10 Things Nobody Tells
You Before Medical
Residency10 Things Nobody
Tells You Before
Medical Residency

Before Hannah started residency, I thought I had a pretty good idea of what we were getting into.

We knew the hours would be long. We knew she'd work nights, weekends, and holidays. We knew there would be 24-hour calls and stretches where we'd barely see each other.

None of that was particularly surprising.

What I didn't understand was how far residency would reach beyond the hospital.

A 24-hour call doesn't end when the shift ends. A post-call day isn't really a day off. Being physically home doesn't necessarily mean someone has anything left to give.

And when you're trying to build careers, have babies, maintain a marriage, make friends, manage a home, and create some version of a normal life around that schedule, you learn pretty quickly that residency isn't something one person does.

We learned some of these lessons well. Others we learned by getting them completely wrong.

These are the 10 things I wish someone had told us before we started.

You Might Not Recognize Your Spouse for a While

I don't mean that as dramatically as it sounds.

Hannah didn't suddenly become a different person when residency started.

But there were definitely days when a different version of her walked through the door.

She had spent 12, 16, sometimes 24 hours making decisions, talking to patients, responding to pages, operating, documenting, and trying not to screw anything up.

Then she'd come home.

And sometimes there wasn't much left.

Less patience. Less conversation. Less interest in making another decision about dinner, weekend plans, or something happening around the house.

Early on, it's easy for the person at home to take that personally.

Why don't you want to talk?

Why are you irritated?

Why do I feel like I'm getting whatever is left over?

Sometimes there actually is something that needs to be addressed in your marriage.

But most of the time, you're watching someone who has spent everything they had that day.

Learning the difference matters.

It also doesn't mean the spouse at home should simply accept being ignored for four years. Residency can explain behavior without excusing everything.

We had to learn when Hannah needed space, when I needed more from her, and when both of us were just tired and probably shouldn't turn a bad Tuesday into a referendum on our marriage.

The 80-Hour Workweek Isn't Really an 80-Hour Impact on Your Family

People talk about residency hours as though the impact stops when the resident clocks out.

It doesn't.

There is the commute.

There is charting.

There is studying.

There are boards.

There is sleeping before a night shift and recovering after one.

There is the post-call afternoon when your spouse is technically home, but has been awake for more than 24 hours and needs to sleep.

There is the entire weekend that gets shaped around a Sunday call.

There are plans you don't make because you don't know whether they'll actually get out on time.

Medicine doesn't have to possess every hour of the week to influence nearly every hour of the week.

I don't think I understood that before residency.

I understood that Hannah would be gone a lot.

I didn't understand how much of our life would be built around when she was gone, when she needed to leave, when she needed to sleep, and when she might actually have enough energy to be present.

That's a very different thing.

Stop Expecting Your Marriage to Be 50/50

I used to think a healthy marriage meant both people carrying roughly the same weight.

Residency pretty quickly killed that idea.

There were stretches when Hannah's schedule meant I carried significantly more at home.

There were also times when my work responsibilities were heavy and she found ways to cover for me.

And plenty of times, neither of us could cover it.

That's why we had a full-time nanny.

She filled gaps that two working parents, one of whom had almost no control over her schedule, simply couldn't fill themselves.

There were weeks where the split might have been 70/30. Other weeks it went the other direction. Sometimes the honest answer was that Hannah and I together couldn't give 100 percent and somebody else had to help.

I think we would have made ourselves miserable trying to keep everything equal.

That distinction helped us a lot.

Post-Call Isn't a Day Off

This one sounds obvious until you live it.

Imagine you've handled the house, work, dinner, bedtime, and everything else while your spouse has been at the hospital all night.

By the next morning, you're ready for some help.

Then your spouse comes home.

And they're wrecked.

They don't need a list. They need a bed.

Now you have two people who both feel like they deserve relief at exactly the same time.

That can create resentment very quickly.

The resident thinks, I've been awake all night taking care of patients.

The spouse thinks, And I've been doing everything here by myself.

Both can be right.

That's one of the things residency taught me about marriage. Sometimes there isn't a bad guy. There are just two exhausted people with legitimate needs that cannot both be met at the same time.

We got better at recognizing those moments for what they were.

Not every frustration needed to become an argument.

Sometimes Hannah needed to sleep.

Sometimes I needed her to understand what the previous 24 hours had looked like for me too.

Usually we needed both.

Having Kids During Residency Exposes Every Weakness in Your System

We had two babies during residency.

That will teach you very quickly whether your family logistics actually work.

Kids don't care about the call schedule.

Daycare doesn't care that you're on nights.

A fever doesn't check whether your spouse has clinic before showing up at 2 a.m.

There were times Hannah couldn't be the parent who left work.

There were times I couldn't either.

That's where our nanny became incredibly important.

And it taught us something I think a lot of medical families learn eventually:

You need more backup than you think you do.

Not theoretical backup.

Not someone who says, “Call us if you ever need anything.”

Someone who can actually pick up your child.

Someone who can stay late.

Someone who can show up when the schedule changes.

