Tuesday, May 31, 2011

Program Size Does Matter

As I was thinking about my previous post I realized that things might be different if our program was larger, or was located elsewhere. This area in the Midwest has a Neurosurgery program and a Family Practice program. The surgical program is the larger of the two and the two don't really mix. The next residency program of any kind is an hour away.

If we were in a larger program the chances of us feeling so out of place would be lessened, but not necessarily. The size of this program didn't really enter into our decision making, probably because I didn't realize how much I would appreciate the support of someone who was also living a similar life. But at the time we were interviewing and matching I don't think we even considered it, that wasn't as important as the quality of training he would receive. Most likely I over estimated my endurance. In runners terms I have hit the wall! The point where you don't think you can go on anymore, but somehow your legs keep moving.

We have also been transplanted the farthest. The residents with families live within a 5-10 hour drive from their extended families making it possible for them to get back home frequently. I am sure our situation would be different if we lived closer to our families. A three day drive back home just doesn't work. Or maybe I'm not making it work. The thought of driving by myself for three days to get home doesn't sound any better than what we are doing here, but really we don't have the money to get there anyway, and if we did we would have to stay for a month to make it worthwhile. I can't leave my husband for a month!

Because our program(s) are so small there isn't a lot of attention paid to the family part of the doctors life. I always imagined that if we were to stay here as an attending that I would start a program for families. Monthly get togethers for the wives so they can meet each other without their husbands. As I write that now, I realize it is me who needs it now. If the demographics were to remain the same few people would really benefit, but maybe not. Perhaps I assume too much.

For our last year here how am I going to make the most of it? Well, I'll just keeping doing what we've always done. I'm having a baby, that will certainly make the time fly faster and then we'll be off for a fellowship in another state and maybe by then I'll feel more at ease, knowing that the end is finally almost here.

I think my ah-ha moment just came! I knew a blog would help me figure this stuff out. I mentioned long distance running a few paragraphs ago. Some residency program are like running a 10K, others like a half marathon, a marathon (26 mi), and this one is an ultra-marathon (50 mi). Things were fine at the 4 year mark, and had that been the end of our journey my view of residency would have been different. As we close out the 5th year so many things have happened that have drained our resources and left us weary. The 6th year I hope we get our second wind and can finish the stretch strong. Maybe I'll consider the fellowship year like the cool-down lap as the race ends. All that matters is that we get to the end.

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