Experiencing Residency as a Young Couple: Frances Mei & Colin’s Story

Today we’re going to talk about relationships in residency. It’s not easy to be the partner of a physician

Dr. Frances Mei Hardin: Today we’re going to talk about relationships in residency. While our journey is specific to us, there are a lot of things that helped us navigate residency as a team. It’s not easy to be the partner of a physician, let alone that of a resident. Colin could honestly write the book on doing it with aplomb. I cannot imagine how difficult it is for a partner to support a resident who is struggling. And there are so many things that Colin did to make my life manageable during training and beyond. We just want to share some of our story and things that we learned and what worked for us. Thanks for coming on today, Colin.

Colin Royal: Yeah, excited to be back on.

Colin and I met when I was a fourth year medical student at Vanderbilt

Dr. Frances Mei Hardin: So just to start with the story of how we met. we met when I was a fourth year medical student doing an ENT away rotation at Vanderbilt in Nashville. And Colin had moved from Boston to Nashville, a couple years before that. Post grad.

Colin Royal: Yeah. And, what she usually does not mention in the story of how we met is that she did not initially tell me that she didn’t live in Nashville. we met and I just assumed she was like full time working at Vanderbilt, living in Nashville. did not know that until our second date.

Dr. Frances Mei Hardin: Yeah, I mean, it’s classified information, like why I don’t have to tell somebody on a first date where I live or don’t live, you know?

Colin Royal: that’s true, but that’s like a classic Nashville thing. Everyone’s always coming in, visiting. Hard to tell who actually lives here. It didn’t matter though.

Dr. Frances Mei Hardin: Yes. So I guess in a sense, I catfished you. But, yeah, we matched on Bumble. Our first date was at Jed’s sports bar in Nashville, just like a Wednesday evening. And, yes, you know, on the first date, like I said, I did not typically. I mean, I would barely even tell people I was a medical student. Like, that wasn’t a huge boon for people in the dating world at the time. On our second date, Colin told me, you know, oh, I really like you. And in response, I was like, oh, I don’t live here, I don’t go here. And so then I kind of had to fess up to the whole, you know, visiting medical student gambit. But that being said, you know, we kind of hung out for a week. I went to Sacramento to do my last rotation at UC Davis and I didn’t have any, like, immediate rotations or any plans after that time. So I actually flew back from Sacramento to Nashville and, you know, we really, continued dating at that time. But yeah, those were the crazy early days. What I do like to say about it is that, you know, Colin did the regular cool guy move, which is that right before I left, he was like, well, you’re going to Sacramento for a month. Like, you know, we’ll see how it goes. Like, I’m pretty busy. We may not talk every day. You know, we’ll just see what amount we talk or what I can fit my schedule. And I was like, yeah, okay, man, sounds good. Bye. Got on a plane every morning at like 06:00 a.m. Sacramento time. You know, he was texting me, like, a new song or a new thought. And, yeah, so it’s been great. We’ve. We’ve been shooting the shit for eight years together now. And, you know, what was crazy about that first year was that I was, you know, going through the ENT interview and match process. one relationship to finding fork in the road was when, in November of that year, I got wait listed at Vanderbilt. And so, you know, I. I told them the news kind of thinking, well, this will. This might just be the end of it, you know, because we had been hoping, obviously, like, to continue dating and stuff like that. But once I realized, well, my, the likelihood of, that I’ll be in Nashville is much lower, you know, I just kind of was like, okay, well, this is it. And Colin was like, no worries at all. He was like, you know, I’ll move with you wherever, wherever you match at, like, whatever we’re going to do. And so obviously that meant a lot. Like, that was pretty early into dating, but it just, like, it was very different from what I’ve experienced before in dating. And not. Not only that, but just even, like, as a physician, you spend your whole life being, like, very career achievement oriented and maybe your family rewards achievement and things like that. And so it just meant a lot, for Colin to kind of validate. He was like, I have no worries about you getting wait listed at Vanderbilt or anything. Like, you know, wherever, wherever you end up going, I’ll move with you there. And I really do think that, yeah, that’s probably one of those early on scenarios that, like, showed his commitment to a serious relationship and also what kind of partner he would be, you know, showed his character for the long term. So what happened was then in March, you know, we did the match process and figured out where we were going in the midwest. And like, two weeks later, we signed a lease site unseen, near the hospital. And so, you know, that was six months into dating that we signed that first lease together, right?

Colin Royal: Yeah, that was, that was pretty crazy. I remember, like, going through the process, I was kept sneaking out at work. We had to, like, call, you know, the, the lenders and do credit checks and everything and. Yeah, I mean, I think we saw, like, three pictures of it and just had to jump on it, basically. We didn’t, like, we weren’t going to get up there for two months or something, so we didn’t really have much of a choice.

