, no one on SDN can tell you if your ex is a doomed relationship or your partner for life. Figure out which one he is and you've got your answer.

 

[Arcan57]

Any advice you get here is fundamentally worthless, since we don't know you or your boyfriend. But here are two things I can say with total confidence:

Residency is way more important than a doomed relationship.

Your partner for life is way more important than any particular residency program.

Unfortunately, no one on SDN can tell you if your ex is a doomed relationship or your partner for life. Figure out which one he is and you've got your answer.

The above is completely true, but there is more pointing toward the doomed category than the PFL category. He clearly doesn't understand medicine as a career, in regards to the comments about you'll still be board-certified. Since it's been a long distance relationship, they'd never had to figure out how to run a household together especially given the demands that are coming in residency on her time. And the relationship failed for reasons that don't sound exclusive to the long distance thing.

My read is that that the OP is worried too much about "the one", and is considering doubling down on an already bad bet. I'm sure whatever residency program you go to will be in a place that has men, some of whom you'll be compatible with and one or more whom you could spend the rest of your life with. Letting your ex-boyfriend determine your rank list is going to seem even more stupid when you're in a place you don't want to be after you've broken up because it wasn't going to work in the first place.

 

[Brunette1981]

I would also say most of the arguments in the OP regarding going East Coast are about wanting to settle down IN GENERAL and wanting to be attached by a certain age also IN GENERAL.

Most of the comments in the OP about the particular relationship are about the things that didn't work.

You definitely shouldn't choose a residency based on wanting to be in a relationship. It is arguable but much more defensible to choose a residency based on a strong commitment to a particular person. Doesn't sound like that's the case here.

Disregarding the whole residency question, OP, do you really want to wake up next to this guy every day for the next forty years or don't you? If you don't, wouldn't marrying him just because you *might* otherwise wind up alone be an even bigger mistake than going to a lower ranked residency?

 

[natashana]

Oh my, I say this as only someone with a complete outsider view can say--move ON! 1. You may be compromising your future and happiness, and he won't do that for you. 2. You've already been with him forever, you should know if it will work out--obvi it won't. 3. If you were meant to be, it long-distance wouldn't make much of a difference. I will be hard to be single in residency--and hard to meet someone, but you may meet your future husband, and you'll never meet your future husband if you stay with him.

 

[Crystal8]

Thanks everyone for taking the time to share your thoughts and insight 🙂

 

[Valadi]

Disregarding the whole residency question, OP, do you really want to wake up next to this guy every day for the next forty years or don't you? If you don't, wouldn't marrying him just because you *might* otherwise wind up alone be an even bigger mistake than going to a lower ranked residency?

This.

 

[dragonfly99]

I think I agree w/Arcan.
I don't think one needs to sacrifice "everything" for a residency, and I have to warn you that it's easy to get sucked in to that. However, your situation isn't like someone who has a kid(s) or is married already and the spouse will have a hard time moving. I don't know many jobs that *cannot* be done somewhere else besides Manhattan. I guess there might be quite a few where he would earn less and/or have to reinvent himself in a new city if he does move.

I think the most important thing is the dating for 3 years, then breaking up. I think if you are 27 that is probably long enough for you to know if you should be with him forever, or at least have a super strong feeling. The problem with staying close friends with your ex is it really doesn't give you enough emotional distance to move on. Women do this too much...we're socialized to be "nice" and not hurt people's feelings. So maybe you are done with him but part of you doesn't want to admit it.

There seem to be some other red flags here also - you aren't together with him, and he thinks you might get back together, yet he's not crazy enough about you to just move to be with you, and you didn't want him back enough to do residency in NYC. But as someone else posted above, nobody can really answer this question for you except YOU. None of us know you or your ex. None of us know your specialty and/or how much of a real difference there is between these different residency programs you are about to rank.

As an aside, I'm surprised so many on here seemed to think that it will make a big career difference where you train...if it's "random community medicine program" versus Harvard internal med, then perhaps, but if it's General Northeastern State U versus UT Austin or U of Alabama-Birmingham, I doubt it. I've been at one of the "Top 5"/famous places and random state U. medicine program - there are some differences but not as much as you'd think - will probably only matter much for those going into academia.

 

[thesauce]

Any advice you get here is fundamentally worthless, since we don't know you or your boyfriend. But here are two things I can say with total confidence:

Residency is way more important than a doomed relationship.

Your partner for life is way more important than any particular residency program.

Unfortunately, no one on SDN can tell you if your ex is a doomed relationship or your partner for life. Figure out which one he is and you've got your answer.

Getting an outside perspective is often very important since the people involved in the relationship are often so tied up with the emotional aspects of the situation that they can't look at it rationally.

 

[Winged Scapula]

I I don't know many jobs that *cannot* be done somewhere else besides Manhattan. I guess there might be quite a few where he would earn less and/or have to reinvent himself in a new city if he does move.

There seem to be some other red flags here also - you aren't together with him, and he thinks you might get back together, yet he's not crazy enough about you to just move to be with you, and you didn't want him back enough to do residency in NYC.

I think this is key. DF is right - we don't know you or your Ex-BF. But most men on here will tell you that FOR THE RIGHT PARTNER, they will make sacrifices for the partner and the relationship. It doesn't see like your ex is willing to do that. I think you need to investigate why that is.

