For some of you, the “it gets better” phase might be years away; for others, perhaps you’re starting to examine the possibilities and begin the interviewing and visiting process.  Since this a  “survivor story”, my idea for this one is to simply give you a peek into what life is like in this particular season and niche of life, and to offer bits of wisdom from our family’s experience.

Keep an open mind.  When my husband was in medical school, he was pretty sure he wouldn’t become a surgeon.  Then, he did his ENT rotation, and a whole new world of possibilities opened up.  Never say never.  It proved to be a beautiful combination of surgical and clinical work.  There was immense variety within the surgical cases, and within the patient population.  He pursued a career in ENT from that point onward, and though he kept an open mind, was pretty sure he did not want a career in the academic world.

Count the cost.  This one is tricky.  No one can adequately prepare someone else for an experience; we just have to dive in and do it.  However, we can find out as much as possible before taking the next step.  My husband spoke with his medical school advisors and felt confident that ENT would be the best fit for him.  He knew he would have to be at the top of his class.  Remembering the big goals helped both of us endure the hours he spent studying.  So much of a medical career is delayed gratification.  Know what you’re getting yourselves into—because of course, a career goal affects more than just the person pursuing it.  We had our first child during V’s fourth year of medical school, and we knew that an ENT residency would have a big impact on him as a new father, especially, but we kept our eyes on the long-term vision and decided it was worth the effort and sacrifice.

Stay on course.  ENT residency from 2005-2010 was rough.  I can’t and won’t sugar-coat it.  The program covered a large general hospital, a busy cancer center, a children’s hospital, and a veterans’ hospital in a fairly large city.  Each year, the program brought on *two* new residents.  Factor in some personal crises among a few of the other residents, and my husband ended up with even more work on his shoulders.  I don’t think he ever thought about quitting, but we were truly put through the wringer.  He barely saw our son during the infant/toddler years.  He was exhausted in every sense of the word.  Not many people around me understood exactly what our lives were all about.  But he did not give up, and neither did I.  We clung to the hope that all of this preparation would pay off.  As residency drew to a close, he was more certain that he would look at private practice opportunities, while still keeping an open mind.

Not Succeeding Does Not Equal Failure.  After considering some strong private practice prospects, my husband joined a medium-sized practice about two hours south of where he’d done his residency.  The location was good, and the set-up seemed promising.  A combination of factors kept V from succeeding in this situation:  some doctors in the practice didn’t retire as soon as they said they would, making it more challenging for my husband to establish his own set of patients.  The area had a lot of physicians who had been around for a long time, and they referred to each other more than the new ones.  Medical school and residency hadn’t really prepared V for the business side of joining/starting a practice; he didn’t know the importance of networking right away and forming professional relationships.  After three years with this practice, V decided to decline partnership and look for another opportunity.  Looking back, we learned some important lessons from that experience, that set us up to scrutinize future plans in a wiser way.

Don’t Burn Any Bridges.  As V started to contact practices again to look for a different opportunity, he cast the net wide.  One of the people he spoke to was an attending from his residency program, who mentioned an ENT he knew in the area who might be looking for someone to join his practice.  V got in touch with that individual, and after just a few conversations, we knew it would be a great situation.

Daily Life Now:  V has been with this second post-training job since the summer of 2013.  He became a partner and has established a thriving portion of the practice.  He and his partner have subsequently expanded their general ENT practice to include balance, physical therapy, and audiology, under the umbrella of a growing physical therapy franchise.  In a given week, V sees patients in clinic 3.5 days per week and does surgical cases 1.5 days per week.  On average, he works from 8-5:30.  There are still long surgery days occasionally, but he has been able to be pretty selective about what cases he does, preferring sinus cases.  He sends young pediatric cases to another ENT in town and refers big cancer cases up to his former attendings at the cancer hospital.  He shares call with the other local ENTs, covering two hospitals, about every six weeks.  Some weeks still really stink, and some are very light.  One thing that is somewhat unique about our situation is how V and his partner are trying to grow their practice and share their new model with other practices around the country.  There is a lot more talk about business and management than in his first post-residency job.  There are more weekend tours of their center, more dinner meetings, and more travel than at first, but we see all of it as wise investment of his time.  He truly has excitement and fulfillment in what he does, and a lot of hope for what’s yet to come!

Keep Dreaming.  My husband is a very goal-oriented man.  He is grateful for where we are in life, but he is constantly looking for “what’s next”.  I am not talking about possessions or wealth, but he is learning how to dream and plan and do, bigger and better.  He makes me tremendously proud, and very excited for the future.  All that hard work was not in vain, and though neither of us might have pictured exactly this as where we would be at 39, I can safely say it’s more than we imagined.

I hope this has been broad enough to benefit many.  I love that this group exists, so we can learn from each other and offer encouragement.  Keep going, ladies.  You’re doing great!


–Alison Phommachanh

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