In return for dedication during the tough months, the agreement that has worked for us is to pay the nanny a generous set weekly fee regardless of her work hours. My husband and I even took separate vacation time so that the nanny could have more, and well deserved, paid time off.

Make time for your spouse. Lack of couple time is an issue whether there are two residents or one. The benefit to having one nonresident spouse is that one person keeps the family running and allows the resident to focus on doing the job well. But it is easy for spouses with different careers to wind up resenting each other if they lack understanding of the other spouse’s challenges. The non-resident spouse generally winds up carrying the largest load of family responsibilities and may feel abandoned by the resident spouse. The overworked resident who complains about work challenges often feels underappreciated, and both spouses can feel misunderstood. With little energy left for family time, it is important for residents to schedule and prioritize couple time and to remember that both spouses are contributing to their future as a family.

When both spouses are residents, the children barely have parents for a time. To address this, we sat down with the calendar as soon as the rotation schedules were announced. The trick was remembering to schedule sleep time. Residents without kids have time to themselves, but parents must remember to schedule child care coverage for everything, including daytime sleeping. Scheduling for our family became even more complicated when my husband became chief resident. Communication became even more important when he had additional meetings that were not scheduled clinical shifts.

One of our real benefits as a two-resident family, especially in the same program and the same specialty, has been the tremendous understanding of each other’s challenges. At the end of a rough day, I am thankful to come home to a husband who absolutely understands what I go through. My husband walks in my shoes and really understands my venting. When something was painful at work, just a quick text message of encouragement from my husband was enough to help me finish my shift.

Celebrating birthdays and participating in school events are important. Because of work schedules, I have missed most actual birthdays and am unable to participate in most school activities. Instead, we eventually have small home celebrations, and ask the nanny to plan the “friends birthday party” on a rare day when Mom and Dad are both off work. We solved the challenge of parent/teacher conferences by writing emails and scheduling occasional phone calls.