Dr. Frances Mei Hardin: Yeah, that was the first time that we would, you know, sign a lease sight unseen. But then I think we bought, you know, multiple houses. We bought this house sight unseen. The market kind of went berserk after that, but, you know, it was just pretty crazy. And when I look back, I mean, I. I get how the optics of that look. And what’s so funny is that right before I graduated, one of the attendings just told me in the or, like, pretty off handed. They were like, oh, I did not think you and Colin were gonna make it. Like, we showed up brand new, you know, much less than a year into dating, maybe like eight, nine months into dating. We were like, yeah, whatever. We moved here together. we adopted our cat, a Maine coon named Adley, that first summer. So, you know, again, we’d been together ten months when we got her. And, you can. Well, people can’t see, so I’m not going to point out beignet. But, you know, it was pretty funny because I think that at the time, a lot of people at the hospital and things like that kind of question people moving to news place together so early on. But I actually do think that residency and kind of the trials and tribulations of all of that did bring us closer together.

Colin Royal: Yeah, I’d agree. And, you know, I actually still have the, voicemail. When you called me and said that we got the house in Columbia, that’s, like, probably one of the oldest things that I still have for most together. But, yeah, I mean, I see a lot of threads and stuff about this online, especially around match week, that time people are always asking about, how did you navigate matching into a city that you weren’t expecting? I have a career here. We have family here. What’s the plan? And I don’t think I did this intentionally at the time in terms of saying, oh, we’ll just move wherever you end up. That’s just legitimately how I felt. honestly, I didn’t even know that much about the process and kind of what was going to happen. But looking back, like, I do think that’s probably pretty critical. Like, if you’re in a relationship about to go into that process, I think you have to have it pretty laid out that, like, no matter what, we’re either moving together or you have to say, like, okay, if you’re in this city, we’ll be together. If not, then it’s long distance. I mean, yeah, I think you just have to have that hashed out or else you’re just going to get. I mean, the process is insane, and there’s really no way to control where you end up. So, you know, almost making that decision before it happens is probably going to set you up, like, a lot better in the long run.

Dr. Frances Mei Hardin: Oh, totally agree. Because I can imagine, you know, if people aren’t doing that, like, that would be kind of heartbreaking for it to be like, oh, you matched in a cool city.

Collins: Having your goals aligned beforehand can help a lot

I will come with you, you know, or, like, oh, you matched in some random town. I don’t want to live in, like, just not coming, you know? I agree that having your goals aligned beforehand and having those, like, full conversations would help a lot. and we will talk a little bit about that actually, later in the episode as well. But one thing that I will say from, like, the resident perspective, and Collins not a physician, he was not a resident. So he did have a lot more mobility in the digital marketing world and everything like that. But we were often advised as new residents, if you had a partner moving with you who was non hospital or, you know, even if they work in a hospital, we were advised that it would be okay to reach out to, like, the residency coordinator to ask, hey, do you know of, like, any jobs or any recommendations for people to connect with, like, in this totally brand new town for this person who’s looking for a job. And we did do that, you know, and talked to the department briefly, and there was very little support from the place that I trained at. And that was not unique to me because I know that there were other resident physicians who also, like, really, even more stringently than in our case, but they were very long term couples, even married at times where their partners needed jobs. And our department and its members were just generally, like, you know, not willing to or able to provide any connection or networking or guidance from that standpoint. But I think that’s a little bit institution dependent.

Colin Royal: Yeah, it’s a tough thing to do, obviously, because, like, you know, just so many different types of jobs that people would be looking for. And, you know, I was working in the publishing industry down in Nashville. Like, I’d been basically doing that since I graduated. There’s not a publishing industry, you know, in Missouri. So that was a little tough. And I knew that I wasn’t gonna be able to find sort of a one to one job. I think they connected me with like the, one of their, like, mortgage lenders that they had worked with who was just kind of a guy about town who, like, knew people. And that was it. I talked to him and he was like, oh, I, you know, I’ll maybe connect you with someone. And I had like, one phone call and that kind of went nowhere. You would think it’d actually be relatively easy, especially where we were. I mean, it’s like a, you know, it’s a fairly tight knit community around there. I’m sure people could, like, relatively easy, easily place a call or two and, you know, help out spouses or people moving there to at least get some interviews. I mean, obviously you can’t guarantee a job, but, that was a little bit of a hectic time there because I knew I was going to have to quit my job. I, mean, this was before remote work even kind of existed. Now, I mean, it’d be much easier for me, but obviously a lot of people don’t, you know, have that opportunity anyway, so.

