Choosing a Residency When You Have a Family

 Sarah Averill, Medical Student, Internal Medicine, 11:36PM Dec 6, 2009

Third Year Medical Student, SUNY Upstate Medical University

“I don't want you to be a doctor!” my daughter snarls at me. “Why?”  I ask, not really a bit surprised because she’s 10 now and expresses herself without the least hesitation. “There’s too much moving,” she says, over her shoulder, now, stomping out of our kitchen. Yup, there’s a budding teenager coming along.
The possibility that we may have to move for my residency has been center stage for the last month as I've crisscrossed the northeast, interviewing for residencies. Making choices regarding residency when you have a family is a bit more complicated than when you are single. Despite all the people who tell me that I should prioritize my residency over all else, I can’t make decisions as if I were unattached. While there is considerable argument among biologists whether human families and communities are evolving towards or away from functioning as superorganisms resembling insect colonies, I have little doubt regarding my own inability to thrive when my children or husband are not doing well. I certainly won't move away without them for residency; if we go, we go together.
If I’d chosen a less competitive field than diagnostic radiology I’d likely have more control over where we went or whether we’d have to move. As it is, I’m at the mercy of the numbers. I had to cast a wide net that encompassed much of the Northeast and some of the Midwest. Questions I asked before even sending out ERAS applications included:
1) Are there interesting places for my family to live, play and explore? Mountains, lakes, or prairies are good; so are museums.
2) Do I have friends or family in the area who can be there for my family while I’m working the demanding hours of internship and residency? Families are resilient, but having built-in contacts is always a bonus, even if it's an old college classmate, or a cousin you used to see during summer vacations. One is infinitely more than zero.
3) How far from the hospital will I have to live and how far will I be commuting? Can I ride my bike or walk from where I live to where I will work? Every hour I’m in the car is one less hour I’m with my family or getting work done, getting exercise, or having fun.
4) What’s the cost of living, especially housing? It’s one thing to cram yourself into a 400-square-foot efficiency on New York’s Upper East Side when you are single, and entirely something else when you have three other people to share the space with.
5) Are there job or educational opportunities for my husband? He’s not in medicine and needs to have a meaningful job and room to grow.
My daughter was born brave. From an early age she pushed me to go on rides that I never dreamed I could survive: the highest roller coasters, the swiftest waterslides. Each time she asked me to go with her -- higher or faster -- I looked at her in dismay. Where did this brave child come from? I'd ask myself.
With my heart in my throat I can't help worrying that my career in medicine and our moving will be difficult for her and leave a mark, make her childhood pockmarked with lonely holes. Then I remember plunging into deep water at unimaginable speeds, the bone rattling turns on the antique and modern roller coasters she begged to go on -- again and again -- the flashes of light where I imagine us plunging into the earth, or out into the stratosphere, into the sky. Where do those flashes of light come from? Is it the song I'm singing to cover up the pounding in my chest?
That's when I remember a Rumi poem on childhood friends and surviving injuries. He reminds me that no one is unscathed and to "keep looking at the bandaged places. That's where the light enters you." Whatever ticket Match day delivers, we are going to ride; it’s going to be high and fast at times, and low and rumbling at other times -- but we are going to ride.