Surviving Medical Training…It’s a Family Affair

Julia Sotile

By Julia Sotile Orlando, MSW, LCSW

Rebecca Sotile Fallon, M.A.

Mary O. Sotile, MA, LPC

Wayne M. Sotile, Ph.D.

“My medical student (or resident) mate is so self-focused! I have sacrificed everything for his/her career, and get little in return. I am questioning whether to stay in this relationship. This is not what I signed on for!”

In one version or another, we hear this lament with painful frequency. So often, partners of medical professionals experience feelings of neglect and/or resentment toward their mate and medicine in general. It takes a special, selfless person to partner with a physician and there is no question that this is particularly true during medical training. In fact, there should be some honorary degree given to you partners who have survived the training years. Even folks with the best intentions and utmost respect for the work of their physician spouse or partner, however, need to feel cherished and acknowledged. And when these needs are not met you are absolutely entitled to feelings of frustration and perhaps even questions about the future of your relationship. We have helped countless couples navigate this challenging time. Here are some thoughts that we hope you will find helpful.

Put your trials in context. To state the obvious: medical training is extraordinarily stressful. It is easy for high performers to lose sight of this fact. Research has shown that, depending on specialty and year of training, approximately 35 to 70 percent of medical trainees suffer from anxiety, anger, disillusionment and/or burnout. How could this not affect your relationship? The fact that the training years are filled with relationship distress and challenges to intimacy and mutual satisfaction does not necessarily mean you are in a “bad” relationship; even great relationships falter in the face of extraordinary stress.

Be cautious about answering this question: “To what do I attribute this?” Stress makes narcissists of us all. It’s a sad but often observed phenomenon: as stress levels rise, people become more self-focused. Perhaps doing so is adaptive; a necessary maneuver to survive. Regardless of the reason, self-focus harms relationships. So, let’s bear in mind that the risks to a marriage/relationship in which both couple members are excessively stressed into self-focus are formidable. Add to this phenomenon any pre-existing tendencies toward either self-indulgence or relentless pursuit of career goals, and the risk of relationship distress is heightened. It makes sense then, that you might have to work a bit harder during particularly stressful times to appropriately express your own needs and to really hear and acknowledge the needs of your partner.

Delay deciding. We have found it wise to offer a bit of counter-intuitive advice to couples we counsel: if you are considering ending your relationship because of chronic conflicts and disappointment, please wait to decide until you are getting along better. We base this advice on two facts. First, research has shown that over 70 percent of couples who state that they are miserable at test point one say five years later (if they stay together) that they are glad they stuck it out; their relationship is now much improved. Secondly, we find that committing to “getting along better before deciding to leave” is likely to disrupt the tendency unhappy couples have of selectively perceiving reasons to stay miserable. Making a “cognitive shift” (as we shrinks call it!) to scanning for, harvesting, and embracing what is working well – rather than collecting reminders of how you are miserable – is a way to at least lessen the speed of your downward relationship slide. To put it simply, find reasons to be happy rather than focusing on all that is difficult. The bad stuff is apparent without you focusing on it…it can be more challenging to look for the good.

Take your risk seriously. With all this said, it is imperative to take seriously your risk. Young adulthood is a time of making life decisions that chart your life course. The sooner any couple accepts that protecting friendship, trust, and intimacy is crucial to establishing marriage health, the better. This is the work of both partners! Working together to discuss openly what is going well and what needs a little work is vital in promoting the resiliency of your relationship. And remember, there is no shame in seeking outside help when things get too difficult…everyone needs a little perspective sometimes.

Even the strongest and healthiest relationships face difficult times. But, with all due compassion, we emphasize that the medical training years create an unfair “test” of relationship health. It is our firm belief that in order for a couple to successfully navigate these challenging years, each partner must feel cherished and loved; and manage any tendencies toward excessive self-focus, regardless of the cause.

Our hopes for you:

-That you will endure these years without losing sight of why you chose one another.

-That you will work to remind each other regularly that you got together with good intentions and loving hearts that remain intact.

-That you will consider that appropriate self-care does not have to occur at the expense of belief in your relationship.

-That you will find ways to express your needs, respectively and respectfully.

-That you each will be heard, acknowledged, and responded to reasonably.

– That in this “trial by fire” you will learn to forgive each other; and

-That the importance of your relationship will remind even the most stressed and ambitious physician-in-training that there is more to life than medicine.

For more thoughts on how to identify and address narcissistic behavior in relationships please read “The Resilient Physician Newsletter” or visit our website at

The Sotiles are founders of the Center for Physician Resilience, in Davidson, North Carolina, an organization committed to fostering resilience for physicians, medical families, and medical organizations. Over 10,000 physicians and medical families have engaged in their unique, time-intensive coaching/counseling process. They also speak internationally and provide consultation to medical organizations. For more information, visit them at



2 thoughts on “Surviving Medical Training…It’s a Family Affair

  1. Such an important article… they should hand this out to all new interns (or maybe even 3rd year medical students). Thank you – will share.

  2. Thank you for being candid about the fact that we spouses of physicians/physicians-in-training can feel neglected and resentful. This is the first time I have heard someone say it out loud. My husband was in training for 11 years, and is now 1 1/2 years in practice. We have three kids all born during those training years. It was hard in training and continues to be hard.