There was a time when I couldn’t IMAGINE sitting where we are today. Orthopedic Surgery training…all of it…takes for-freaking-ever. No, but literally about 33 years. Intense ones. Insane ones. In case you wanna read about it, it’s all HERE. And then…one day…

It was over.

He was done.

And our family took a collective deep breath, and looked ahead at this new world that awaited us.

One without the same pressures. One with a little more scheduling flexibility. One with more financial stability. One without STEP exams on Orthopedic In-Training Exams. One without stressful research.

I don’t know what the experiences are like for other families. But from my perspective, 1 year out of training, looks a lot, LOT different from one year ago. So if you’re in a medical fam and are wondering what to expect following the nonsense that is medical training…stick with me here. You’ll hear about it from both my side of the story (as the wifey), as well as my handsome husband’s. If you’re not on a medical journey, fear not! You are invited, too, of course!!!! XO!

Before we get started, you need to know that our experience has been shaped by a couple of things. 1. My husband did two fellowships (one in trauma and one in joints replacements), and 2. He works in Private Practice with a group of 10-15 other surgeons. Academic life, versus private practice life, is sure to look much, much different one year out of fellowship (and yes, this is one of the reasons my husband ended up choosing the private path after much deliberation).

Okay, let’s dissect this from a variety of factors here:

Schedule

Not gonna lie, my husband’s schedule seemed eerily similar to his schedule in fellowship and residency INITIALLY. Was I disappointed? Well, *ahem,* yes. I talk more about his schedule in THIS post. I, crazily enough, thought that he’d be be home significantly more than he is. Like, 25% more. I have no idea what I based these expectations on. But over the past year, he missed a LOT of bedtimes and I missed a LOT of him. I know, I know…cry me a river.

But it’s all good, because I understand that getting your practice up and running takes a LOT of hard work. If you think you’re going to finish your fellowship, print out some fancy business cards, and patients are going to be busting down your door, you’re probably going to be disappointed.

In my husband’s case, he is fortunate to have a team helping him with drumming up business, but his bottleneck is that he doesn’t have the Operating Room time to complete all of the surgeries he has lined up. So, he has to scheduled his cases when the other surgeons aren’t operating, which means a sizable amount of evening work. The hospital is slowly giving him more blocked time, as he proves that he needs it. This, as I understand it, is often a struggle for junior partners.

However, I do know that as he progresses, his schedule will only continue to improve. I mean, the experienced surgeons are very rarely out operating late. AND, I have seen first hand that his schedule has been getting better over the course of the year. I hope and pray the worst of it is over!

Autonomy in Patient Care Decisions

Autonomy has been one of the biggest positive factors in our quality of life since getting out of training. Why, you ask? Because my husband is a lot happier being in charge of his own patient’s care. I believe that surgeons in general tend to have leadership qualities that don’t always flourish under the critical eyes of academic faculty. They want to be making their own decisions, using their creative minds, completing their own challenging problem-solving. I talk about some of the personality quirks of doctors HERE.

The flip side of this coin, however, is that there is some potential for autonomy to actual make things HARDER. So while it’s a tick mark in the “pros” column for my hubby, it could be a con for the doc in your life. We have heard that some surgeons really struggle over this change in autonomy because they may second guess their decision-making, surgical skills, or surgical approach, etc, and with no one else to be a buffer, the final decision lies with them. This will keep some overachievers awake at night. Fortunately, in my husband’s supportive practice, he has about 10 surgeons he can call up when he faces a unique patient care situation and needs some input. Plus, though he’s not perfect, he feels that his fellowships prepared him well in this regard.

Operating Alone

All along the way, if you’re in training, you had staff with you while you were operating, or immediately available. Being in charge of your own operating room, like REALLY in charge, is a pretty glorious feeling, according to my husband. He gets to dictate the pace of the operation. He, as I said above, gets to make all of the important decisions about the operation. He picks the music that gives him confidence. He has a team that knows him (and not the attending that he’s working under). Operating as the primary surgeon on the case makes him happy, confident, empowered. I’m sure it goes without saying…but I’ll say it…if he’s happy, I’m happy. And conversely, if the surgeon ain’t happy, ain’t nobody happy. (For real though).

Taking Call

I would’ve voted call just completely out of our lives if I could have by now. But at least it has changed in three very important ways since training: 1. All call is home call. It is nice that he’s now home for call unless he’s operating or rounding. But even when at home, it is stressful for him, and he’s here, but “not here,” ifyaknowwhatImean. 2. Call is less busy. Sometimes he’ll go a whole evening and not receive a call. One 24-hour period at Harborview, he received 39 consults while in residency. So yes, much less busy than most of the call he took during training, but still not vacation. 3. Call comes from different sources now. My husband mainly gets paged now by other providers (for consults) or from patients. In training, he would field calls from any number of hospital staff for any number of wildly bizarre and sometimes inappropriate questions, and it was just…painful. And I shall leave it at that.