Dr. Frances Mei Hardin: Yeah, but I’ve definitely, I mean, I have friends who have chairs where they just personally, you know, were willing to make phone calls or help connect people or just, you know, give a gentle recommendation or kind of explain the situation and help network. So hopefully when people do have that type of, like, resource and support available that, you know, they’re, they’re able to use it. Yeah.

Colin Royal: And I, think for like, partners of residents, like, especially if you’re fairly young. I mean, I was, what, 26, 27? You were 24, 25. I think you got to be pretty realistic. unless you’re able to match into your hometown and you don’t have to move anywhere if you’re going to move to a brand new city. I basically just restart it. I ended what I was doing and I literally got onto Google maps and just scanned every street with all the businesses in town and just kind of cold email and called people. And I ended up finding a guy who sort of not even really a friend of a friend, but he knew a guy that I went to college with and he had started a business and ended up having a good interview with him and working for him. But I just think, unfortunately, you do have to take a backseat in a lot of cases. just knowing that there’s no flexibility around residency and this is what you’ve got, you’ve matched in a certain spot and hopefully, yeah, you can take your job on the road or work remote or whatever it is. but it’s pretty likely that you’re going to have to either restart or drop down a level or find something new that wasn’t quite in line with what you were expecting, maybe in your own career path. But, you know, at least for me, I mean, I think it was well worth it. I was also looking for something that could give me flexibility, like moving forward. knowing that, you know, you were going to be working all these crazy hours, I was going to have to help out a lot more and that we would be moving eventually. Like, we probably wouldn’t stay there. So, trying to start like a long term career, even in one spot doesn’t even really make sense from that standpoint.

Dr. Frances Mei Hardin: Yeah. So, you know, I know you did start over in digital marketing, but kind of like gained a totally new skill set, which then did translate into, you know, like, multiple kind of successful job moves down the road.

Colin Royal: Worked out very well, obviously. I think I got pretty lucky with it, but, yeah, I mean, it’s a, it’s a tough reality. Just knowing that, like, you know, kind of any way you spin it, you’re going to take a backseat a little bit. A little bit, at least from a career standpoint. and depending on how long the residency or, you know, what the prospects afterwards are going to be, you know, that might continue moving forward. So you definitely have to be pretty realistic going into it.

Edway says people need to look for jobs in smaller towns when moving

Dr. Frances Mei Hardin: Yeah, I mean, so what advice would you have for somebody who is going to move to a totally new spot with their partner who’s a resident and, you know, that they do need to look for jobs, like in smaller towns. Is Google maps a good way to just legitimately scour?

Colin Royal: I mean, you know, that, that was a little bit of my, my last resort. The problem is, you know, you don’t match until March and then you gotta move there in July. So it’s like a very tight window. I mean, you got a couple months, basically, to figure it out. I don’t think I landed that job till maybe end of may or something. So I was kind of coming down to the wire in terms of, like, what I was going to end up doing there. But, yeah, I mean, I went through kind of all the job boards I had applied for, everything that was available kind of within my skillset, and I got a few interviews and it just kind of didn’t go anywhere. so that’s when I just resorted to literally reaching out directly to people. And, you know, that’s such, like a kind of boomer advice at this point, right? Just like, put on your best suit, walk in there and ask for a job. it literally did work for me, though. So, I don’t know, they might be out.

Dr. Frances Mei Hardin: Yeah, it was a small town. It was a small town and, like, it was, you know, like Colin said, it was pre remote work. Like, I think your job search would have looked different today, but, yeah, yeah.

Colin Royal: I mean, I think, I guess the difference probably in what I. When I was initially applying to jobs, I just was kind of putting my resume out there for a ton of different stuff. and I was like, I’ll kind of take whatever. And then once that didn’t work, I really honed in and I said, okay, this is what I want to do. And, and there are a limited amount of companies in this place that we’re going to that, that do that. And so I need to make, like, really specific personalized pitches, like, to those. And I think that’s kind of ultimately the difference. what happened there is, like, I just. And, you know, frankly, I was willing to work for not that much money. Like, we were moving to a smallish town. Cost of living was pretty low. And, you know, we, we didn’t have any kids. We, didn’t even have pets at that point. So, like, there wasn’t much in terms of expenses I was worried about. so I definitely took a pay cut just to do that. for me, it was worth it because I was going to be kind of learning a new skill set, something that was going to be very transferable in the future. In that sense, it was worth it to take the cut and try something new. and I think that’s kind of what you’re going to have to make the decision on. Like, do you want to try and find something along the same lines you’ve been doing that maybe isn’t as good of a job or it’s going to kind of stagnate your career, or this might be a good time to hit the reset button and say, you know what? I’ve just been working whatever job for five, six, seven years out of college because that’s what I, my first job was. And is that really what I want to do forever? Or is this an opportunity to kind of step back and, you know, try something new.

