You and/or your partner have matched into your desired specialty for residency training, congratulations! That is a major accomplishment and deserves celebration. Unfortunately, it may be coupled with the bittersweet reality that you and your sweetie will be apart for a number of years during training. 

You are not alone! In the dual-income world we live in, long distance relationships are common. My now-husband (Ophthalmology) and I (ENT) were long-distance for three years. Travel between our two sites required a total of five hours with a long airport drive plus flight. During those three years, we got engaged, got married, and reunited for my husband’s fellowship. We learned a lot about ourselves and our relationship during the years we spent apart and we hope that this guide will generate conversations between you and your partner about how you can structure your own LDR plan.

Step One: DTR.

(If you’re married, skip this section.)

It is likely that if you entered the match as a couple, you have already discussed your commitment to remain together for the long haul. If you haven’t or your partner is not in medicine, now is a critical time to take an honest assessment of your relationship individually and with each other to “Define The Relationship.”Communicating a shared goal of reuniting in the future helps brighten your time apart. We found couples counseling helpful in the months before we began our time apart. It helped us solidify the foundations of our relationship – sharing professional and personal goals, managing conflict, and identifying our values. Negotiating our goals as a team is an exciting adventure!

Travel

During residency you may not have many weekends off. Visiting each other can be a logistical challenge and you may only have 24-36 hours of time together on each trip. Explore the commute – how many hours of driving is it? Are there direct flights or does it require a transfer?  What airlines and flights fly that route? Are the airports/airlines usually on time or are delays the norm? How expensive are the flights? Be sure to budget travel plans as a major expenditure. Travel was the third highest expenditure in my monthly spending, after rent and food. Take advantage of airline sales and flight cancellation rules. Southwest has very flexible last minute cancellations and changes, allowing you to purchase flights before the call schedule is publicized. 

Travel is often more burdensome on the person traveling – every weekend away from home is a weekend you won’t be able to take care of your activities of daily living – grocery shopping, cleaning, errands, gym time, etc. For this reason we would recommend discussing what is equitable for your relationship so that the travel burden does not always fall on one person. When you do have those precious 24 hours together, plan fun dates so that you are creating new positive memories together. Having our NEXT rendezvous planned so we knew every goodbye was temporary helped us stave off pangs of loneliness. 

Vacation

Many programs will give you 15 days of vacation; some require these to be taken in one week increments. If both of you are residents, this gives you a maximum of 6 weeks of potential time together. It is reasonable to ask your Program Director or senior residents what vacations look like – are you guaranteed the bookended weekends? Are you able to take half-days off? How about the Friday or Monday before a vacation week? How does the program split holiday call? You may choose to coordinate your vacation time so that you can take a trip together. Alternatively one person visits the other during their vacation week and vice versa. This strategy doubles the potential time spent together, with the downside that one person is working while the other is visiting. This downtime can be used to focus on academic work, or to support your partner at home – cooking, chores, and showing and growing your love together. 

Communication

Phone calls and FaceTime are an improvement from the era of calling cards and letters, but you still lose learning about each others’ body language and day-to-day habits. Discuss how you want to communicate and how “present” you want to be during those interactions. For example, while it is easy to multitask while being handsfree with AirPods in, your partner may quickly become background noise in your ear. The long-distance “tele-company” could feel comforting, or it could feel like that time spent together was not intentional. If that is the case, you can try sharing a book, cooking a recipe together, watching a movie or TV show simultaneously…experiment with what works for your relationship.

Intimacy

Your relationship can still grow while you are apart. Distance allows new and more creative ways to express affection. How you show love and receive love are important things to be aware of and to discuss with your partner. For example, if your primary mode of connection is through physical touch, being in a LDR is necessarily going to limit this. Similarly, caring for your partner by doing chores, preparing meals, running errands – are all quite limited by distance. Now is an excellent time to investigate secondary and tertiary love languages! Hand-written letters, cards, ordering UberEats for each other, surprise gifts – these all helped get us to the finish line. It reminded us that distance is not forever, and it was fun to explore new ways to show love. Scheduling intentional check-ins was an invaluable tool so that we could be candid and thoughtful about how our needs were and were not being met.

Plan For Reunification

While the days in residency feel long, the months fly by! Sooner than you think, graduation and fellowship applications will be around the corner. This will present another fork in the road where your personal and professional paths will need to be negotiated. This is an opportunity to renew your commitment to your shared goal to reunite with one another. Available fellowship programs in the area may guide your fellowship subspecialty choice. Locums positions can fill time without sacrificing experience. These conversations can be challenging. When the decisions and distance become overwhelming, remember that the LDR is temporary and before long, you will be reunited with your hunnie. It is worth it!