Residency and relationships

[cuparevage]

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Here is the situation:

-I have been with my gf for fours years now.
-My gf is a 4th year med school student. We agreed that she would apply only to residency program in the same state where we live to try to match where we are.
-Yesterday, she told me that she will have to apply for other programs that are 2.5 hours away from where we live and that she will commute daily. (5 hours driving + working hours).
-She suggested we move closer. however, where she wants to move will cut out only 1 hour.
-We are madly in love and dependent on each other.. She is a great person, and we really supported each other through our school, career, and life.

What should I do?

 

[fancymylotus]

Here is my situation painful situation:

-I have been with my gf for fours years now.
-I have a daughter from a former marriage. I have made it clear that I won't be able to relocate away from my daughter. I see her twice a week
-My gf is a 4th year med school student. We agreed that she would apply only to residency program in the same state where we live to try to match where we are.
-Yesterday, she told me that she will have to apply for other programs that are 2.5 hours away from where we live and that she will commute daily. (5 hours driving + working hours).
-She suggested we move closer. however, where she wants to move will cut out only 1 hour.
-We are madly in love and dependent on each other.. She is a great person, and we really supported each other through our school, career, and life.

What should I do?

Are you in school as well? If not, are you working a job that you can potentially find in another city? How old is your daughter? What's your custody arrangement? Could you potentially change it?How long is the residency your gf is applying for?

Need more logistical details before giving advice.

 

[Stagg737]

Despite the likelihood that this is a troll post, I'll bite.

Depending on what field she's trying to enter and where you live, she may have no choice but to apply to locations that are farther than ideal. Even doing that, there still may be no way of helping the fact that she may end up in a program somewhere far away or not matching at all. It might help if we knew what her desired specialty was or what general area of the country you're from (or at the very least if you're near a major metro area).

I also see a few red flags in general with your relationship and her career/attitude towards medicine. There's no problem with being 'madly in love', but I've found that being too dependent on another is typically a sign of an unhealthy relationship. There's nothing wrong with relying on others, especially an SO, to a certain extent, but medicine is an extremely demanding field. So if you're too dependent/attached right now, it's only going to get significantly harder once she starts residency.

The last thing I'll say with the given amount of info is that your gf sounds like she's either Wonder Woman or has no idea how in over her head she is getting herself. The fact that she's willing to commute 2.5 hours, or even 1.5 hours each way blows my mind. I know I would never do that and I don't think 99.99% of residents out there would be willing to commute nearly that distance. Plus, how is that going to work for her if she has to be on call? I hope for both of your sakes that she gets in somewhere nearby, so that this isn't an issue for you. If she ends up far away though something's going to have to give somewhere. It'll just be up to you two to figure out what that actually is.

 

[cuparevage]

I work for

Are you in school as well? If not, are you working a job that you can potentially find in another city? How old is your daughter? What's your custody arrangement? Could you potentially change it?How long is the residency your gf is applying for?

Need more logistical details before giving advice.

I'm done with school. I have a great job that I doubt I will get in another state. We also prefer not to move away from my daughter.

 

[cuparevage]

Despite the likelihood that this is a troll post, I'll bite.

Depending on what field she's trying to enter and where you live, she may have no choice but to apply to locations that are farther than ideal. Even doing that, there still may be no way of helping the fact that she may end up in a program somewhere far away or not matching at all. It might help if we knew what her desired specialty was or what general area of the country you're from (or at the very least if you're near a major metro area).

I also see a few red flags in general with your relationship and her career/attitude towards medicine. There's no problem with being 'madly in love', but I've found that being too dependent on another is typically a sign of an unhealthy relationship. There's nothing wrong with relying on others, especially an SO, to a certain extent, but medicine is an extremely demanding field. So if you're too dependent/attached right now, it's only going to get significantly harder once she starts residency.

