I realize that for OP this has been resolved, but I wanted to point out things that I feel weren't emphasized or brought up.
I don't mean to be entitled. I fully realize how maddening in this must sound to those who didn't match, and I apologize for that. Even though I thought I'd fully assessed my feelings and hashed it out with my family, I had a very poor understanding of where I actually stood on the matter. When I interviewed at the program I matched at, I thought it was great and would have ranked it over the local programs if it hadn't been for my family. One of my mentors strongly suggested that I rank it in my top 3 because he felt it was so solid in my field. Given these things, it's very possible that I would regret backing out eventually. So maybe I am being childish.
I unfortunately I didn't truly realize how unwilling I was to relocate until it was staring me in the face.
It honestly sounds like you matched at a great program, and in the long-run it may be for the best. Don't forget also that a lot can change in 1 yr. You can easily go yourself, and be long-distance for a year and see if the program/location really is right for you and your family .
You've worked this out, but others may actually benefit from spending a few months in the area, or even doing more research in seeing how that area can actually accommodate your needs and the needs of your wife. Maybe even a transition in terms of her clientele would be best, so she could join you later in the process. Anyways its not really relevant now.
Medicine is definitely not lollipops and sunshine. You go into med school and work and work and tell your family "one more year" or "one more step exam" etc etc. Even if you would have gotten your #1 spot you likely would be happy for probably 3 months tops. I think you get built up through the application process and then med school and everyone is so proud and then you get to residency and realize; well you just see everything for what it really is. I have never met a resident in ANY specialty that is just bursting with enthusiasm about their career choice. This business if filled to the brim with redundancies, paperwork and politics; and then there are the patients.
Point being, just start your residency. The world will continue to spin regardless of how you or your family feels so you might as well just suck it up complete the residency. Your kids probably already don't see you enough anyway from medical school so they probably won't notice if your gone. The rest of your life you will be absent from important events because of your job but this is what you signed up for; why is this such a surprise?
You do not meet
many residents bursting with enthusiasm about their career choices, but honestly, I've met plenty of physicians (a few years out to a decade out) that love what they do everyday. Talking to a family member that finished residency last year, working is actually immensely better than being in training. Much more responsibility and much more pressure, but also much more independence, and generally a better life. I guess the compensation helps too. Don't get too down on medicine just yet. From what I've heard, residency is pretty much a black-hole, from which all happiness in life cannot escape, but fortunately its duration is finite.
This.
I got 'geographically shafted' before I started IM residency, and let me tell ya...it has sucked hard:
-The sense of loneliness and isolation from family has really done a number on my overall mood and mental state for the last 3 years. I've powered through it and kept my chin up, but I definitely think I met DSM-5 criteria for depression for most of residency, and this has probably gone a long way towards the jaded/burned out/blah feeling i have towards medicine in general at this point. Having my wife/kids nearby would've made it a lot more tolerable.
- The separation has severely strained my marriage. We were frequently close to divorce during residency, and it may yet still happen.
- We waste absurd amounts of money paying on rent in one city/mortgage in another plus two sets of utilities etc...our finances are definitely stressed.
- Driving back and forth from two cities was a huge waste of time/money/wear and tear on my car etc. My car has 213k on it at this point. All this time spent driving etc ate into my reading time and prevented me from getting into a true 'rhythm' for much of residency.
In short...yes you can 'power through' and yes you can do it and yes you probably just need to bite the bullet and do it if you still want to be a doctor, but that doesn't change the fact that it sucks. Don't listen to the people who say it's all gravy and no biggie etc...3 years (or however long your residency is) can seem like a really long time when you're trapped in a situation like I have been.
Fortunately, I got good training at a good IM program, did very well as a resident, and matched fellowship at an outstanding program (name brand, you'd all know it) in the city where my wife/kids have been living. My kids, however, barely know who I am (one was born during residency, and there is good reason to believe the kid isn't even mine - but I digress) and the wife is on the verge of hiring a divorce lawyer. Cleaning up the damage done during residency will probably be much harder than landing that 'prestigious' fellowship spot.
Overall this sucks. It certainly would have been possible for you to sacrifice aspects of your career to move back home, but I suspect that there were problems early on and honestly throwing away your sacrifice and your career goals may have may have not had a significant impact on the outcome of your marriage. I wish you luck, and I hope whatever is best works out.
So, to those who have ragged on me for all of my "mistakes" and "not discussing things," let me shed some light on the situation.
My wife had a fit at the prospect of moving initially. I explained that, although I would prioritize all local programs, including those which were poor quality and those that would make my commute hellatious, next would have to come a stack of programs that would require a move. The alternative was to risk not matching, thus relinquishing even more control over our location. My wife would intermittently discuss things like a rational adult, while other times refusing to. I was able to eke out a few places she flat out refused to live under any circumstances, plus a few places she intermittently agreed to tolerate… this was the best I could do, and this is how I formed my rank list. I honestly didn't think it would come to that anyway, because so many programs at the top of my list were so noncompetitive. Luckily (????) I landed at a place that she, at one point, agreed to tolerate. It's also a much more solid program than many at the top of my list.
The very difficult thing here is that she will not be forced to discuss things. I would say that I'm the "easygoing one," and have willingly made many, many compromises with jobs/med school throughout the years because I understand this. The unfortunate part about this whole process is that you can be as easygoing as you please, and sometimes you get dealt a hand that takes all choice away from you.
