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The only thing that is certain about the medical lifestyle is change. Moves for medical school, residency, and attending positions dominate a landscape peppered with call schedules, pagers, and licensing exams. As my husband prepared to finish a fellowship and move on to his first post-training job, I remember trying to soak up every last memory that I could of the years that we had spent preparing for this time. I wanted to memorize the landscape of the life that we had been creating.

We brought three children into the world during training and had somehow managed to survive the grueling pre-80 hour work week residency and fellowship with our marriage intact. We had reached the end of training … passed the goal line … and the paradox was that even though I thought I had been so miserable, saying good-bye to friends and moving on to the next step was harder than I had ever imagined. If anyone would have told me that the end of training would bring on nostalgia and sadness, I wouldn’t have believed them. This was part of the journey of our lives and I wasn’t ready to let it go.

As I settled in to the post-training life, I found that the tools that had gotten me through residency and fellowship still applied. Adjusting to change can be challenging. Here are some of the things that helped me along the way.
1. Get involved in your local medical spouse guild. I can’t emphasize this enough. The auxiliary is an excellent place to meet people from all walks of life.
Many of the spouses are working through adjustments like yours, so it is easy to find an understanding ear.

2. Join a Playgroup. If you have made the choice to stay at home with your children, then you know how wonderful and stressful this can be. Joining a playgroup is the perfect way to meet other stay-athome
moms.
3. Cre ate a niche for your self. One of the things that I found difficult during my husband’s training is that the focus seemed to be completely on the resident and their life and accomplishments. I sometimes found myself feeling envious and resentful. We make a lot of sacrifices for our spouses to accomplish their goals and sometimes it can be frustrating. I decided to go back to school part-time. This gave me something important that I was doing for myself. It really helped to bring me out of a slump and give me some direction as we settled into our new lives.

4. Communicate.
Talk with your spouse about how they are managing all of the changes. Share your feelings too. This is a stressful time for both of you and working through it together will help keep your relationship strong.

5. Go out together .
Make time to go out alone with your spouse once a week if you can. Hire a babysitter if you need one, but take time out for yourselves.

6. Go out on your own.
This was a hard one for me. Initially, I found that I wanted to spend any moment where my husband was home with him. What ended up happening is that I would wait for him to get home and then expect to spend quality time with him. He was tired and needed some downtime (especially if he was post-call) and I ended up disappointed. Establishing a group of friends that I could go to the movies with or going to an auxiliary meeting once a month gave me time to get out and enjoy being with people. I felt more fulfilled and was less needy when my husband arrived home exhausted and headed for bed.

7. Speaking of the be d…
Don’t forget to nurture your relationship with your spouse there. Enough said.

8. Co-op with a friend.
I found it difficult to find a sitter for my children when I had an appointment or an errand to run. A friend and I came up with a wonderful
child-swapping solution — you watch mine, I’ll watch yours. It worked out great and it was free! The best part of all, was knowing that my children were with someone that I trusted.

9. Budget.
The biggest adjustment that we made after training ended wa financial. I think we had an idea in our minds that the first attending paycheck would solve all of our problems. It took some time for us to come up with a reasonable working
budget that allowed us to pay off student loans, make a modest house payment, and still have a little left over each month. Don’t forget to keep budgeting when training ends.
10. Explore your community.
When my husband was finishing his fellowship in Florida, getting out and discovering new beaches to take the kids to was a favorite pastime of mine. There were so many fun playgrounds and family activities to enjoy. The hardest part about him accepting a post-training job in Minnesota was saying good-bye to those beaches and parks. As I began to explore Minnesota though, I discovered that there are beaches here too. Looking in the local papers and
asking new friends and neighbors for suggestions helped me to find the fun
family activities that I was craving.

It has been eleven years since wetraded in the beaches of Florida for the ice and snow of Minnesota winters. The transition took time, but we still use the 10 tools to navigate through the ups and downs that are inherent to the medical lifestyle.
Good luck on your journey!
Kristen Math is the founder of the international Medical Spouse Network (www.medicalspouse.com) and author of the book “Surviving Residency: A medical spouse guide to embracing the training years.” She earned her MS in Molecular Biology from the University of Florida, and she is a stay at home  mom to five busy children.