Dr. Frances Mei Hardin: Yeah, absolutely. Well, in terms of how things went from there, like, intern year was a blur. You know, we spend six months on ent and then six months off, you know, going through other rotations the year we, you know, it honestly, like, it went pretty smoothly. Yeah, it was busy. We had a new kitten at home. That’s Edley, the Maine coon. But, you know, it went still pretty well. Very minimal drama or anything. But when I became a second year resident, multiple kind of crazy things happened at once. Which number one, for Ent, when you become a second year, then you start taking junior call. And we were home call, but it was definitely a busy home call. and not only that, but we were taking airway emergency calls. So even as a brand new second year resident, you could be called, to the ICU, to the emergency room, wherever, for a very acute airway. And so the learning curve on now suddenly taking junior call, that. That is a, ah, very steep one. And also, it’s just a big lifestyle transition because we never took much call as an intern. Definitely no real call. A little bit of buddy call, things like that. But, yeah. So now your primary call. so you’re not getting much sleep, because your primary call, like, you know, at least one night a week, and the night that you’re on, you don’t get much sleep.

We got our puppy, Beignet, in July of intern year

Additionally, we did something really crazy, which is that we got our puppy, Beignet, the goldendoodle. If you are watching us on YouTube, you can see that beignet is calmly passed out in the corner of my office behind me. he is a very chill guy. Oh, he’s up. Oh, he heard his name. Okay. he’s a chill guy, but he was not a chill puppy. And so, of course, like, that’s pretty normal for puppyhood, but it really. I remember that summer very well because, you know, I was taking call. The couple nights I wasn’t on call, we had a puppy crying in our bedroom. And so kind of dealing with all that was a lot. And then also, one of our chief residents was kind of an enormous bully, and it created a lot of strife at work that wasn’t even really, like, targeted at me, not even personal at me, but just kind of across the board, strained relations between a lot of the residents, you know, attendings in residence, et cetera. So that was a crazy year. I do feel like that’s kind of when things took a turn.

Colin Royal: Getting beignet was. Was kind of wild. I mean, I remember going into it, so we got Edley pretty quickly, and.

Dr. Frances Mei Hardin: That was, like, it was July of intern year.

Colin Royal: Yeah. And, which was, like, almost immediately, that was like, okay, we’re gonna get a pet. We’re gonna try it out. And Edley, you know, as a Maine coon, basically acts like a dog. she used to play fetch with us as, like, a kitten. I mean, she’s. She’s crazy. She’s super talkative now. but I remember the plan was you were gonna have, like, a month or two of research your third year, and that was when we were going to get a dog. And so you were going to have, you know, a month or two to spend at home with the new puppy, and that was, like, the big plan. and then all of a sudden, you found. You sent me a picture. We just ended up getting him, like, immediately, way ahead of schedule. And, yeah, he’s a very anxious guy. He was. At least he still kind of is. But, and we had a dog next, like, our next door neighbor had that little yappy dog who would just bark, like, all night and keep beignet up. That was pretty rough. That was a tough timing to, like, start your junior call with, like, a new puppy who, like, couldn’t sleep through the night. I think you had some. Some rough nights at the beginning there.

Dr. Frances Mei Hardin: Yeah, but we, you know, just in terms of. But, you know, I would not do anything differently, like, in terms of, you know, would I not get a puppy at that same time, knowing everything that happened? I would not, because beignet is the best, and he would go on to, like, saved my life a couple times during residency. So, like, you know, shout out to beignet, and I would not do anything differently from that standpoint in terms of how we adjusted, though. Like, definitely. I mean, Colin and I, always kind of stayed in sync. Like, we were on the same schedule. We were going to bed really early together because he would get up with me in the morning. Like, there were not situations where I was getting up at, ah, four or 05:00 a.m. To go round and, you know, he would just stay asleep or that he was staying up way later than me, you know, where we had different sleep schedules or anything like that.

Colin Royal: Yeah, that was probably the biggest adjustment. I mean, honestly, I’ve always been kind of an early night guy, you know, especially during the week. Like, if I’m not, I wasn’t going out, when I was younger. Like, I was probably in sleep by, you know, ten at the latest anyway. But, yeah, I mean, we were like getting ready for bed at 08:00 and then. Yeah, up at 435, whatever it was, which of course then trained Edley and benier to get up that early. So then that just became our schedule. Like, no matter what, very hard to sleep in on weekends after that. But yeah, I mean, you know, realistically, like, we just had to cut out a lot of stuff. Right? Like, I stopped watching sports for a long time, basically because games will start at 7730 and maybe catch a few minutes of it and go to sleep. which was fine. I mean, I’m. This is like a relatively easy sacrifice, obviously. but it is, it is what happens. I mean, you just have to really change your lifestyle in a lot of ways. We, if we were going to go out to dinner, we were going to go out and do something. I mean, it was like, if we don’t get out of the house by 06:00 530, we’re done. Like, we’re not. We never ate dinner past like 510.