The last thing I'll say with the given amount of info is that your gf sounds like she's either Wonder Woman or has no idea how in over her head she is getting herself. The fact that she's willing to commute 2.5 hours, or even 1.5 hours each way blows my mind. I know I would never do that and I don't think 99.99% of residents out there would be willing to commute nearly that distance. Plus, how is that going to work for her if she has to be on call? I hope for both of your sakes that she gets in somewhere nearby, so that this isn't an issue for you. If she ends up far away though something's going to have to give somewhere. It'll just be up to you two to figure out what that actually is.

She is a wonder woman. That's why she is kind enough to make such an unusual offer to keep her relationship. I've been on this forum for two hours, and i'm seeing the majority of people are just advicing others to drop their SO as if they are just another quarter in the pocket. Human-up people!

 

[fancymylotus]

She is a wonder woman. That's why she is kind enough to make such an unusual offer to keep her relationship. I've been on this forum for two hours, and i'm seeing the majority of people are just advicing others to drop their SO as if they are just another quarter in the pocket. Human-up people!

I've spent multiple years ~1000 miles away from my other half because of med school etc.

We only suggest dropping the SO when it's clear that he/she doesn't play the supportive/understanding role that he/she should for something like this.

You know, I'm going to start demanding that he calls me Wonder Woman.

 

[Danbo1957]

Lose the girl friend, keep the daughter. Be a man.

 

[22031 Alum]

She is a wonder woman. That's why she is kind enough to make such an unusual offer to keep her relationship. I've been on this forum for two hours, and i'm seeing the majority of people are just advicing others to drop their SO as if they are just another quarter in the pocket. Human-up people!

If you aren't in medicine, it can be hard to comprehend just how much it requires. Matching to a residency spot is NOT the same as applying for other jobs. Depending on the specialty and her stats, if your SO limits herself too much, she may end up without a spot at all. And that would make it a lot more difficult for her to end up in a residency later on, as your best shot at matching is the first time. You have to have an honest discussion about whether being close to your daughter is worth the possibility of your SO ending up with a very expensive degree with no prospects in her desired field. Only you two can decide that.

 

[Stagg737]

If you aren't in medicine, it can be hard to comprehend just how much it requires. Matching to a residency spot is NOT the same as applying for other jobs. Depending on the specialty and her stats, if your SO limits herself too much, she may end up without a spot at all. And that would make it a lot more difficult for her to end up in a residency later on, as your best shot at matching is the first time. You have to have an honest discussion about whether being close to your daughter is worth the possibility of your SO ending up with a very expensive degree with no prospects in her desired field. Only you two can decide that.

True, but it also depends on where they are. If they're in a major metro like New York or Chicago and she's not shooting for something too competitive, there could be dozens of programs within an hour or so. There's obviously a lot of factors that play in, like you said, they'll have to figure out what will work, if anything.


@cuparevage You're getting a lot of negative responses/dump her responses because people here have seen very stable relationships fall apart. Medicine is one of the few fields that demands you be married to the job (at least for a certain period of time) just to succeed and not even stand out. Relationships and everything else come second, so the fact that she is making those kinds of sacrifices is pretty outstanding from the norm. Can you make it work? Maybe, but you'll probably have to sacrifice quite a bit, and it might be more than it's worth, especially if that thing ends up being your relationship with your daughter. Like Alum said, at some point you're going to have to sit down with her and you'll both have to have a very serious talk about the whole situation and only you will be able to decide what's right for you. Good luck and I hope that it somehow does work out for you all.

 

[cuparevage]

True, but it also depends on where they are. If they're in a major metro like New York or Chicago and she's not shooting for something too competitive, there could be dozens of programs within an hour or so. There's obviously a lot of factors that play in, like you said, they'll have to figure out what will work, if anything.


@cuparevage You're getting a lot of negative responses/dump her responses because people here have seen very stable relationships fall apart. Medicine is one of the few fields that demands you be married to the job (at least for a certain period of time) just to succeed and not even stand out. Relationships and everything else come second, so the fact that she is making those kinds of sacrifices is pretty outstanding from the norm. Can you make it work? Maybe, but you'll probably have to sacrifice quite a bit, and it might be more than it's worth, especially if that thing ends up being your relationship with your daughter. Like Alum said, at some point you're going to have to sit down with her and you'll both have to have a very serious talk about the whole situation and only you will be able to decide what's right for you. Good luck and I hope that it somehow does work out for you all.

