3 days ago
4 Steps for Keeping a Residency Romance Alive and Thriving
Social Scientist Ruth Diaz went on her first date with a medical resident on his only day off that month. As they wandered through a garden in Portland, Oregon, there was a comfortable familiarity between them, and that feeling soon blossomed into love.
Over the course of several months, however, things deteriorated. Missed holidays, communication breakdowns, cold dinners. Their relationship ended in less than a year.
Packed schedules, along with physical and mental exhaustion, can make it difficult for residents to maintain any personal life. So when it comes to romantic relationships, attempting to be physically present with partners, let alone emotionally present, can be daunting. While some couples manage to navigate these issues, frequently the demands of residency end up wreaking havoc on romance.
And here's a wrinkle: Deteriorating relationships can be a sign of wider struggles.
A 2022 study published in the Journal of Neurosurgery found that residents' significant others who reported relationship dissatisfaction were more likely to also report that their resident partners had higher levels of burnout and a lack of work-life balance.
'I didn't look at it like, 'This is your residency's fault,'' Diaz said of her breakup. 'I think it's like how they analyze the Titanic. Part of it was a guy who wanted to retire and went really fast. Part of it was they built the ship badly. And part of it was the weather changes and the bad technology. But I do think among the pressures on our relationship, residency was the iceberg.'
So why do some partnerships navigate the iceberg of residency while others hit it head-on? Medscape Medical News asked residents and experts for a four-step relationship treatment plan.
Step #1: Adjust Your Relationship With Time
The most obvious challenge for residency relationships is a lack of time together.
Hiba Hadadin, MD and Yazan Hijazein, MD on their wedding day
Hiba Hadadin, MD and Yazan Hijazein, MD, were married on June 15, 2024, in their native Jordan. Four days later, they flew to their new apartment in Louisiana to start residency at LSU Shreveport — she in pediatrics and he in internal medicine.
In lieu of a honeymoon, they have since coordinated their few shared days off to travel to nearby states. 'For me, that's basically a honeymoon,' Hadadin said.
Hadadin and Hijazein entered residency together through the National Resident Matching Program couples match program. According to a 2021 survey by InCrowd, 58.5% of healthcare professionals in relationships were dating others within healthcare, citing reasons including the ease of meeting people in the field (at least compared with the difficulty of meeting people outside of it) and a shared understanding of the residency schedule.
Even if dating fellow residents is easier, it still isn't easy. Hadadin and Hijazein rarely have the same day off. Often, their most romantic dates tend to involve eating lunch together in the hospital cafeteria.
Sarah Epstein, LMFT
Sarah Epstein, LMFT, a family and couples therapist who often works with healthcare workers, got engaged to her husband during his surgery rotation. 'He successfully negotiated for a 'golden weekend,'' Epstein said, 'or what we normal people call a 'weekend.''
The only constant in residency schedules is change, so Epstein suggests that couples need to adapt continuously. 'The schedule makes getting into a rhythm next to impossible,' Epstein said. 'The moment we settled into one way of being, he switched, and we'd have to adjust again. We had to begin mapping out things on our calendar in advance and being extremely intentional when we had time together. Adjusting became the norm.'
Carl G. Streed Jr, MD, and husband, Chad Rubalcaba at Streed's medical school graduation
Intentionality and ingenuity go a long way when it comes to navigating erratic residency schedules. Carl G. Streed, Jr, MD, MPH, got engaged to his now-husband Chad Rubalcaba before starting residency in 2014. Without the guarantee of having their anniversaries off, Streed and Rubalcaba created a practice of celebrating 'monthiversaries' whenever Streed had that night off. They're now at almost 200 monthiversaries.
Epstein urges couples to set aside even a few minutes of time to check in throughout the week during busy periods. 'Intentionality is at least making it known that 'I see that this is happening, I understand that this is hard on both of us. I miss you too. What can we do? Is there a 5-minute coffee break? Are there sweet texts going back and forth? Is there physical touch happening? Are we going to bed together? How are we going to make this work?''
When asked how their relationships survived or are surviving residency, Hadadin, Streed, and Rubalcaba all said they clung to the impermanence of training.
'Knowing that residency is not forever is mainly what keeps me going,' Hadadin said. 'There are going to be some days that will feel the worst, but there is light at the end of the tunnel, as they say. This is not going to be your lifestyle 5 years from now.'
