Surviving as a Medical School Spouse

The summer before my husband began Medical School, I was given some second-hand advice from someone who had recently been to a med school orientation.  This was the advice: You, wife, are no longer a priority.  You need to let him study, go to class, go to labs, be consumed by this.  It chews men up and spits them out.  He won’t have time for you.

Harsh.

But honestly, it was what I needed to hear to help me orient to the reality of Medical School.  That is the worst case scenario.  You build up from it, but you keep it as the base level of survival.  Medical School, Dental School, Law School–these are intensely competitive places.  Not only will your spouse have to ingest a ton of new material everyday, much of it on his or her own out of the textbook, but they will have to do it better and faster than the other highly-qualified people sitting in the auditorium.  Even if that isn’t strictly true, that is how they will feel.  The constant pressure of feeling like they are never measuring up, or keeping up, is exhausting.

So that’s where they’re at.

Your Role

My advice to you, spouse, is to not create a similar situation for yourself.  If you work, find a job that isn’t going to make you continually stressed out and frustrated.  If you stay home with kids, don’t hyper-schedule play dates and park days and music lessons until you have no time left to take care of the house and meals and laundry.  Your job, at least for these few years, is to make “a soft place to land” for your spouse.  Make your home comfortable and inviting.  Have food on hand, and clean clothes in the right places.  This is your spouse’s safe place, away from the stress and insecurity of school.  You are the partner in this.  You do the home stuff so they can do the school stuff.  And you will all benefit from a life built together.

If the idea of being the main homemaker disturbs you, I have two suggestions: 1) Have a frank and open discussion with your spouse about how this set up is temporary, and explain that being in charge of the home (and kids, and finances and yard work…)  is your personal sacrifice for the time of his schooling and training, and his commitment to studying and getting a good job is his sacrifice. But when he is a practicing physician, there will be a bit of reshuffling of household duties.

2) Think seriously about the importance of housework. Recently Melinda Gates made a public statement about the unfairness that the drudgery of unpaid housework falls primarily to women. I immediately thought, “well don’t say it like that!” The truth is, nothing else contributes to quality of life like a clean, happy, organized space with good real food to eat. You don’t have pull in six figures to accomplish the happiness that comes from a well-ordered life. There is a science and an art associated with housekeeping; it’s a skill to master and pass along to the next generation. It may not always be interesting, but the effects of it are satisfying. It is just as important as the wage-earning jobs that bring the money home. Housekeeping turns the money into a life.

Clean happy spaces

Attitude Is Everything

But back to the marriage: The truth is, there will be many, many, many nights when they are not good company.  They have to study.  They have lectures.  They have discussion groups.  They are tired.  But isn’t that great?  You can do what ever you want!  Get deep into a hobby like photography, blogging, aerial silks, whatever.  I started sewing a lot when my husband was in school, and I loved those nights when he was engrossed in his books and I turned on the podcasts and sewed away.

The key to this is mindset.  Don’t fall into the trap of resentment and bitterness.  Be independent and do what you want to do.  Part of the secret to this is not to plan around your spouse. If you are going to the beach or taking the kids on an excursion, plan things you can handle solo. And if he ends up being able to join you, it’s just a bonus.  The worst resentment I’ve seen and experienced was when the spouse was unable to get away for a trip or evening and the whole family had to stay home because of it. Just don’t plan on him, and go regardless. For sure you have hobbies and passions that pre-date your marriage.  “Hanging out with my husband” isn’t the only thing that brings joy.  So fill your evenings with things you enjoy doing (and look forward to), and when you do get an evening together, just savor it, instead of complaining that you don’t have enough time together.

Your spouse will always be your best friend, but make sure to collect a group of trusted girl friends for the day-to-day socializing that most of us need.  Joke with them, go to lunch, go window shopping (more on finances in a minute), fill up on social interactions during the day so that you don’t rely completely on your spouse to fill that need.  Sometimes they just can’t, and if you are fine anyway because you’ve had a good day with good company, you won’t resent them.  Just be mindful of the line between supplementing your social needs and replacing your spouse.  Make time to catch up with him or her each evening, even if it’s just right before you fall asleep, or on the phone if they are staying late.  Keep them as your #1, and be loyal to them.  Marriages start to come apart when spouses start complaining about each other to other people.