Thank you very much, Stagg737.

I understand where the negativity is coming from. However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside. She is not giving up on me. I'm not giving up on her. I'm here to get help that support that direction. I am here for the "know how" factor from people who have gone through similar scenarios and made it, or didn't. I know that there is no absolute majority.

We talked yesterday. We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Thanks in advance.

 

[gators21]

Thank you very much, Stagg737.

I understand where the negativity is coming from. However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside. She is not giving up on me. I'm not giving up on her. I'm here to get help that support that direction. I am here for the "know how" factor from people who have gone through similar scenarios and made it, or didn't. I know that there is no absolute majority.

We talked yesterday. We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Thanks in advance.

This post just shows how little you know about this process. I hope things work out for yall. 1.5-2.5 hr drives sound miserable after call.
Not only that what about journal clubs, skills labs, and other requirements. I hope you know this isn't a 40 hr a week job

 

[fancymylotus]

Thank you very much, Stagg737.

I understand where the negativity is coming from. However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside. She is not giving up on me. I'm not giving up on her. I'm here to get help that support that direction. I am here for the "know how" factor from people who have gone through similar scenarios and made it, or didn't. I know that there is no absolute majority.

We talked yesterday. We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Thanks in advance.

The match can be a crapshoot. She should apply everywhere in the area you mentioned not just the closer 11. Be prepared to have to move and/or see your daughter or your girlfriend (way) less.

 

[Stagg737]

Thank you very much, Stagg737.

I understand where the negativity is coming from. However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside. She is not giving up on me. I'm not giving up on her. I'm here to get help that support that direction. I am here for the "know how" factor from people who have gone through similar scenarios and made it, or didn't. I know that there is no absolute majority.

We talked yesterday. We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Thanks in advance.

I agree with a lot of what's been said in this thread. To be blunt, I don't see her succeeding or even surviving in residency if she has a 2 hour commute. She'll be spending 20 hours a week minimum just driving, that's a ton of down time to lose during residency. Personally, I would prefer to live within 15 minutes of my program and will not live more than 30 minutes away. I honestly don't know how someone would be able to live farther than that unless they're taking a train or have a pretty cush residency. This is coming from someone that already commutes pretty far for med school.

As for her chances in residency, you'd have to ask someone farther along than I am. Different fields want different things. In some fields, class rank counts for almost nothing and you just have to do well on boards and on audition rotations. In some fields, stats are all that matter and audition rotations are secondary. You'd have to say what field she is shooting for and what her CV looks like if you want people to let you know what her chances might be. Even then there are a lot of intangibles. Think of residency less like a job application and more like a hyper-competitive and very critical version of rushing for a frat or sorority. From what I understand though, there are very few fields where only applying to 11 programs is a good idea and unless she's shooting for one of those (ortho for example), she should be applying to more. l

Like I said though, most of that second paragraph is just what I've been told by residents and physicians, and others on here are far more knowledgable than I am.

 

[22031 Alum]

However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside.

Everybody always wants to believe that they will be the special ones to beat the odds. But it's called beating the odds for a reason. I am not saying you shouldn't be optimistic, but trying to help you understand the perspective of the people responding. We've seen plenty of people think they are going to be the exception, only to fall short at whatever it is- this goes for relationship stuff, "beasting" an exam after a history of poor performance, and so on.

We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Bolded is a big clue to everybody here that you don't understand the process well enough. We need to know what specialty she is applying in, her Step 1 and Step 2 scores, and clerkship (rotation) grades to begin to be able to quote you the chances. Applying to only 11 programs is dangerous even in less competitive fields, unless she is a superstar (and I mean objectively, not in your eyes). Again, you may be asking her to give herself a very real chance of not matching and ending up with no job and lots of debt.

 

[DokterMom]

I understand that you don't want to move away from your daughter, but do realize how much easier it will be for you, with a 'regular' job, to drive 2.5 hours twice a week compared to her with a 'job from hell' schedule to drive that far daily.