Step #2: Frame Residency Like an Illness
Long hours and looming exams can also leave residents emotionally exhausted even when they're off duty. Diaz's dates with her former partner usually involved studying for their respective programs at late-night coffee shops until they couldn't think anymore.
'A lot of our connection couldn't go beyond these basic functions of the screaming visceral demands of our bodies to eat, sleep, drink water, and try to see a scene of nature here and there,' she said. 'He was in a semi-dissociative haze by the time he got out of his shifts.'
Streed recalls a similar experience. 'When working in the ICU, I always felt very drained at the end of every shift,' he said. 'I was not as emotionally available in certain situations.'
A lack of energy can be even more impactful for dual-healthcare couples. At one point when Hadadin was working night shifts and Hijazein was working during the day, they didn't see each other for 10 days in a row. Now, when they do see each other, they are sometimes too exhausted to truly reconnect. 'I had a month in wards where it was very hectic,' Hadadin said. 'I would just go home and sleep. I didn't have the energy to do anything.'
As much as time management, a core component of residency relationships' survival is the management of expectations. 'I would invite anyone dating a resident to frame the program like an illness,' Diaz said. 'It's a chosen illness, but a time of inhuman strain and suffering nonetheless. By seeing it this way, it's easier to recognize that people who have this illness need extra nurturing to cope with the missing function.'
Of course, this doesn't mean that nurturing exhausted residents should fall on their nonresident partners. Nor does it mean those partners' needs are less important. Epstein cautions against what she calls 'ranking stress.'
'Everyone is entitled to their experience,' she said. 'My husband is an emergency physician. If my stress was compared to his, mine would be invalidated on a daily basis.'
Step #3: Prevent Resentment
When Hadadin wakes up on her one day off each week, one of the first things she does is clean the house. But when her residency schedule gets in the way of household chores, her husband picks up the slack, and vice versa.
'We both understand how hectic our schedules can get, so we try to be considerate of each other,' she said. 'I feel so lucky to have a partner who helps out and understands how busy I am.'
But when household needs like cooking and cleaning fall on the backburner during residency, these essentials often get neglected completely or to fall on one partner — in heterosexual couples, it's typically the female partner.
Sarah Epstein with her husband
Speaking from personal experience, Epstein describes this as a 'recipe for resentment.' She found herself taking on a lot more of the housework during her husband's residency, and this remains the case when her husband is in the midst of an especially busy period at work.
'The important thing is us both seeing what's happening, making arrangements for what I'll need when he's less available, and his re-engagement after the busy stretch,' she said. 'He'll do more bedtimes when he's around, or make sure to cook and freeze food before a stretch of overnight shifts. By being aware of which parts of the job can lead to resentment, we can plan and do preventative work.'
While balance is important, it's also crucial to recognize that it isn't always going to be a 50/50 split. This is a sentiment Streed and Rubalcaba included in their wedding vows. 'Residency, for me, felt like being selfish, but the nature of residency was that my time was going to be more focused on training,' Streed said. 'Understanding that this is temporary, and we'll work together, is something we put in our vows — this notion of 60/40.'
Beyond the practical aspects, domestic duties can sometimes be romantic: Some of Streed's most treasured memories from residency are the times when Rubalcaba would bring him home-cooked meals during long shifts.
Step #4: Train for the Future
Despite the fact that residency is finite, Epstein points out that practicing physicians' hours often remain long and inconsistent, if to a lesser degree. Instead of seeing residency in a vacuum, she sees it as an intensive preparation period for the ongoing challenges of a life together.
'Some couples fall into this sort of postponement mindset, where the only goal is to get to the other side,' she said. 'But I work with many couples after training where there hasn't been intentionality or good communication, and there's a ton of built-up stuff they now have to deal with. I have never worked with a medical couple that doesn't have some baggage from their time in training.'
Diaz also advises residents to acknowledge and process the impacts of residency and 'get therapy' afterward. 'Even if it all seems good on the surface, that doesn't mean that your partner hasn't been absorbing ongoing wounds and not sharing or even staying conscious of them. These wounds will impact your relationship.'
Epstein often hears echoes of her own experience when working with couples who are still dealing with the fallout of residency. The good news, she says, is that building empathy, communication skills, and intentional practices can help couples move forward from residency stronger than ever.