Dr. Frances Mei Hardin: Yeah, I won’t.

Colin Royal: Out of time.

Dr. Frances Mei Hardin: Yeah, yeah, as a resident, I definitely wouldn’t, but, you know, just in terms of one of the things that really did help, though, and, like, it really started that year. So as a second year when I did have consults, like in the middle of the night or we also had the 02:00 a.m. Flap check, you know, that’s an ent juniors task. Colin would typically drive me in for all of those. And, you know, I mean, that’s going way above and beyond the call, but I will say that it really made it feel like we were a team. And also, I mean, it made it much more enjoyable. I mean, still not very enjoyable, but in terms of like, you know, being miserable, driving around alone at night, maybe falling asleep at the wheel too, you know, I. I actually had like, a true partner and buddy and also, like a safer driver who wasn’t as sleep deprived.

Colin Royal: Yeah. I mean, more than anything, I think it was just dangerous for you to be driving back and forth. And sadly, I mean, that’s what most people do. Most residents are just driving themselves back and forth, just like completely out of it. Getting woken up all of a sudden. You got to hop in the car, throw your scrubs on, drive in at 230 in the morning, and then you might be there all night and then just have to round again in the morning.

Dr. Frances Mei Hardin: Oh, I see.

Colin Royal: Any news here? But it’s pretty wild.

Dr. Frances Mei Hardin: Yeah. And I think that, you know, just, we could talk all day about the transitions during training.

When we started fourth year senior call, things got busier

But the transition to senior call, that was the next like really big crazy one. before we get into relationship tips here, just to kind of share anecdotally, like when we started fourth year senior call that ran Friday morning at 07:00 a.m. Until the next Friday morning at 07:00 a.m. And so it could be okay because you know, your second call, you’re the senior, you’re not the, the junior or first call. So we weren’t getting phone calls anymore that were like nurses asking for Tylenol for a floor patient, but we were getting all the outside hospital calls and also all of the patient and patient family member phone calls. So still kind of a lot of ancillary, phone activity. you know, sometimes like somebody calling in at one or 02:00 a.m. And you can like hear the party in the background and they’d be like, can we have more narcotics? Can we have more oxycodone? And you’d just be like, oh, no, sorry. And they just hang up, you know, but that, that’s a wake up. Like, that’s a sleep interruption. And anyway, the first couple times that I took senior call that last Friday morning when I was driving to work, like day seven, kind of not much sleep for seven days in a row. Being on twenty four seven, I backed up into our car garage while it was still the process of opening. So it was like half open and I just, you know, was totally discombobulated, like probably pretty much asleep and just would back up into it, which that really puts a dent, in the garage door. That’s probably worse than if you just backed up into it and it’s just like closed the whole time. But Colin was nice about it. I did that twice. Two separate times where it got fixed in between.

Colin Royal: Yeah. One of them was like during, I don’t know if it was during like sort of the height of COVID but it was during the first whatever, six months of COVID or something. And we couldn’t get a garage door. It was during all these kind of supply chain issue stuff. I mean, we just had a broken garage door for over a month or something. I remember that. Like we couldn’t, they had to ship one in from several states away. It was a crazy process, but yeah, I mean, it just shows how insane that whole. I mean, seven days on is just wild. And it always was. It was the last Friday morning. It was like, we’re done. Like you’re finally done with call. Like just gotta survive the day. And then boom, you’d come back in, you’d be like, hey, I think I hit the garage door again.

Dr. Frances Mei Hardin: Yeah, I love that. I would be like, hey, I think I hit it. It’s like, you know, sitting at 45 degree angle. It’s like hanging off the garage. Yeah. Yeah. Well, that’s me trying to do like a gentle spin zone, I guess. But anyway, you know, now we did want to kind of delve into basically just kind concrete relationship tips. Like, not saying we’re experts, but there are a couple things that, like, really helped a lot. Especially again, as things got busier, you know, by third year, for sure, by fourth year, senior call, all the administrative duties and also just like much greater operative responsibility and clinical responsibility that comes with being a senior. But one, thing that helped a lot. I mean, I don’t even remember where I first read or heard this, but it basically just said this idea where to change gears, that when you leave work, you know, so I would leave the hospital, I would call Colin immediately. I had about a ten to 13 minutes commute home and I would just let it all out. I’d just recap the day. I’d be like, here are the six beefs that I have from today. And when I arrived home, the policy was like, I pull into the garage, I get out of the car, that phone call ends. That was it. That that was the time that I had to recap the day, vent about the day. and what was really nice is then that there was no more. Then there was a moratorium on work talk. And, like, honestly, the moratorium on work talk was probably one of the best things that we ever, ever did for our relationship.