Of course, she'll apply to everywhere local. But where she ends up isn't completely up to her. She needs to cast a wider net and you need to take a deep breath and deal with the uncertainty. If there are other parts of the country with easy access (train, cheap flights) and jobs in your field, expand her residency search to those areas as well.

 

[ortnakas]

She'll be working 80 hours a week, plus driving 5 hours/day? That's 105 hours a week she wouldn't be home, pretending that this is only a 5 day a week job.There's 168 hours in a week, giving you only 63 hours you might be in the same place... assuming neither of you are working the night shift ever, and hopefully, the poor girl's going to be sleeping for a decent chunk of that.

I'm cool with love conquering all, but in this case, that might mean you are okay with moving, or you're both okay with a long-distance relationship for a while. Those sound like better options.

 

[tvelocity514]

Any chance of you getting a sabbatical/LOA from your job? If she's doing 80 hours a week, she will be unable to do a 2 hour commute. It just won't be possible for her to drive home safely.

I think you really need to take this into consideration. Your SO will be driving back and forth while she is VERY TIRED. There won't even be a future with her if she accidentally falls asleep at the wheel etc because you can't move to be closer to where she is doing residency. I understand you want to be with your daughter and have a decent job, but you have to pick between your SO's safety/well-being or your job and staying near your daughter. Just my two cents but you can always move back after she finishes residency. This isn't a permanent move. Also, you can express this to your current company in hopes they will take you back when you return. Good luck though- I know this is a tough choice to make.

 

[MiaMia14]

I started residency 2 months ago. I moved about a half hour away from the hospital due to it being halfway between where my SO will work and where I am working. I have already found myself with negative thoughts towards the deal..."I know we compromised, but he works normal hours and after I work 16 hours the last thing I want to do is spend an extra half hour in the car". Not to mention it's not like I can just leave a half hour before I have to be there...I have to account for any traffic (luckily at 4 in the morning the traffic is light haha but during night float when I had to be there at 5:30pm it was not fun), parking, getting into the hospital, and changing (most places won't let you wear scrubs into the hospital you have to change into theirs when you get there). So I have to leave at a minimum 45 min before I have to be there to be on time. Honestly, it would be impossible to drive 2.5 hours everyday. I've almost fallen asleep driving home and I'm only driving a half hour. During my time not at the hospital I find it hard to want to do anything at all besides sleep....working 80 hours is very tiring. I still only get about 7 hours of sleep a night. If I had to drive 5 hours I would only be sleeping about 4-5 hours a night if she did absolutely nothing but go immediately to sleep when she got home. it would be impossible. She would have to leave the house at 3am to get to work by 5:30 after getting home around 9:30 (if she got off around 6:30-7.) if she did end up matching at this place, it seems much more feasible for you to make the drive twice a week to see your daughter rather than her making it 6 days a week on top of working 80 hours.

Unfortunately to survive in medicine a lot of sacrifices have to be made, especially on the SO's end and ESPECIALLY if said significant other isn't in medicine. I told my boyfriend that I would try and match somewhere where he would either be able to keep his job that he loves, or at least be able to transfer to a different district office within the same company. That gave me a pretty good list of places to look at...however I ended up applying to 75 programs and only a handful of them would have worked out for him and I had to make him aware that there was a very real possibility that despite me trying to do this for him, it wouldn't work out. (For those of you like wtf why SO many programs, I was a DO student applying acgme without USMLE). I only received 8 interviews out of all those programs. It will depend on her competitiveness in her specialty how many programs it will be safe for her to apply to/rank. It ended up kindve working out...he didn't get to stay with his current job...and he is moving hundreds of miles (Texas to NJ) away from his entire family...but he at least is staying with the same company and doesn't have to find another job...I have told him at this point in my career I HAVE to be selfish otherwise I may be $300,000 in debt and not be able to pay it back, and I will have invested almost 10 years of my life into a goal I would never be able to achieve. If you don't go to residency, you don't work as a doctor. My boyfriend has been VERY supportive of me, and he understands that it was necessary for him to make sacrifices and I am very aware of it as well. Good relationships often fall apart due to these issues and you have to be able to compromise and to work with your SO openly and honestly if it is going to work. We had endless conversations about my rank list, locations, job prospects etc. this isn't something you can just go into willy nilly and hope for the best. Good luck to both of you.