If I decide to go and she won't, it may well be the end of our marriage. If she's that inconsiderate of my want/need to follow this through in order to basically be set for life, then I think it would be best if we went our separate ways. Again, the concern is the kids.
Your wife needs time. Client base can be established anywhere, but it will be hard, and the idea of throwing away the work she has put in for years, is not easy to swallow. She deserves your patience and understanding no matter how unreasonable she's being. This goes for everyone. Your SO goes through med school and residency with you, and they put a lot into it that you don't see. They share your stress, and unfortunately, rarely are able to recognize the joy you feel working towards what you want. They deserve patience, and it might be frustrating, but you just have to ease them into things. Communication is key, so keep them in the loop, and always take the effects of your decisions on them into account. Put yourself in their shoes, and recognize its tough to drop everything and follow you when they need to.
Thanks to all, as gaining different objective perspectives has been really helpful as I try to wade through all of this. I'll try to address several points that previous posters have brought up:
1)It's funny that someone brought up having my wife tell me what her ideal plan would be. I actually did just that last night. Her answer: I don't want to move, I don't think I even want you to just quit, I just want things to stay exactly the way they are. My pointing out that this is no longer possible fell on deaf ears.
2)Sadly, she has refused counseling, although I admit that I hadn't considered the possibility of going to counseling alone.
3) I can see how someone might look at my initial desire to quit and say "marriage >>>>helping people." Actually, the further this goes, the more I remember that the reason I went into medicine in the first place is to help people, and the more I'm reminded of that, the stronger my resolve to push on. There is a particular population under duress that I wish to gear my medical career toward helping, which is a cause I have always been passionate about. As you can imagine, attempts to explain this to my wife were received as "getting on my high horse" and "thinking my career is so much more important than hers."
4) I tried to revisit the idea that at one point, my wife had kind of, sort of approved this place… at least to the greatest degree I could get her to approve any place that wasn't here. (Note that she has NEVER been there- with kids, it's hard to do couples interview travel.) She simply said that she didn't know how she'd feel about moving until she was staring it in the face.
She also said that, while she loves me, she has derived an enormous amount of satisfaction from her own career, especially since I have obviously often had to study, be on call, etc. during med school. She perceives that during residency, I'd be even more tied up and she'd have lost the satisfaction she gets from her career that has made this livable. She also feels that me expecting her to leave our current situation would be the equivalent of her telling me I needed to choose between her and medicine, which she isn't actually trying to do. My take on that: I did not ASK for this either- in fact, I did everything possible to avoid it. When choosing med schools, I happily passed up a much more prestigious (and cheaper!) school in a distant city for the sake of our family. I don't mean to use this as collateral, because it didn't feel like a sacrifice given that it was best for my family, and I'd happily make the same decision again in a heartbeat.
It is true that my response to conflict has usually been just to give in because it's "easier for everyone." If you can stay COMPLETELY consistent with that strategy, it works great, until life deals you a hand you can't reasonably change. It also covers up the fact that you don't have adequate conflict resolution skills in the relationship, and that you haven't primed your SO to respect you as an equal.
Your wife is way more understanding than I initially thought, and honestly she seems to be reacting to this in the same way most people would
initially. You need to work harder at making life there seem better (I get that she already agreed, but I would still focus on this). You also need to thank her for going through all of this with you. You need to really emphasize that you recognize how hard it is to just drop what she's worked towards, and that you will work hard to make the transition as easy as it could possibly be. Communication is key. You may feel that these are obvious, but you still need to verbalize it. Recognize that you both have aspirations and perspectives and sometimes it takes time to communicate those things in an effective way.
On the flip side, maybe it's better something like this happened sooner rather than later. The two of you clearly have conflict resolution and communication deficiencies that would one day, if not now, cause major problems in your marriage. I've never been married and am not even currently in a relationship so i may be a little too far removed from a situation like this but I have always had and will continue to have this opinion about pursuing a career in medicine: It's better to be single or dating a fellow med student/resident going through all of this. I couldn't fathom having kids and trying to do med school and residency. I can barely get 4-5hrs of sleep some months, how the hell do you keep a family going doing that? Although I supposed with a supportive SO not in such a time consuming/demanding occupation that it would be easier, but it's a lot of pressure on them. Not to mention having to potentially sacrifice better programs/training due to family and location restraints AFTER you worked so hard in med school. HO w frustrating would it be to know you weren't pursuing your full potential? Yes there are people/couples/families who have made it work and that's wonderful and ideal but the reality is that there are families/couples/people for which it has torn apart.
This is definitely a thread that needs to be stickied. Future applicants need to realize what they're getting themselves in to. There is so much more involved in this decision than "I wan to be a doctor to help people".
I would argue that for families/couples/people for which medical school and residency has torn them apart, those people's relationships would likely have collapsed under the struggles of life. And perhaps its best for it to happen when they're both still young. Is medical school/residency a painful and traumatic experiences, absolutely. But there are a ton of painful and traumatic experiences to be had throughout life, and being able to handle them and rely on each other while experiencing them is pretty much a demonstration of the strength of the relationship. Obviously we don't know, and can never know, but the fact that some couples stay together through the worst of life and others collapse through it kind of exemplifies that. The loss of a child or even a sudden shift in financial stability for example is an experience that strengthens many couples, and tears many others apart.
I agree, that many don't know what they're getting into, and many don't realize how much medical school and residency may change them and their relationship, but I don't think we can blame medicine for a failed relationship any more than we can blame losing a job.
