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Hi y’all! Baby Adaleine is going to be here SO soon! Thank you for your patience on the less frequent blog posts as we nest and prepare for her arrival! 

As promised, here is part 2 of Life During Residency!

What Makes Residency Challenging

The long hours and the scheduling unpredictability

There are a few thing that made Intern Year (the first year) and the following years challenging. The first is adjusting to the new schedule. Interns and Residents alike work a LOT of hours. There have recently been regulations put into place to not over-work medical trainees, but it’s still a lot! Tony worked an average of 80 hours per week during his Intern year, which included Sundays. He was sometimes off on Saturdays, but that was always one of my busiest and longest days of the week at the spa (I’ve worked 9-6pm on Saturdays since 2007!), so sometimes it truly felt like we were two ships passing in the night.

During the first year when we had our lovely live-in au pair, it was SO helpful because Tony’s schedule changed so often, and so I could always rely on knowing there was someone there for Isla. Interns and Residents don’t have a “set” schedule where they can punch in and punch out. Let’s say they are scheduled from 7am-7pm for the day. If 7pm rolls around and a patient is in distress or if a code happens, they can’t leave until the patients are taken care of. The au pair was able to work around my schedule instead of his, and this was so helpful.

Also, the unpredictability meant that sometimes I went out on double dates or dinner parties alone, I’ve even been to a few weddings alone, and sometimes I even had to cancel plans at the last minute. Family dinners were hit or miss- I learned to make my own plans and if Tony could join that was great but if he couldn’t I didn’t let myself get disappointed. If I wanted a girls’ night out (or even just some time alone for myself!) I would schedule it with the au pair to cover bedtime and bathtime. She would often accompany me and Isla if we went out to dinner- she truly was a part of our family! I don’t think life would have worked that year without her!

If this is you, or will be you, I recommend:

  • Have a live in au pair or a nanny who lives close by who is willing to accept the challenge of Intern year and essentially be at your beck and call. Good communication is key- a lot of childcare arrangements happened at the last minute (and sometimes last minute cancellations!) Be willing to be fair if she is expecting a certain number of hours for the week and you either go over or under- compensate her appropriately.
  • Make your own plans. Don’t wait on your SO to start dinner or to go out if you are hungry. They will try their best to predict when they are coming home but if it doesn’t work out dust yourself off and make sure you have some lovely food waiting for them for when they DO come home- residents often are so in demand at the hospital that they don’t have time to eat properly during their shift. Your SO will be so grateful believe me!

Living in a Big City on a Resident’s Salary

Another challenge is that although trainees are compensated and given a salary as opposed to medical school in which they are unpaid, the salary residents are given does not reflect the hours they put in. Living in an expensive city can make this very challenging. Here are my recommendations:

  • Communicate as much and as often as possible. Tony and I still use a budget spreadsheet in which we log every dollar that goes out and comes in- that way we are always on the same page and can stay on track with our goals.
  • Your student loans are no longer in deferment from medical school (and this may include undergrad for you- we paid the interest on the undergrad loans so that we at least wouldn’t slide backwards during the 4 years of medical school!) Federal loans are on a repayment plan based on income, and you can file your taxes separately so that the loan payment reflects your medical spouse’s salary and not your combined income if you work. We also opted for the federal loan forgiveness program for physicians- in 10 years whatever is unpaid will be forgiven. Interest rates were low during my husband’s residency so this really served us well! Make paying back these loans a priority. Your Attending years will thank you- if you want more money advice and inspiration go to The White Coat Investor!
  • Cook at home as often as possible and pack your lunch for work. One of the biggest vacuums for money can be dining out, especially if you live in a large city with great restaurants. We allowed ourselves a date night once a month if time allowed, and a very tight budget on dining out. If I took Isla out for dinner without Tony it was either to Wegman’s or Chipotle, and not very often!
  • As the SO of a resident, let’s face it, unless you are a resident too, most of the household money that gets spent gets spent by YOU. I was in charge of the grocery shopping, buying clothing for Isla, making sure everyone had enough personal care items in the house such as toothpaste and shampoo, etc. One of the best ways I could alleviate Tony’s stress about these lean years was to be as mindful of the budget each month as possible. He wasn’t able to oversee everything and he relied on me to make decisions that allowed us to make ends meet. It’s a huge trust- make sure you keep communicating and that you both feel the same way about big issues such as carrying a balance on a credit card. Whatever it is you decide to do for your financial hygiene is up to you, but make sure you are both on the same page about it. For example- Tony and I both can’t sleep at night if we carry any kind of debt other than student loan debt- so I made sure to not overextend us each month. Also, putting 10% of my gross income into an MMA and 12.5% of my income into my retirement is very important to me-Tony has different percentages that he is comfortable with. We discussed it and made sure we agreed beforehand. It truly takes teamwork to make the dreamwork. Don’t forget you are investing in your future and this time won’t last forever!

