Today’s podcast on dating in medical school is special because this is not only for you as a premed but also for your significant other. Share this podcast with your loved one who is going through this process with you. This will help both of you.
Sarah Epstein is a Marriage and Family Therapist, and her husband is a second-year emergency medicine resident. They started dating when he was starting to study for the MCAT.
Sarah is the author of Love in the Time of Medical School. We talk about how you can keep your relationships strong. In her book, she talks about keeping relationships going through the stressful time of being a premed, being a medical student, and being a physician.
[02:18] Going Through Medical School as a Significant Other
Sarah explains that those who are significant others of premeds and medical schools have a lot of challenges, both that a couple faces together and that the significant other deals with on their own.
To give you a little background, Sarah is finishing up her training as a Marriage and Family Therapist in Philadelphia. She started writing the book three years ago when her husband was a third-year medical student. He was on his surgery rotation, which felt like the pinnacle of all the challenges.
He was working 15 hours a day, and she didn’t know what to expect. There was so much she wished she had known going into this process—in terms of what she can expect, what medical school looks like, and what kinds of relationship issues would come out each year. So she started putting all this together.
Sarah started writing about her own experiences. She started conducting research on physician couples. And she started interviewing others who were dating medical students. She wanted to get a sense for what other people’s experiences have been like.
[Related episode: How Relationships Change as a Premed and Med Student]
[04:38] Dating a Medical Student
Sarah started dating her husband Brian when he was a senior premed. They went to the same university. A month after they started dating, he started studying for the MCAT. In hindsight, she thought it wasn’t the smartest decision. But she got to see the whole journey, from taking the MCAT and applying to medical school all the way through to residency.The MCAT was really my first taste of what it means to be dating someone who's dedicating themselves to a life in medicine.Click To Tweet
Being in it together
Being supportive, asking a lot of questions, and finding interesting ways to spend time together when he was studying a lot became the key for them. They had to find ways to just be in the same room or spend time together where they could take study breaks.
They started to think of it as something they could face together. They had a team mentality. He was doing all the work, but she was cheering him on. Marking his progress studying made her feel like this is something they were doing together.They had a team mentality. He was doing all the work, but she was cheering him on. Marking his progress studying made her feel like this is something they were doing together.Click To Tweet
[07:05] Good Communication Is Crucial
Sarah and her husband talked a lot. And over the course of medical school, that was one of the fundamental keys to making it through each step. Unlike other kinds of training, every year of medical school is something different. There’s a new schedule, new goals to reach.
So they talked through what it means for him to do well on the MCAT. She would also tell him her concerns about getting to spend time together. She wanted to feel validated by him that it’s still important that they get to spend time together. And having that dialogue and re-negotiating over the last seven years, over and over again, what their relationship is going to look like, was crucial.If you think your relationship will just work out on its own, it really isn't true. There too many variables and too many priorities to put in place.Click To Tweet
Sometimes it also meant that studying is his priority for right now, and they can wait to celebrate an event/occasion until after the MCAT, or after the applications are turned in, or whatever.
[09:40] How Much Say Do You Have in the Decision-Making Process?
As the significant other, how much do you get to contribute to the decision-making process for the student? Depending on where your relationship is, it’s going to impact what kind of say or input you have.
When Brian was applying to medical school, they decided that their relationship was not far enough along that she would have a say in where he applied. He basically made the decision based on his scores, grades, and where he’s going to apply. So she played a supportive role. When he had his acceptances, she helped him decide what made the most sense for him.
Sarah recommends thinking about where your relationship is when it comes to those application times. Have that conversation with your partner about whether you should have a say. If you’re already married or in a very committed relationship, this could look different.Medicine dictates the timeline sometimes.Click To Tweet
Whether your relationship is ready or not, you’re going to have to make some big decisions around who gets to decide which medical school. And if you’ve only been dating for a few months, that could feel out of sync with where your relationship is. And this is the first taste for the partners of people in medicine that medicine really does call the shots sometimes.
[Related episode: Should You Consider Romance When Selecting a Med School?]
[12:20] How to Frame Your Conversations
Especially if you think you’re not really a good communicator, Sarah suggests the tone and the way you frame your conversations is really important.
Premed students are very protective over their ownership of the process. They’ve worked exceptionally hard to get to where they are. So they feel like they really own it. And that’s acceptable and appropriate if the relationships is not at a certain point.
So talk in terms of yourself and say something like “I feel like I need to prioritize what I need during this application process. But I would love your help to look at the options.” or “Are you also feeling this nervousness around the application process? Let’s sit down and talk about it.”
