Fellowship from a spouse’s perspective

Appreciate friends, family and spouses for their help and support along the fellowship journey.

September 2007

As physicians in training, there is no doubt that we sacrifice a lot.

We sacrifice many hours of sleep, time with our loved ones, and time to enjoy ourselves outside the professional arena. Most of our old friends have traveled more than we have, enjoy several hobbies and definitely make more money.

Despite these somewhat difficult circumstances, we continue training and doing our job because we love what we do.

Juan Rivera

But, what about the people close to us – wife, husband etc. – who also make significant sacrifices and are not necessarily directly involved in the medical field?

Working honeymoon

Take for example my wife.

We got married when I was a fourth-year medical student. The day after our wedding, we left Puerto Rico and began my internal medicine interview trail.

Yes, that was our honeymoon!

I eventually matched at University of Texas Southwestern in Dallas, where I completed my residency. My wife, who was studying at the time and had a promising job, left everything and moved to the United States with me. There was no 80-hour rule when I did my residency, so she spent a significant amount of time alone. When my family was finally getting used to Dallas, another match came along and it was time to move to Baltimore.

We just recently returned from a vacation home to Puerto Rico where we spent a significant amount of time with our extended families. Our kids really bonded with their grandparents. On our plane trip back, I could tell that it was difficult for them to leave their extended family behind. I have to admit that I felt a degree of guilt.

I got curious and asked my wife what she thought of my fellowship years as compared to our years in Dallas. Were things a little bit better now? She gave me three responses.

Rivera and his wife on their working honeymoon. Courtesy of J Rivera.

“There is definitely more time to spend with family,” she said. Most cardiology programs have two clinical years and one research year. Although some clinical rotations can be extremely busy, for example the CCU, there are others that are more flexible and demand less of our time. As fellows, we usually have a good amount of weekends off. The research year can be time consuming, but usually we are able to control our schedule.

“I get more involved with your job,” she said. Interestingly, home call has brought my wife closer to the medical profession. I experienced a lot of exciting, sad and happy events while I was on call in the hospital, but I rarely talked about them at home. During the clinical portion of fellowship, since I was on call from home, my wife became more attentive to the calls that I received, especially if they required me to leave the house.

In the past two years, she attended the funeral of two of my patients and experienced the love and gratitude that we fellows often receive from family members. There is no doubt in her mind that all of our sacrifices are totally worth it, she told me.

“I can see the light at the end of the tunnel,” she added. Being a fellow is definitely hard from an economic standpoint. A good percentage of us are married and have children. We are students living a grown man’s life. We work 80 hours a week and make $40,000 to $50,000 a year. We feel that as hard as we work and as much formal education as we have, we should be making enough money to live comfortably and send our children to good schools. Instead, we are forced to moonlight to make extra cash.

Of course, moonlighting time is time away from home. I think what my wife means by “seeing the light at the end of the tunnel,” is that we will be better compensated once I am an attending. I don’t believe for a second that anything else will change. Our job, if we want to be successful, will always entail putting in a lot of hours and sacrificing some of the things we enjoy doing.

Being a medical trainee, resident or fellow, is not easy. No one said it would be. But despite the long nights, stressful moments, economic challenges and horrible hospital food, there is no other place that I would rather be or another profession that I would rather pick. I feel blessed to be in a position to help others.

Once in a while it is important to thank the people who are not doctors but have shared this journey with us.

Juan Rivera, MD, is a Fellow at the Johns Hopkins Ciccarone Center for Prevention of Heart Disease and a member of the Cardiology Today Fellows Advisory Board. He also writes a cardiovascular prevention blog for Hispanics called Corazon Hispano. The blog can be viewed at: corazonhispano.blogspot.com.