Residency as a Temporary Arrangement

The last thing that was most challenging for us during Residency was knowing that it was only for 3 years and that we wouldn’t know where we would live next until the third year was almost over. For me professionally this was challenging- my livelihood is based on my relationships with my clients. A mutual trust and their being able to rely on me each week or each month is crucial to not only their therapeutic outcome, but also to my career thriving. Depending on what your career is, here are my suggestions for this time of “limbo”:

  • I was completely transparent and honest with my employer. When I was hired back I told them we may only be living in the area for 3 years. This affected promotions, but I don’t regret that at all. I was working as a general esthetician at the spa and I wanted to be promoted to Medical Aesthetician (like what I am doing right now in Raleigh!) A coworker of mine also was interested in the position and was working equally as hard as me to prove herself capable and worthy of it. At the end of the day, since I was honest with my boss about not staying in the area for longer than a year after the promotion was being offered, the promotion/new title went to my colleague. Generously, my boss allowed me to train in all of the new medical skills that I would have been performing if I had received the official title. So, I trained in dermaplaning, peels, micro needling and laser. I am using these skills now! I believe that honesty is the best policy, and that the trust and respect in your relationships with your colleagues and your employers is more important than professional growth. I think if you foster the relationships, the professional growth will follow, as it did for me! I still always feel grateful to Bella Santé to this day!
  • I was completely honest and transparent with my clients/patients as well as soon as we found out about the match at Duke. This allowed me to make sure that they had a good fit with a new therapist before I left. This was the very least I could do for their loyalty- some had been coming to me since I began my career!
  • Remember that EVERYTHING is an opportunity for growth and to learn. If you have a great arrangement that you love, know that it is OK to grieve if you have to leave it. I remember the first time I moved away from Bella Santé- the big company meeting was that following September after our July move to Rochester for med school- I am not even kidding you when I say that I moped around that whole day and texted my former coworkers to fill me in on how it was and to make sure they said hi to everyone for me!

Lastly, some HIGH points of Residency and some things to look forward to:

  • Hospital dinners, balls, and get-togethers. 

A few times a year I treasured the time when Tony and I could go out and spend time with his co-residents in a relaxed setting. This allowed me to live in his world for a little while and also for us to reflect on and celebrate how far we had come each year and all of the challenges that we surmounted. When they spend so much time away from home, going to these events can make you as the partner feel included in their life. For me also this was always a time when Tony acknowledged me and the sacrifices I was making to help make our family life during his training work! It’s a happy time to communicate and celebrate each other!

  • Moonlighting.

Moonlighting is an opportunity for your SO to work as and get paid as a physician for extra shifts. This was how we saved for our big move to NC and how we saved for a house! It also gives your SO a glimpse of what they are working so hard for- the time when they are compensated appropriately for their years of education and training. I think the emotional benefits are even more rewarding than the financial! Moonlighting alleviated so much stress in our home!

  • Vacation Time and Golden Weekends

Residents DO get some time off throughout the year. This is so necessary to everyone’s mental health and stress level. Take trips if you can afford it! A Golden Weekend is when your resident has both Saturday and Sunday off. We didn’t travel much, but even just having Tony home and being able to see each other for  at least 2 consecutive days in a row was so great! During residency we visited friends and family in NY, Ohio, extended our trip for Tony’s brother’s wedding in Jacksonville, FL and went to Charleston, SC and Savannah, GA for a few days, and we also spent a day on Nantucket for Labor Day Weekend. These little mini weekend getaways allowed us to reconnect and recharge!

Have more questions? Was this helpful if you are either in Residency or about to begin it? I would love to read your comments and answer any further questions for you!

Coming up during my maternity leave I have a lot of great new interviews and new topics to share with you! In the meantime, stay tuned for a post on my Hospital Bag Essentials, Post-Partum Self Care and Life During Fellowship!

Thanks for stopping by! XO, Ashli


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