 

[235009]

What field is she applying for? If it's not something competitive (psychiatry, internal medicine, pediatrics, anesthesiology, family medicine, and a few others) she'll likely be fine and will match somewhere in the DC Metro area and you can ignore all the ridiculous advice everyone jumped to without the most important piece of information.

 

[22031 Alum]

What field is she applying for? If it's not something competitive (psychiatry, internal medicine, pediatrics, anesthesiology, family medicine, and a few others) she'll likely be fine and will match somewhere in the DC Metro area and you can ignore all the ridiculous advice everyone jumped to without the most important piece of information.

I asked about it... we really don't have enough info to help OP but I was tying to get him to understand that it's about much more than "scoring 80s and 90s."

 

[235009]

I asked about it... we really don't have enough info to help OP but I was tying to get him to understand that it's about much more than "scoring 80s and 90s."

Yea i saw. And without that crucial piece of information people felt a little too comfortable doling out the gloom.

 

[sloop]

What field is she applying for? If it's not something competitive (psychiatry, internal medicine, pediatrics, anesthesiology, family medicine, and a few others) she'll likely be fine and will match somewhere in the DC Metro area and you can ignore all the ridiculous advice everyone jumped to without the most important piece of information.

He said "pediatric EM" when I was talking to him in the other thread. He didn't seem to understand that this is a fellowship and not a residency. I was unable to elicit whether she is planning on doing this route via EM or pediatrics.

http://forums.studentdoctor.net/thr...hip-with-your-significant-other.172712/page-2

 

[Mad Jack]

Thank you very much, Stagg737.

I understand where the negativity is coming from. However, if there is a place for a challenge and people that at already emotionally attached are willing to take it and fully support each other, statistics can be set aside. She is not giving up on me. I'm not giving up on her. I'm here to get help that support that direction. I am here for the "know how" factor from people who have gone through similar scenarios and made it, or didn't. I know that there is no absolute majority.

We talked yesterday. We are in Northern VA/DC and she is applying for all programs in a close proximity from us in the following order VA/DC, UMD, Delaware and Philadelphia. She has excellent grades. Always 80s and 90s. Yesterday, she said that she will apply for the closer 11. I don't want to be unfair to her or to myself. What are the chances?

Thanks in advance.

If she matches 2.5 hours out, this isn'd about a challenge or support. It's about the physical capabilities of the human body. There is no chance you could make internship work with a 5 hour daily two-way commute. Many shifts are 16 hours, running back-to-back-to-back. That would put her to a maximum of 3 hours of sleep a night, if she fell asleep right away, an amount she'd be running on for days on end. After that, shifts can stretch for 24 and even up to 30 hours, depending on the service she's rotating to. Most weeks, she'll be working 6 days, which would be 30 hours of commuting on top of her 80 hour work weeks, which is enough time in a car and sleep deprivation to drive pretty much anybody insane, not to mention put them at serious risk for a MVA on their way home. Just hope she matches close by and things will be fine, because that long of a commute is essentially impossible with the way shifts are structured and the physical limits imposed by sleep deprivation.

 

[cuparevage]

I would largely agree with you, with the exception of one thing...

A 2.5 hour each way commute is not sustainable. Period. Regardless of field. It also is, for a great many fields, simply unrealistic. You can't be on call, backup call, jeopardy, anything, and be 2.5 hours away from the hospital.

Thank for your input everyone. All opinions make sense.

Here is the info:
Step 1 score is 233
Step 2 is expected to be 250 based on the practice tests.
Clinical grades from this years, are 3 honors 3 high pass.
She wants to apply for Pediatrics and emergency medicine in the 11 closest programs to DC. She later wants to apply for Pediatric Emergency fellowship.