So be gentle about it. Don’t make it about you. Avoid talking in “I” statements and talking about how hard you’ve worked. Say you’re excited and you want your partner to be involved in helping you research schools but maybe you want the ultimate decision over where you go. But then tell them you’re so excited to hear their feedback about what seems like a good fit. In a way, try to include the person by asking them what their thoughts are.Include your significant other, even if the decision is ultimately something you're going to do on your own.Click To Tweet
[14:44] Dating a Premed or Medical Student Long-Distance
For Sarah, this is one of the hardest parts, especially for the significant other. Because medical school is rigid. You’re going to be somewhere for four years.
Sarah and Brian were actually long distance during his first year of medical school because Sarah was in Thailand. So they didn’t only do long distance, they were twelve hours apart.
Moving When Your Partner Gets into Medical School or Residency
When she got back, Sarah moved to Miami where Brian was enrolled in medical school, not knowing anyone. She didn’t have a network there. They went to school in Boston and she’s originally from Dallas. So she picked up and moved to a place where she knows no one to see if they could make it work.
And it was really hard for her, for a number of reasons. What does it mean for her that she’s moving for her boyfriend’s career? Does this mean she’s prioritizing his career training over her own? So it was a hard decision for her. But they’ve done the long-distance thing and then she moved for him.Not everyone can make the decision to move for their partner.Click To Tweet
Everything was practically new for them. And one of the things that really helped them was that before she moved to Thailand, she visited Miami and she saw his apartment. They walked around the medical school. So being able to picture it made her connect to his world. She was able to picture what he was doing and who he was spending time with. Sarah admits it’s going to feel alien to some extent, for someone who’s not in medical school to hear about the experience.
Making Long-Distance Dating Work, Even During Medical School
While the first year of med school was exceptionally busy, Sarah says it’s fairly easy to understand and grasp what your partner is doing. The hardest part for them was Brian not being able to conceive what her life was like in Thailand. She was living in a fishing village and teaching Thai children their ABCs. And being unable to come to visit her to get a sense for her world was difficult.
They also had to grapple with the fact that before they were long distance, they could pick up and talk to each other whenever. It didn’t require a lot of forethought. But then suddenly they can’t talk between the hours of 12 and 7 because someone’s asleep. And he’s got this incredibly busy schedule and so did she.
So consciously making times to Skype with each other was vital. They had to prioritize it, even if they were both tired or it was first thing in the morning. He had to miss an event or something like that. They had to put in enough face time. And things changed considerably. He came to Thailand over winter break, and Sarah claims it saved their relationship.He came to Thailand over winter break, and Sarah claims it saved their relationship.Click To Tweet
[19:10] Dating in Medical School and Living Together
Sarah says the first year of living in Miami was harder on her than on Bryan. At least they had set expectations when they were apart. They created routines to make sure they were talking to each other. But when she moved to Miami with a new job and a new apartment, he had his friends, his routine, his support system. And he had an exceptionally busy schedule.
The second year was difficult since Bryan had to start studying for Step 1. Once again, they had to re-negotiate what their time together would look like. Whether it meant sitting in the same room while they’re each doing their thing, or finding other ways to feel connected, they had to foster smaller ways to connect when they couldn’t be together. Basically, Sarah ended up being the third wheel to medical school.I was the third wheel to my boyfriend's relationship with medical school.Click To Tweet
Keeping in Touch About Your Schedule
Bryan did a few things to make it work that Sarah considered to be really vital. Brian was good at keeping her aware of what his schedule would look like. He made her feel she knew where he was going to be and he stayed in touch when he had to study longer than he thought. Or when he had to go to an extra lab.
Knowledge makes you feel a little bit more in control because at least if he can’t see you, you can plan for later. Especially in Brian’s third or fourth year when he was doing something different every month with a different schedule and different expectation (clinical rotations), this kind of communication was important for them.
Additionally, small gestures became a lot more important, like taking the time to take a study break and go out for coffee. Or they’d take on little tasks around the house. They’d take time to notice those breaks in the schedule.
How the Ebb and Flow of Medical School Affects Relationships
Sarah describes medical school as being very busy, but there are points in the schedule that are less busy than other points. This could be right after an exam, when the new material hasn’t piled up yet, or before you start an intense study period. When the schedule is less busy, you try to put some time in the bank.
When those difficult study periods come along or when he’s working a 15-hour day on surgery, they’d start texting each other more. He would leave her post-it notes around the house telling her he missed her. Sarah appreciated that knowledge that he was thinking of her and their relationship even when he couldn’t invest in it at that moment.Couples dealing with medical school really have to be intentional about noticing the ebb and flow, and taking advantage of the less busy periods.Click To Tweet
[23:08] Connecting with Other Significant Others of Medical Students
Being in Miami, Sarah says she was able to hang out with groups and medical students and describes it as quite an experience in terms of feeling a sense of alienation. But sometimes at medical school, they’d have parties and then their partners would come. That would be how she would meet other SOs going through the same thing.