As an aside, I'm surprised so many on here seemed to think that it will make a big career difference where you train...if it's "random community medicine program" versus Harvard internal med, then perhaps, but if it's General Northeastern State U versus UT Austin or U of Alabama-Birmingham, I doubt it. I've been at one of the "Top 5"/famous places and random state U. medicine program - there are some differences but not as much as you'd think - will probably only matter much for those going into academia.

I generally agree with the above. In most cases it will not make a difference except if going into academic or working in certain circles. If the OP is planning on coming back to Manhattan she *might* have a competitive edge on future jobs if she trains there or a big name place, but once you get settled in, the name usually takes a back seat to your reputation for taking care of patients.

 

[Crystal8]

Thanks everyone for your continued advice. I truly do appreciate it. While I know that ultimately this a decision only I can make, all your comments are helping me so much. As thesauce said: my purpose for posting on this forum was because I wanted to glean an "outside perspective" for an unbiased, more objective perspective not biased by fear or personally knowing me or my ex. Also, many of you are at least either in or have completed residency training if not fellows and attendings, so I'm very grateful for a more mature insight to relationships and residencies than me or my friends can generate at this point in time.

That said, Dragonfly 99 made a good point. No one knows the specialty to which I'm applying "and/or how much of a real difference there is between these different residency programs you are about to rank." As I think this is a valid point, perhaps that piece of additional knowledge would help those giving advice...or maybe it won't, but the relevance of that piece of "missing" information has crossed my mind, so I've decided to give it:

I'm applying for psychiatry residencies with the intent of getting a Child-Adol fellowship. My top programs are Mayo in Rochester, Baylor, Rush, Georgetown and the other two I liked (that would be conducive to reconciliation with my ex by virtue of location) are UMDNJ RWJ in Piscataway/New Brunswick and Temple in Philadelphia. My thought process has been that in a specialty like psychiatry the training I'll receive varies greatly amongst programs. However, all the programs I'm deciding to rank, I've decided will give me *at least* good training, if not better, and the psychiatry attendings and residents who I met on these interviews are those which I would like to be when I'm finished with training. I don't know if this is necessarily the "right" way of approaching choosing a program, but I felt it's a reasonable factor to consider. Also, I've always thought I'd be happy as a community psychiatrist, and while this is true, I've lately been thinking about trying to achieve a more leadership role in the field. Whether that's via administration or research, I haven't yet decided, though I ultimately still aim to hit that work-life balance.

I would also like to say a quick addition: I am by no means saying that I think UMDNJ or Temple are lesser programs than my top programs (I am still ranking them, just don't know the rank order list), just that they seem to offer more of a solid, community program vs the others which seem to have more of an renowned background which may (or may not) help me in my future. Please correct me if I am wrong, this is just from my narrow, limited MS4 perspective, and also why I've decided to give this additional info about my situation.

Thanks for the continued responses, everyone.

 

[Dejavu]

I will be blunt as only a guy who has been happily married for 41 yrs can be.

Listen to your own post, move on from this guy, concentrate on your career right now, and believe me, your life partner will find you. I know.

 

[dragonfly99]

People were a lot more nice on this post than usual...
maybe nobody wants to be on Santa's list of bad boys and girls this year?
On second though I don't think you should take relationship advice from me...ask your friends who are actually married perhaps 🙂
. I finally figured out that I should get dating advice from my married friends and probably not from my single friends... LOL.
Happy holidays everyone.

 

[inc]

I think this is key. DF is right - we don't know you or your Ex-BF. But most men on here will tell you that FOR THE RIGHT PARTNER, they will make sacrifices for the partner and the relationship. It doesn't see like your ex is willing to do that. I think you need to investigate why that is.

This, times a billion.

 

[peppy]

You might want to get the input from the psych forum folks on those particular programs to help you decide. I'm a psych resident but I only applied ot a couple of the programs on your list. None of the programs you mentioned seem like bad programs, but I do think that it would be a shame to give up a chance to train at a place like Mayo where you will see things that you won't see anywhere else, if that's the place you liked best, only to be with a guy who is most likely not a good long-term prospect.

While overall fellowships in psych are not competitive, in the sense that you'll almost certainly be able to get a fellowship spot somewhere, going to the right program and/or knowing the right people absolutely can be a factor in whether you can get into your first choice program for fellowship.
Often, fellowships only interview a few people for their available spots, and from what I've seen so far it seems that it is pretty common that the fellowships prefer to stick with the known quantity of their home-grown residents rather than taking outsiders from other programs.

Even if you think you may end up deciding you just want to be a community private practice doctor, I think it makes sense to keep your options open by going to the best place you can if you actually did like the place and felt comfortable there (of course, it's arguably not a good idea to go to a place you think you'll hate just because of a prestigious rep).

 

[Crystal8]

Thanks for all the above comments, guys! And, yes, everyone actually has been really nice, patient and thoughtful in their responses to my original post, which I appreciate so incredibly much. Happy holidays 🙂

 

[gutonc]

Thanks for all the above comments, guys! And, yes, everyone actually has been really nice, patient and thoughtful in their responses to my original post, which I appreciate so incredibly much. Happy holidays 🙂

I will only add DTMFA (Google it) and call it a day.

 

[Sneezing]

Move on. Its over.