Someone who can fill the gap when both parents have obligations that aren't moving.

Residency schedules often function as though the rest of life will simply arrange itself around medicine.

It doesn't.

Someone has to absorb the unpredictability.

If you have kids, figure out who that person is before you're both staring at each other at 6 a.m. with a sick toddler and nowhere for them to go.

You Can Resent Medicine and Still Be Incredibly Proud of the Person Practicing It

There were times I hated medicine.

I don't think I've said that enough.

Not Hannah's career. Not what she was becoming. Not the patients she cared for.

I hated what medicine demanded from our family sometimes.

I hated watching her miss things.

I hated schedules that changed.

I hated weekends that disappeared.

I hated watching her come home completely depleted.

And at the same time, I was incredibly proud of her.

Those feelings can exist together.

I think spouses sometimes feel guilty admitting the first part because we're supposed to be supportive.

And residents sometimes hear criticism of medicine as criticism of them.

That can make honest conversations really difficult.

You don't have to love everything medicine asks of your family to support the person you love doing it.

"It'll Be Better After Residency" Is a Dangerous Way to Live

We said this plenty.

After residency, we'll have more time.

After residency, we'll travel more.

After residency, Hannah will have more control.

After residency, things will slow down.

And yes, some things did get better.

But four years is a long time to put your life on hold.

Especially when you're having children, building careers, making friendships, and becoming a family during those exact same years.

One of the things we did was get Mexican food every week.

It wasn't some intentional residency survival strategy. We just found a place we liked and kept going back.

Eventually, the staff knew us. We knew them. We had our normal order and our normal routine. In a place we had moved to because of residency, that little bit of consistency helped the area start to feel like home.

And more than anything, it felt like we were actually living there.

Not just passing through for four years. Not just organizing our lives around Hannah's next rotation. We were going out, building relationships, enjoying ourselves, and creating routines that belonged to us.

Looking back, I think those small things mattered more than we realized at the time.

That's what I wish more families understood going in.

Don't wait for attending life to start living.

Take the trip when you reasonably can.

Find your Mexican restaurant.

Make friends outside the hospital.

Celebrate anniversaries even if they have to happen three days late.

Build traditions that don't require a perfect schedule.

Residency is temporary.

Match Day Changes More Than One Person's Career

This one can be uncomfortable to talk about because Match Day is rightfully a huge moment for the physician.

But when Hannah matched, it didn't just determine where she would train.

It helped determine where we would live.

Where I would work.

Who our friends would be.

Where we'd eventually have children.

What childcare options we'd have.

How close we'd live to family.

What opportunities were available to me professionally.

Medicine makes a decision about one trainee and an entire household starts rearranging itself.

That doesn't mean the resident should feel guilty.

It also doesn't mean the spouse should pretend those sacrifices aren't real.

My career mattered too.

There were times Hannah covered for my work responsibilities because I had something I couldn't move. There were other times I moved things because medicine wasn't moving.

We constantly negotiated whose obligation had less flexibility.

Sometimes hers won.

Sometimes mine did.

Sometimes our nanny made it possible for neither career to lose.

I think medical couples are healthier when they can acknowledge that reality without turning it into a competition over whose career matters more.

Money Can Buy Something Incredibly Valuable During Residency: Margin

Residents aren't making much money relative to the hours they're working.

So the instinct is often to optimize every dollar.

I understand that.

But residency changed the way I think about spending money.

Sometimes you're not buying a service.

You're buying back an hour.

You're buying reliability.

You're removing an argument.

You're making an impossible week slightly less impossible.

We paid for a full-time nanny.

We bought a house eight minutes from the hospital.

Those decisions cost money.

They also gave us something we desperately needed: margin.

That doesn't mean everyone should hire a nanny or buy a house close to the hospital.

It means I wouldn't evaluate every residency expense solely by asking, What's cheapest?

Sometimes the better question is:

There is obviously a limit to that. Residency is also a terrible time to start spending like you're already making attending money.

But if you have the ability to spend strategically on the things that give your family time, reliability, or support, I wouldn't automatically dismiss that as wasteful.

Time becomes very expensive during residency.

Don't Wish the Whole Thing Away

This is probably the one I understand most clearly now that we're on the other side.

There were plenty of things about residency I couldn't wait to be done with.

Call.

Nights.

The lack of control.

The constant schedule gymnastics.

Watching Hannah work herself into the ground.

But when residency ended, something strange happened.

There were parts of it I missed.

Not the 24-hour calls.

The life around them.

The friends.

The people who understood exactly what season we were in.

The little routines we'd built.

The house.

The restaurants.

The babies.

The version of our family that existed during those years.

We spent so much time looking toward graduation that I don't think I fully appreciated how much life was happening before we got there.

Residency was hard.

It was also where Hannah became an OBGYN.

It's where we became parents.

It's where our marriage grew up in a lot of ways.

It's where we learned what we could handle, what we couldn't, and when we needed help.

So yes, count down the calls.

Celebrate when a brutal rotation ends.

Put graduation on the calendar and look forward to it.

Just don't convince yourself that your real life begins when residency is over.