I agree with everyone that's it's impossible to drive 2.5 1 way everyday. It's crazy. I'm now asking, while I know there is no certainty, whether the given facts warrants a good shot at getting at one of those closer 11 programs to DC/Nova where we live.

In other wants does that put us closer to the comment came from "MeatTornado"?

Thank you, all

 

[235009]

He said "pediatric EM" when I was talking to him in the other thread. He didn't seem to understand that this is a fellowship and not a residency. I was unable to elicit whether she is planning on doing this route via EM or pediatrics.

http://forums.studentdoctor.net/thr...hip-with-your-significant-other.172712/page-2

So essentially low (peds) or moderate (EM) competitiveness. Not as grim as people are making it seem if she's willing to go to any program as long as it's close by and makes it clear to the programs that this is extremely important to her.

EDIT: wrote that before seeing OP's reply… she'll likely find a peds match somewhere.

 

[cuparevage]

So essentially low (peds) or moderate (EM) competitiveness. Not as grim as people are making it seem if she's willing to go to any program as long as it's close by and makes it clear to the programs that this is extremely important to her.

EDIT: wrote that before seeing OP's reply… she'll likely find a peds match somewhere.

Do you know how competitive DC area with these scores those specialties?

 

[235009]

Do you know how competitive DC area with these scores those specialties?

Not specifically but pediatrics is a buyer's market in general

 

[Psai]

I get pissed when my drive from the hospital takes 10 minutes

Almost fell asleep at the wheel with a 5 min drive. Can't believe this dude thinks that a 2.5 hour commute is reasonable especially for a doc

 

[DrBodacious]

To OP. I did 2 yrs long distance my first years of residency. We were engaged for 1yr, then married the 2nd. We had a direct flight, that took about 4 hrs door to door to see each other. So we would see each other one, maybe two weekends a month. Frankly, that wasn't much less than I had time to spend with her, anyway. As a resident, especially early on, I was reading /studying a lot.

So if you're 2.5hrs away, I wouldn't plan on either one of you daily commuting. You shouldn't agree to that being the plan, or expect her to do that. It's not possible during residency. Just plan on seeing her on some weekends. You can go there, she can come to you. 2.5 hrs isn't bad for that.

If she's not "the one" this isn't worth either of your time. If she is, I'd propose, that'll step up the commitment level.

 

[Instatewaiter]

Thank for your input everyone. All opinions make sense.

Here is the info:
Step 1 score is 233
Step 2 is expected to be 250 based on the practice tests.
Clinical grades from this years, are 3 honors 3 high pass.
She wants to apply for Pediatrics and emergency medicine in the 11 closest programs to DC. She later wants to apply for Pediatric Emergency fellowship.

I agree with everyone that's it's impossible to drive 2.5 1 way everyday. It's crazy. I'm now asking, while I know there is no certainty, whether the given facts warrants a good shot at getting at one of those closer 11 programs to DC/Nova where we live.

In other wants does that put us closer to the comment came from "MeatTornado"?

Thank you, all

233 is just above average (man 230, std of 20 in 2014) which is not great but still fine. Her grades seem reasonable. If she is applying to peds, she should be able to match at one of the programs in the DC/Nova/baltimore area.

 

[Instatewaiter]

But let me just say that if she doesn't apply broad enough and doesnt match, you will have completely ruined her future.

 

[futuremdforme]

But let me just say that if she doesn't apply broad enough and doesnt match, you will have completely ruined her future.

Yeah... if I were her, I wouldn't take the relationship into consideration when applying without an engagement and a plan for a wedding...

 

[ortnakas]

I would largely agree with you, with the exception of one thing...

A 2.5 hour each way commute is not sustainable. Period. Regardless of field. It also is, for a great many fields, simply unrealistic. You can't be on call, backup call, jeopardy, anything, and be 2.5 hours away from the hospital.

Agreed. OP wasn't asking about her chances of matching in the metro area (which might be really good, and would solve everything) but about the feasibility of living 2.5 hours away (which just won't work).