Fair compensation

Please don’t interpret any of this as being braggy. But I know you’re wondering, so I’m just going to go there.

Yes, it’s nice to finally be paid (more than $2/hour – yes, my husband once did the math in residency). And that call I mentioned above, at least you now (SCORE) get paid for it. The increased financial freedom that comes being in practice has indeed been a relief for us.

That being said, for some others, the bad news is that there still may be financial stressors. It depends on the type of position you obtain, and the financial structure of the group/position. If you’re going into private practice, you may have to “buy in” to their share of the group. For some new surgeons or physicians, it may mean that a lot of their income, initially, goes back to their “buy-in” to the group, especially if the surgeon isn’t busy enough. It’s all exceptionally complicated, and I know shockingly little about it. What I do know is that my husband has to work long and hard to make sure that he is able to bring home the bacon. He’s doing great, but I’ve heard stories about other new surgeons being stressed in this regard.

Lastly, about finances, the increased income has begun to positively affect our quality of life. We remain very cautious with our money, of course. I mean, my husband drives a junky car that is exactly 17 years old. 😂But one thing that has been nice for me, specifically, is that we aren’t afraid to get babysitters now. When I was struggling with having challenging, young children and he was never home, my husband made a great point in a conversation once. He said that he’s not “working so hard for our family for me to sit at home alone with the kids and be miserable.” Ouch. But it was TRUE. Getting that “permission,” if you will, to get help that he wasn’t able to provide, was a school bus-sized weight off my back. So now, if he’s gone a lot, I don’t feel so guilty paying for a babysitter for a couple of hours so I can go roam the aisles at Home Goods, or run my nail wrap black market (yes, this was a thing for a while) to help me maintain my sanity. And if the girls need new pairs of gloves, or their leggings all have holes in them, I can buy more and not stress. If we need new functional furniture, we can swing it. We don’t HAVE to keep sitting on the peeling bonded leather couch was literally all over our children most of the day.

Clearly, this is just a small sampling of what we do with our money. Our priorities are giving, reducing debt, saving/investing, and then modest quality of life improvements.

Respect

Although my husband wouldn’t put this on his list, I have to add it here. In training, you feel like a nobody most of the time. You work your lil’ tushy off, and often get treated like…dirt. Once you’re in an attending position, the position commands respect. Fi-na-lly, your opinion matters a bit more, and you have your own team helping you to accomplish your patient care goals, rather than being bossed around by people in literally every position of the hospital.

I went to visit my husband in his clinic soon after he started. The two sweet ladies at the front desk weren’t expecting me and asked me who I was there to see. When I said my husband’s first name, they looked at each other confused and then back at me rather skeptically. I sheepishly then called my own husband, “Dr. ______” so they knew who I was talking about. They turned all smiles and guided me back to him. That’s when I really knew he had made it. 😂 It’s wild to me that there are people he works with that don’t even KNOW his first name! Of course, MY respect for him hasn’t changed, but I know it must be nice for him to have his workplace environment respect his education and hard work after so many years of what felt like quite the opposite.

New Opportunities

Having training behind you definitely has some other perks as well, to the tune of travel and other leadership positions. Yes, during training, you may have the opportunity to present your research at conferences, but now, my husband gets to be an instructor at courses. He LOVES it. He is also asked to teach at conferences across the country, so when our littlest is less “little,” I plan to tag along and see the country with him through these work/play adventures.

There are SO MANY more new experiences I could talk about here. At the risk of sounding totally annoying, some examples include access to the exciting hobbies of his partners, destination work retreats (that families are invited to), prime-location Christmas parties. There are a plethora of really fabulous things like this that are new to us. However, we remain QUITE hesitant to enjoy them, as it’s all still so new to us and we’re finding our place.

And really that’s what we’ve been doing all year…just trying to find our place. I think I can see it off in the distance, but we’re still not there and settled in to it yet! The past year has been a bit of a wild ride, but I think my husband would agree that it feels amazing to have training behind him (us). We are BEYOND grateful for all that is this world of medicine and the opportunity for my husband to impact so many lives for the better. Cheers to the next however-many-years of practicing!

I hope this has been a helpful bit of encouragement to those of you still navigating training (there IS a light at the end of this tunnel! You will get there, too!) And for those of you who aren’t doing that “training” stuff, I hope you found this little trip into our lives to be interesting!!!

Oh, and hey, if you haven’t already, why don’t you come join me on Facebook or Instagram for more fun and updates!?! I love, LOVE having new friends!

So much love to each and every one of you lovelies, and may this next year be your very best year yet – whether you’re still in training or not!!!!