Colin Royal: Yeah, I mean, that basically stemmed from before. Then it was, you would come home, you’d be exhausted, you would kind of vent about what was going on. Maybe you get a consult or you get texts from someone. I mean, that’s the thing. I think what I didn’t know about residency was just the sheer amount of non. Like, when you’re not in the hospital, you’re still just going to get tons of stuff coming in your way. Like, you were just getting texts and calls constantly, even if you weren’t on call, just someone else, you know, another resident saying, hey, did you see this person? I was going to put this order in, like, just constant check in stuff or scheduling or, you know, studying for exams or whatever. I mean, there’s just. You rarely get a chance to just come home and kind of unwind you. Like, you can never turn your phone off, basically. so then, you know, when you were coming home, spending, you know, 20, 30, 40 minutes talking about the hospital, whatever, wed eat dinner, youd be exhausted youd kind of tune out, put on a show or something, and then it was, like, time to go to bed. And then we kind of realized, hey, this is just happening a lot where, like, youre just so wound up the entire time that youre home. And, I think youre basically trying to dissociate more than just, okay, lets get away from the hospital, use home, beignet, Edley, the whole crew as like, your kind of place to recenter. And it, I mean, it worked, right? Because, yeah, you had what, like maybe ten minute drive home top, depending which hospital you’re coming from. But that was, like, the perfect time because you usually got out after me. So I was usually home. I was, you know, walking beignet or whatever. And so, yeah, it was like the second you pulled it in the garage, you know, shut it down, and then that’s it. Like, now we, we kind of live our home life and, you know, try to get you to actually enjoy the small amount of time that you have outside of the hospital.

Dr. Frances Mei Hardin: Yeah, the work moratorium talk really just did help me more than anything, because then there’d even be times, like, if it’s a gorgeous weekend and, you know, we’re, we’re on a walk with our dog, like, the intrusive thoughts would want to come at times. And, you know, by just literally, you know, myself cutting myself off or Colin being like, hey, work moratorium. Like, then it would just be shut down. And I definitely found that, like, once I started identifying that and honoring that, like, you know, there’s all these things like what you feed grows, you know, and so by just not engaging in, like, perseveration about work, it helped a lot to just truly be less bothered by work. One quote that I really love that this kind of all, you know, makes me think of is this. I realized I spoke more passionately about the things that upset me more than the things that brought me peace and happiness. I don’t want to be the kind of person who obsesses over their pain. I’m learning how to change the conversation and redirect that energy creatively.

Colin Royal: Yeah, I remember you saying, that at some point. I’ve definitely heard that before. It is something that I think you had to work on because, like you said, there were just so many things to deal with in residency that, yeah, we could spend an entire weekend just dissecting it. And sometimes it’s hard because, you know, you want to have constructive conversations about it. And, you know, we really had to watch ourselves from, like, okay, this. This is purposeful, and we’re sort of talking strategy and actual ways to deal with this stuff versus just complaining or really kind of digging in and feeling bad about it. And honestly, even sometimes, we were having constructive conversations, and then we’d realize, hey, we’ve been talking about this for, like, an hour, and I just want to enjoy the nice day. We got to just pretend the hospital doesn’t exist.

Dr. Frances Mei Hardin: Yeah. Which sounds like a totally impossible feat at first, but it’s something that can be practiced and ultimately achieved.