There will definitely be times of friction and discouragement.  I don’t want to give the impression that you need to be a martyr for your marriage; be open in your communication about your needs and expectations.  Try to talk about it calmly, and if possible, don’t do it when your blood is boiling.  I’ve found that if I email or text my spouse and say “I want to talk with you about something serious tonight, so lets find some time to talk after the kids go to bed” or something like that, he is mentally ready for the discussion and it doesn’t catch him off-guard and put him on the defensive.  These are adult conversations.  The ones where you are both exhausted and bothered are more like toddler conversations.  And you can’t un-hear the things you say to each other in those moments, so try not to say things that you don’t want him/her to remember.

Finances

Finances are tricky during professional school.  If you aren’t independently wealthy, chances are, you will take out loans. You get large chunks of loans every semester, or every year.  My advice on this is to have a “Super Savings Account” to put the big chunk in, and then make a budget for how to spend the chunk over the next 6 months (or until the next loan portion comes in) and only transfer in your monthly allotment to your checking account.  When you run out of money in the monthly account, don’t spend any more.  Most married students can also apply for Food Stamps and Medicaid.  It can be a huge hassle, but these programs can help ease the financial strain.  It depends on so many variables, but it may be worth looking in to.

The needlessly complicated, redundant, bureaucratic business of funding med school

Also, factor the cost of schooling into your decision on which school to attend. If you have choices, choose a program that isn’t going to cost 40K per year, because then you have to take out 90K to live on each year (if you are planning to stay home and take care of kids). I would advise, from a purely practical point of view, to go to school at a state school, and then go to a prestigious residency when they are paying you.  A prestigious medical school often self-selects for intensely competitive, highly qualified candidates. Which just frankly sounds horrible. Read Malcolm Gladwell’s David and Goliath for more on that.  Keep in mind that attending Harvard as a med student doesn’t necessarily mean you will be working one-on-one with the well-known doctors; but doing residency there means you will be trained by them in your actual field of practice.

Living on loans is stressful. Whatever you spend will be repaid, with interest. So if you are considering buying a new double stroller for $300, consider that by the time you pay that money back, the loan money used for the stroller may end up being $500. In almost every big purchase, it is wise to check out used and refurbished options. Bookmark Craigslist on your computer.  And yet, these years before children start coming are pretty awesome in your mobility and freedom, so if you get a chance to fly home for a wedding or an awesome vacation that won’t be possible in a few years with little kids, it probably is worth the doubling effect of the money. Weigh it all, and be mindful with your money.

But don’t get consumed by it.  My husband worked for a family practice group during undergrad, and the wife of one of the doctors gave me advice about money on the other side of the spectrum, she said she would agonize over the debt and be so worried about how to pay it off.  When they went out to McDonalds for dinner, they would split an ice cream cone because she didn’t want to add any more to their mountain of loans.  Then she said “That was a big mistake.  The loans get paid off.”  Don’t spend too much time worrying about it.

By the time you come out of school and residency and start practicing, you can start paying off the loans each month. And there are multiple avenues for getting loan repayment assistance.  So don’t be extravagant, but buy your own ice cream cones.  Your debt won’t follow you forever.  I would advise though, to not get into commercial loans, like loans from a bank.  Stick with student loans, they are more flexible with payback times and do income based-repayment for when you are just getting started.  It takes forethought and a tight budget, but if our family of 5 could live on student loans for 4 years, I think most people can.

All The Things

So remember: You are a soft place to land for your stressed and tired spouse.  Try not to match his level of exhaustion with your own.  You need to build a social network to help you feel fulfilled without having to rely solely on your spouse.  Find hobbies or interests that you look forward to, especially on those nights when they are busy.  Be open and communicate with your spouse in an adult way.  Be careful with money, but no need to be miserly.  Buy your own ice cream cone.

And above all, enjoy medical school!  I have such fond memories of the friends we made there and the way our marriage grew and transformed into a truly inter-dependent relationship.  So many of our friends had the same experience.  You can go through this stressful situation and be torn apart, or go through and be glued together.  Now that we are deep in residency, I look back and think, “What was so hard about med school?”

 

Med School Outing

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5 responses to “Surviving as a Medical School Spouse

  1. Thank you again for a timely post. These lessons can apply any time a spouse is going through difficult things.

  2. Great advice, except those of us holding down a job while husband is in medical school don’t have time for hobbies, nor is the house very clean or organized. I’m only surfing because I’m nursing the baby. Her nursing sessions are seriously my only downtime, it sucks!

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