The marriages of resident physicians are at risk unless both doctors adopt a combat mentality to survive the grueling hours, extraordinary stress and time apart during medical training, writes a Wake Forest University expert on medical marriages in the current issue of the Journal of the American Medical Association.
Dr. Wayne Sotile, director of psychological services for Wake Forest University’s cardiac rehabilitation program, says in a JAMA report that resident physicians who marry need to accept that residency is not a time for marriage building, but marriage survival.
“Overall, medical training is not a time for growth in a marriage; it is a time for personal survival without, one hopes, damaging the relationship,” Sotile says. “The analogy we suggest when working with couples, one or both of whom is a resident physician, is to think of themselves as if they were ëon point’ in a war zone, that is, in the lead position that bears the highest risk and stress of battle formation, and alter their expectations and dealings with each other accordingly.”
Under such a high degree of stress, and having so little time together, Sotile says married doctors need to abandon expectations that they can have it all: a thriving career, a loving family life, an intimate relationship with their spouse, and sufficient personal time outside of work.
“Quality-of-life concerns are not foremost in this setting; recognizing this helps couples realize that their reactions to their spouses are not due to their having married the wrong person, but are normal reactions to excessive stress,” Sotile says in the JAMA article co-authored with his wife, Mary, which is based on their book, “The Medical Marriage: A Couple’s Survival Guide.”
According to Sotile, half of all medical students marry during medical school or residency training, but 60 percent divorce within 10 years of their residencies — often because of marital discord produced by work-related stress.
Resident physicians are at particular risk for marital problems because of longer hours, increased inability to wind down after work, sleep deprivation, lack of energy to engage in social and leisure activities and inability to effectively manage time.
Although divorce rates remain high, Sotile says that younger physicians are striking a healthier balance between work, marriage and family than older doctors. “From our work counseling nearly 600 physicians over the last 20 years, we are seeing that today’s residents are a new breed of doctor with a different value system than prior generations,” Sotile says.
“The current generation of younger physicians are also much more likely than their predecessors to not have work be the primary area of concern in their lives or draw so much of their identity from medicine,” he says. “I had an older physician who heard a younger colleague talk about his desire to see his kid’s ball game say, ëI didn’t take time off to go to my kids’ ball games until my kids were too old to have ball games. What’s wrong with that?’ ”
The Sotile’s current JAMA article on medical marriage is the first of a two-part series commissioned by the American Medical Association. The next article, to be published in an upcoming issue of JAMA, will focus on women and the particular challenges residency presents them in marriage.
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