Okay, so to go on to this last big topic, relationship contracts

Okay, so to go on to this last big topic, relationship contracts. I don’t know if you guys have heard about these or not, but, you know, there’s a big. A huge time article from 2019 on relationship contracts. We’ll link it in the notes for you and everything. But basically, when I learned about this, like, kind of, you know, midway through residency, I was like, whoa, this is pretty cool. Like, we should give this a shot. And, you know, just kind of for broader context. Colin and I, we got engaged second year. We actually had our initial wedding booked for the first weekend of April 2020. So we were one of the first COVID wedding cancellations. And when that call was made, you know, the global pandemic was announced, like, two weeks before the wedding. We had no food in the house. The fridge was filled with the juice cleanse. You know, I was, like, going crazy doing final preparations for the wedding. But, of course, I’d been watching the news, and I’d been telling Colin, hey, like, this is looking pretty bad. Hey, our New Orleans destination wedding looks like, kind of one of the first epicenters here. And, you know, all this stuff, but, you know, of course, yes. So we. Absolutely. We canceled once the pandemic was announced, and I bought, like, two birthday cakes, three pizzas. We threw out all the juice. We just, you know, from that standpoint, we partied a little bit. Not from the global pandemic standpoint, but, Okay, regardless, we ended up then eloping that fall of 2020 in Malibu, just the two of us. And the New Orleans wedding ended up, you know, rescheduled for a year and a half later. So when I was chief, we had our big New Orleans, party with friends and family, and it was. It was great. So I say all this context just to paint the picture. Like, you know, we were. We were together together. Like, we were very committed. You know, we were engaged for most of residency and things like that. So anyone who is engaging in a long term committed relationship, I definitely think benefits from, these types of, like, relationship contracts. But basically, these contracts are not designed to, like, tackle a specific challenge, but instead, they can help couples map out and agree on what really matters to them long term. And having an explicit agreement makes it easier for couples to navigate the many transitions that they face across their working lives together. you know, so you can create a roadmap for how to face unexpected challenges now. And that way, when they arise, you’re prepared for them. And this really, like, directly links back to what Colin was talking about in terms of. Of before the match. Just talking about, well, what is our plan going to be? What if we match at the spot we want to? What if we end up in an unexpected city? Like, am I good with going to any of these cities on your 20 city list? You know, things like that. Couple contracting involves in depth discussion of three areas, values, boundaries, and fears. And so values, of course, that you can sit down and discuss include, like, what makes you happy or proud, what gives you satisfaction, and what is your definition of a good life under boundaries. The types of questions that they discuss are, what lines are you unwilling to cross? And are there any certain geographic locations you could not stomach moving to? Are, there geographic locations you would not be willing to leave? And how many hours would your partner have to work each week for your life together to be unmanageable? And so what I also really loved about, like, this whole concept of relationship contract is, of course, you can meet on the timeline that works for you, too, independently. I’ve certainly read about, different ones that are every six months or quarterly, everything that can be included in the contract can range from bigger picture stuff, like financial freedom, the decision to have kids, all the way down to minutiae. Like, how is the housework distributed? Who is responsible for cooking? Who does the vacuuming? what’s cool about contracts is that they do provide a built in occasion to sit down with your partner and talk about what is or isn’t working without feeling like, you know, you’re nagging or without. It also kind of is a nice way to avoid catching somebody when they’re not in the right headspace. You know, like, all of us have moments where we’re probably, like, less able to or, willing to receive feedback, of course. Whereas if this is just a regular, like, quarterly event, hey, this is our check in okay, we’re gonna, like, react, read our contracts, make any addendums necessary, you know, like, update any sections necessary. another thing that I really enjoyed implementing was this thought where. Okay, so instead of just, like, you know, nitpicking day by day or nagging somebody about something day by day, instead, if you just notice something that bothers you, like, mostly, I mean, I’ll use examples of stuff I do that is bothersome, which is, like, leave, you know, cups near the sink, but not, like, put them in the dishwasher. But instead of just kind of, like, every day being like, hey, you know, please do this instead. It can go onto the agenda for the next relationship check in, at which point it can be kind of, like, discussed in this very, you know, two way manner, and then maybe even put into the contract.

One way of thinking that I really enjoyed reading about was just, um. It was long op ed on divorce after the fact

One way of thinking that I really enjoyed reading about was just, It was this perspective. It was a long op ed, on divorce after the fact. And what the person had kind of, reflected on is that he was like, you know, my wife did always ask me to put the dishes, like, in the dishwasher, not just leave them in the sink. I really never thought it was a big deal. Like, she was just freaking out about it. It always seemed to, like, matter hugely to her. I kept being like, you know, who cares? And in this. In this reflection, he was like, you know what I didn’t realize the whole time is that it was meaningful and a big deal to her. So I wish I’d done it. Like, just because, you know, and I can definitely relate to that because there are things that you just think, well, this isn’t that big of a deal, and it definitely doesn’t bother me, but it’s a great reminder just that, like, if something does bother your partner, I mean, treating that with very substantial weight is part of the key to, you know, a healthy, long term relationship.

