Medical Marriage Q & A

Medical Marriage Q & A

By Kim Blackham

When my husband began applying for general surgery residency programs nine years ago, the concept of Facebook hadn’t even been conceived. We were still utilizing old-school dial-up internet, and much time wasn’t spent online because we had to disconnect in order to make phone calls. The social networking and support that is available today didn’t exist when we were making this big decision.

Consequently, when I was concerned about surgery residency and wanted to get an idea of what this would look like for our family, my only option was to network in a snowball sort of way with me asking someone, who would refer me to someone else, who would in turn refer me to someone else.

After speaking with the wives of a handful of different surgeons, I was overwhelmed and terrified. All of them told me it was the worst thing they did for their marriage and family and they strongly advised against it. We tried to have faith and hope that if we made our marriage the number one priority, we could make it through, but the truth is, I was still very afraid.

We quickly learned, however, that we could make it work. We could not only survive training and a career as a surgeon, we also thrive.

As a marriage and family therapist, my passion is to see the stigma of medical marriage changed. I want to help medical couples create the relationships they’ve always wanted – right now, not at some later arbitrary point when training is over/boards are passed/they’ve adjusted to practice/kids are grown, etc.

As part of that, I will be writing a series of Medical Marriage Q & A articles that address your questions and struggles about physician relationships. I invite you to submit your Medical Marriage questions to [email protected].

How do you get household basics (like budget decisions, kid issues, etc.) talked about and agreed upon when your spouse works 14 hours a day in residency and comes home exhausted? I want to be in unity in decision-making, but it’s tough to bombard him or her with things when I know he or she is just so exhausted. Tips?

Thank you for submitting this question. It is one that most medical couples struggle with. When both of you are busy and exhausted, it can be hard to feel like you are in sync with decisions and agendas. Often, when you do finally have time to discuss these things, one or both of you may be too tired to actually make a decision, and you realize the next day that it still isn’t resolved. Try some of these suggestions this week and see if it makes your team work more effective.

Be Clear About What Support You Need

Sometimes a spouse may not realize whether you are asking for their input or if you are just giving them information. Be specific. “I need you to help me come up with a plan for Ella’s summer camps. I need to register tomorrow, so we need to make a decision together tonight.”

First Things First

It’s true; you won’t have an endless amount of time to go over lists and lists of housekeeping items. Prioritize which things to discuss and focus on those first. There are reasons why effective business meetings center around an agenda. It’s easy to get sidetracked and off topic – or worse, to go around and around something without resolving it. Try to create a short agenda with specifics to keep you on track and make your discussion more effective.

Set a Specific Time Each Week for a Planning Meeting

If the housekeeping agenda items are discussed on a weekly basis, they are less likely to pile up and become overwhelming. It will also help reduce the frustration that your spouse is never around to talk about these things. With physicians’ crazy schedules, you may not have the luxury of a set day and time that remains consistent week after week, but don’t let that deter you. Get creative and find a way to check things off each week, so they don’t become overwhelming.

Sprint or a Marathon?

Decide together if it works better to discuss them all at once or spread them out over a week. Some couples get overwhelmed when they have to make many decisions at once, while others get frustrated when the decision-making conversations come up night after night, and they don’t have any time just to enjoy each other.

Give Them a Heads Up

Prepare the doctor ahead of time rather than springing it when he or she gets home. A quick text late afternoon that says, “Hey Babe – Just a reminder we need to talk about a new vacuum when you get home. Hope you’ve had a great day,” can at least put it on the radar. It doesn’t mean it will be remembered, but at least it won’t come as a total surprise when you bring it up again.

Executive Decisions

Decide ahead of time which things qualify for an executive decision. One woman told me she was afraid to make decisions because she didn’t want her husband to feel left out. When he explained which things he was okay with her deciding, it made it easier for her to just make an executive decision and let him know about it later.

When it comes to the financial piece of executive decisions though, it may help to decide on a predetermined limit that you both are okay with the other person spending without discussing it together first.

Share Calendars

Create a sync-ing calendar in which to manage all the family events. Google calendar is wonderful for this. Each family member or topic can have a different color and can be shared and edited by those you give permission to. So, for example, if  Timmy’s schedule were blue, you could easily visualize where he needed to be at any given moment: School from 8:30-2:30, soccer from 5-6, scouts from 7-8, etc. When your partner receives his or her call schedule for the month, he or she can quickly block the time out in yellow so you know not to schedule friends for dinner on the nights the doctor will be working. Even if you are not together, you can both separately look at the schedule and have some semblance of being on the same page.


Kim Blackham is a licensed marriage and family therapist and certified emotionally focused therapist. She has extensive training in sex therapy and sexual addiction therapy and is a frequent contributor to both online and print media. As the wife of a surgeon, she is passionate about helping couples in medical marriages. She and her husband have four children ages 3-12 and live in Tampa, Florida. Visit her online at

5 thoughts on “Medical Marriage Q & A

  1. We have been married 16 years, have three kids, and have been in this medical life for 12 years. This is good advice for the business side of the marriage, but what about the more emotional side? I feel like we are business partners at best. After work, kids, finances, we have no time to actually share our thoughts and feelings (which are hard to pry out of him on a good day).

  2. We are currently in the last year of med school, and I’m wondering; what are some practical, everyday thing we can do to keep our marriage strong? Especially with intern year coming up.

  3. Hi. I am in tears tonight as I type this. After 10 + years of marriage I am so discouraged. I have been with my husband since undergrad. I have been with him through everything in medical school, residency, and now our first year in a “real job” He just continues to be more and more bitter all of the time and I don’t know why. I take care of 99% of all our house and family needs and I have never complained about his work hours. I feel like medicine has changed him through the years into a miserable person. He seems to hate life and everyone in to including me. Please let me know if you have any advice. We also have a 2 and 6 year old.

  4. L.C.- Thanks so much for your comment and for reading the blog! Many times I’ve felt like a business associate in my own marriage. Kim is going to follow up and address your comment exclusively in next week’s blog post. Stay tuned!

  5. Genuinely enjoy the time you have together and enjoy and appreciate the little things. Support each other and don’t dump too much on him. Ask how their day was, share yours and focus on each other and you’re family. Also be happy being by yourself if they’re at work. It’s not that bad. Love each other, support each other and enjoy each other when you’re together.