Then they’d call on each other when one of their partners was on a tough rotation or when they were both studying at the same time. She also had one friend from college who’s a partner with someone in Brian’s class. So during study weekends, they’d hit each other up and plan a girls’ weekend.The ability to connect with other people who 'get it' saved me a lot of sanity.Click To Tweet
Building a Support System While Dating a Medical Student
Sarah recalls she was going to have wine with the partner of someone in Brian’s class. But then this friend texted Sarah and said her boyfriend was going to bed at eight, and she was setting her schedule to meet his, so she asked if they could do wine early, at five. Sarah agreed, of course, because she gets it.
Other people who are dating medical students understand that you’re living this weird schedule and you’re doing your best to match the medical school schedule so you get to see your partner. It makes a big difference to have friends who understand that.Anyone dating a medical student really needs to tap into an emotional support system.Click To Tweet
In terms of having a support system, Sarah says that anyone dating a medical student really needs to tap into an emotional support system. If you’re a local and lucky enough to live in a place with a big network of friends, let your friends and family know this is the reality, and that you might need a night out when your partner is studying. Let them know you’ll need to vent about this and what it’s like to be dating someone in medical school.
Find those specific people in your network. Not everyone is equally good to vent to. So have one or two people that you can call up and say you just need to talk for a few minutes. Find those people who get it. Sarah is also a big fan of therapy as a support system.
[26:29] The Hardest Times to Be Dating in Med School
In terms of study periods, Sarah considers Step 1 as by far the hardest. She recalls after Step 1 was over, she was just talking to Bryan and broke down crying because there were so many things she hadn’t gotten to tell him. There were so many conversations they had to put on hold. And both people had to go into long-term thinking mode. You can’t have those day-to-day times together.
Rotations are also difficult at the beginning in third year. First and second are difficult but predictable. But third year is incredibly unpredictable. Not only is your partner doing a different rotation every month, but they also have a different schedule. They have different attending physicians to make the experience easier or more difficult. They can’t necessarily stick to the schedule if somebody needs to stay late or an emergency comes in.Adapting to the change in schedule over and over in third-year rotations can be really difficult.Click To Tweet
Dating a Third-Year Medical Student
That said, it was important for them to look at the schedule in advance as much as they could, or have Brian talk to classmates about what this rotation was like, so they can prepare themselves. If he’s working 15-hour days, then she’s putting five social events for herself on the calendar. Then they’re going to spend a bunch of time together before it starts. So this became a very important part of their preparation.
Obviously, surgery was really tough since he was working very long days. They had an unusually difficult time with his pediatrics rotation because they both expected it to be a very light rotation. But it turned out that it wasn’t. So the feeling that they had prepared for something light and then got the rug pulled out from under them was difficult.The unpredictability is the biggest factor for couples when you're dealing with clinical rotations.Click To Tweet
[29: 57] Common Complaints from Significant Others of Med Students
When Sarah got to talk to other significant others while she was writing her book, there were themes that came up again and again. The lack of time together was one of the biggest ones.
Another one is that sense of waiting. Almost everyone talked about how they would avoid feeling like they were waiting for their partner. Whether it’s waiting for them to come home or waiting for them to finish with their exam or waiting for them to finish with medical school. There is this feeling of powerlessness in the face of all of that waiting.You're kind of put into this passive role of just having to sit and watch your partner do these things that are taking up all this time. Click To Tweet
So you’re kind of put into this passive role of just having to sit and watch your partner do these things that are taking up all this time. These SOs also talked about the things they would do to make them feel like they weren’t waiting. Like if their partner would finally be free, and if they had already made plans, they’d stick to those plans. Sarah explains you can’t drop everything and relinquish your life to medical school.
Loneliness in Med School Relationships
Another theme that came up was that sense of loneliness. It could come up when you feel like your partner is just not available. And you feel like a medical school widow or orphan. One woman even described the feeling as being married to the shadow of the person. She felt she was married to the idea of this person because, in reality, they were never there.She felt she was married to the idea of this person because, in reality, they were never there.Click To Tweet
Also one of the other things that came up is navigating social circles that involved a ton of medical people. When a bunch of medical students or doctors or residents get in the same room, that becomes the topic of conversation. So dealing with the feelings around that was one of the things that all of them talked about.
I can relate to this personally because, even when I would get together with Allison, my wife, and her fellow neurology residents, they would niche down and talk about neurology stuff, and I felt I was an outsider, even though I was a physician myself.