Colin Royal: This was definitely pretty important. I feel like this was, a nice turning point in a way, because, you know, after junior call, I mean, it goes on for two years. You’re just exhausted by the end of this. Like, I feel like every day became just, let’s get through that day. And then we were just waiting for that one weekend day that you might have off. and when we finally got free time, it was, well, we got to have fun. We got to do something, enjoy ourselves, and we just never really carved out time for these types of conversations. and it definitely let stuff linger, and it was usually little stuff like that. It was like, please don’t leave the laundry unfolded after it’s dried. Just seemingly small things that can just irritate you and especially when you’re under the amount of stress that you were under. We just tried to eliminate as many of those things as possible or at least have an open discussion about why things are happening and what sort of are the trade offs for it. I think that idea of, rather than kind of nitpicking or criticizing in the moment, but I remember we used to just sort of keep running lists. I just had a list in my phone, and it’s just like a grievances list in a way. but the idea was I would just write it down kind of without any context. And I would just say, I don’t even know, like, whatever. Didn’t pick up beignets toys or something. And then if we had something scheduled, like our relationship dinner or whatever, it was two months down the line the day before, I would look at that list, and usually half the time I’d be like, I have no idea what this is. Obviously, it’s not that big a deal. I was just frustrated in the moment, or it was something I found irritating and wanted to air some grievances about. But, okay, now, looking back at my list, there are two, three things I actually want to discuss, and we can kind of have a. Yeah, basically, I think this was written by a lawyer or something, right? Where, you know, and that’s. That’s sort of the structure we use. It was like, okay, I’m going to present my initial arguments, and then we’re going to kind of go back and forth and determine, you know, a way that we can, sort of both win in this situation. Right? Like, do we actually need to do this? And in often cases, you know, for example, like, we. You were always trying to get fresh fruit and, you know, have water bottles on hand and stuff like that. And I, you know, didn’t always have time to run out to the store or frankly, I was just, you know, tired and kind of didn’t want to cook or something that night. and so, you know, an easy compromise at times was, okay, let’s try out, like, a meal service. We get things delivered to us. It’s an easy, you know, 1520 minutes thing, and it’s only two or three times a week, so it’s sort of more like an event. and it saves having to go to the store, get fresh fruit or whatever it’s going to be, and it’s just like an easy compromise, and it’s kind of a win win. And without intentionally setting that out and kind of working through the issue, I don’t know that we would have come to that. It would have just been more kind of sniping.

Dr. Frances Mei Hardin: Absolutely. I know my grievances list. It doesn’t make any sense. I can’t make heads or tails of it. So then by the time that negotiations roll around, I’m just like, honestly, things are pretty good. Like, if I. If I cannot remember, you know, what my issue with x item was, then it obviously was not that big of an issue.

Colin Royal: The grievances stuff. Sure. Like that. That’s kind of an easy thing to point out. But realistically, I think what gets solved with this is the true, like, bigger issue. Not even issues, necessarily, but just, the bigger topics or long term decisions and things that can easily get put off. You know, you are a pretty direct person, and you generally will express, you know, what you want. I’m not really like that. I’m more, vibey, I guess. And so it’s easy to just kind of, like, coast through, and I’m more of the mindset, you know, case. right. But in this way, it sort of forces us to both come together and, like, have real talks about what our future is going to look like. Where do we want to move? What type of job do you want to take? That was a big thing, right? Like, do you want to do a fellowship? Do you want to stay in academics? Do you want to do private practice? Where do we want to live? Where do you want to interview? And, you know, I think without us coming together, you know, taking the time to really examine all those things, you kind of laid out. Right. Like, what are the values that we have? Like, what are the boundaries and sort of fears? Like, how can we plan for these things? in a way that both kind of satisfies what we’re looking for and then doesn’t leave anyone blindsided. And also, you have a really good understanding of the thought process that each of you are going through, so that even if you’re upset about it or it’s not the way that you wanted it to, you understand how you got there as opposed to now something happened and you haven’t had these kind of foundational conversations behind it.

Dr. Frances Mei Hardin: Yeah. And I think a very practical takeaway for any physicians, you know, residents, is the geographic location piece, because you’d hate to, you know, be tied to a job now in a different geographic location, and you learn that your partner has no intention of ever leaving, you know, the West coast. Like, that’s something that should just kind of be, well, hashed out and on the books ahead of time. Because even in the, like, non healthcare industry versions of this, I’ve read about, you know, just like, two people who are in a corporate power couple. You know, they both work. One person gets the job offer of their dreams, and when they bring it to their partner and they say, hey, this is where we’d have to relocate to that person is just not open to it because they are not open to that geographic location or, part of the world. And so those are great conversations to just have. And, of course, help you have a better understanding of the other person as well.

I think you could teach a class on partner residency

Thank you so much for joining me today, Colin. I really do think that you could teach a class on how to be the partner of a resident physician.

Colin Royal: Well, I definitely, put in plenty of time for it, so I feel like I got my own, you know, five year degree, 10,000 hours.

Dr. Frances Mei Hardin: Yeah, no, you. You are, like, legitimately an expert, I think. Follow me on Instagram at Francesmay, MD, and rethinkingresidency. Visit my website, rethinkingresidency.com, to learn more about resident physician stories and ways that residents can most effectively navigate the game of residency. I cannot wait to connect with you on the next episode of Promising Young Surgeon.