[32:53] Not Being Able to Share Gross Surgery Stories
In their household, Sarah and her partner have a “no yucky stuff” rule because Sarah would faint just hearing the gross stuff. Her husband being an emergency medicine doctor, there are so many things she never hears about because she can’t handle it. But he knows there are twenty other people in his life who are happy to hear about it. And she will hear about other things.
Sarah’s dad is the oldest of four boys, and her grandfather was an anesthesiologist. The joke in the family was that all the girlfriends who came over to dinner had to pass the test of sitting through his surgery stories. Apparently, one time her granddad was talking about intestines coming out of someone’s body during a surgery, and her grandma was serving spaghetti at the same meal. So there can be a lack of awareness that not everyone can handle this stuff.
Alienation from Not Knowing Medical Jargon
Sarah adds that most of the partners of medical students don’t know much medical jargon, and so they felt dumb when put into those conversations. They didn’t know what it meant when someone talked about blood pressure numbers and whatever they were learning that day. So it can be an incredibly alienating experience.A lot of medical students' partners I spoke with talked about feeling incredibly isolated by not knowing medical jargon.Click To Tweet
Sarah says after the first time this happens, you’ll see it coming. So talk to your partner in advance and set up a signal so they become aware of it, too. You’re going into it as a team, so make your partner feel like they’re not alone in that moment. You and your partner are in this together. Don’t make it feel like they’re the med student and you’re not. You’re a team.
If your partner doesn’t change the subject, then you can try changing the conversation to another aspect of the topic yourself. For example, Sarah finds certain things about the hospital that are interesting, like the relationships between attending physicians and the medical students and residents. So she’s happy to ask about that. But that can be a way to pivot the conversation away from the technical details.
And when it comes to the yucky stuff, you have to come straightforward or have that signal with your partner so they can step in and say to the others in the conversation that you don’t want to hear it.
[37:20] 3 Keys to Surviving and Thriving in a Relationship in Med School
Sarah says there are three keys that lead this kind of relationship to survive and thrive. First is communication. For a medical student couple, that means re-negotiating what the relationship is going to look like as medical school progresses. Communicate about each other’s stress. Listen and validate that stress. Having your partner validate your stress goes a really long way. Have those little gestures when things are tough. Re-negotiate the relationship. Validate each other’s stress.
Second is intentionality. You can’t just let it happen because it won’t. Things will fall through the cracks. There’s always more studying. There’s always more to do at the hospital. So really be intentional and make sure you find time together.
The third key is flexibility, which Sarah admits is the hard one for her since she likes to have a plan and to know what’s going on. So, be able to relinquish a little bit of the control. Move plans around and find creative ways to spend time with each other.Being flexible is vital because you just can't control the changes in schedule, needing to stay late, and other details like that.Click To Tweet
[39:50] Dealing with Discouragement from Other People
Sarah has had people telling her that all doctors cheat on their spouses. She has also been asked if she’s going to raise kids alone one day. Or people tell her she never has to work (as if her decision to work only has to do with finances and not her own ambitions). And these are things that can be hard to deal with.Sarah has had people telling her that all doctors cheat on their spouses, and asking her if she's going to raise kids alone one day.Click To Tweet
Sarah suggests you have to pick your battles because this will happen a lot. So she’d often either brush it off or make a joke about it. That would be the best response to an acquaintance.
But with people close to you, be more honest with them about how it feels to hear comments like that. Tell them what it means to support you. Tell them it’s hard, and tell them what kind of support you need—that you need them to be there to listen to you. Let them know that you can’t be hearing things like that because it’s not helpful.
You want to surround yourself with people who are going to be encouraging and supportive. It’s okay to tell people what you need from them, even if it’s not their first instinct.
[42:20] The First Steps to Being Intentional
Sarah recommends having a check-in with your partner. Wherever you are in your relationship, those check-in’s are really going to be important to see where your partner is at so you can improve things.
It’s possible that your partner who’s not a medical student may be feeling stressed about what medicine is going to mean for your collective future, but they haven’t felt entitled to talk about it because they’re not the one taking the exams. Or maybe the medical student is feeling overwhelmed or guilty that you had to move somewhere for them.
So get some of those feelings out in the open by sharing what you’ve been feeling about the process. Talk about how you can start supporting each other. What do you need? What do they need? How do you manage each step?
Also, cut yourself a little bit of slack as a couple as you’re trying to figure it out. You’re working on it. And as long as you’re working together on it as a team, you’ll get there. You can get there.As long as you're working together as a team, you'll get there. You can get there.Click To Tweet
Links and Other Resources
- Love in the Time of Medical School by Sarah Epstein
- Related episode: How Relationships Change as a Premed and Med Student
- Related episode: Should You Consider Romance When Selecting a Med School?
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