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If your partner is a doctor or medical student, prepare yourself for dozens — possibly hundreds — of conversations about their career. If you’re lucky, these conversations are pleasant moments in which you get to show pride about your partner’s accomplishments, discuss the challenges openly, or talk about something you have learned as an outsider looking into the medical establishment.

Unfortunately, many of us experience a far more frustrating reality when our partner’s career comes up in conversation. Let’s break down some common things people say to med student and physician’s significant others and what’s behind them.

Financial comments

It’s not clear why, but commenting on doctors’ and future doctors’ imminent wealth is perfectly acceptable, despite the generally frowned upon topic of money and salaries. As a group, medical partners are viewed as recipients of winning lottery tickets. Well-intentioned acquaintances and friends think it’s cute to tell us how many homes we’ll have or how little we will have to worry about money.

These comments are problematic on multiple levels. First, discuss other people’s salaries can be uncomfortable for the person whose salary you’re discussing. Second, these comments imply that we have chosen our partners at least partially based on their earning potential and earnings. Third, these comments can create stress for doctors and medical students who are struggling under the immense weight of medical school debt and cannot foresee when they will achieve the expected level of wealth.

With the changing climate in health care and the financial burden of medical school, many doctors do not achieve the stability and wealth that previous generations of doctors enjoyed (I recently spoke to a woman who told me her goal was to pay off medical school loans by the time her baby daughter, her third child, graduates from high school). When I hear somebody mention physician wealth to a spouse, I cringe and hope that they aren’t speaking to a couple that is struggling financially.

Assumptions about you based on presumed doctor

In the last six years, I have been informed countless times that I will not have to work because my now-husband was going to be a doctor and he would support me. Another fun comment I’ve heard is that it “must be nice to be a trophy wife.”

I’m sorry, but why are we assuming that doctors’ spouses could not possibly want their own careers, that they will only work if financially necessary? It is destructive to tell men and women to build their dreams in reaction to and based upon their partner’s choices. My career is not a reaction to my husband. It’s my career. Sometimes, career sacrifices are made and medical couples know that better than anybody. We choose those sacrifices.

But the assumption that these sacrifices reflect a lack of ambition or dreams is insulting. Those comments tell me that the speaker thinks about my husband’s work as fundamental to his identity and mine as an afterthought or necessity in times of financial instability. It also tells me that the speaker views the physician’s career as inherently worthwhile and mine as disposable, or at least certainly, not as important as a physician’s career.

Physician as primary

Which brings me to my next point. Inherent in these comments and others is the toxic assumption that the physician inherently holds the primary position in the family. Medical couples struggle to create balance in their lives, making medicine a part and not the entirety of their relationship. Often, the universe of medicine forces other interests and talents to take a back seat. Comments that assume medicine is the central family theme only reinforce the version of reality that most couples want to avoid.

During our honeymoon, Brian and I were walking with an older couple we’d met. The man asked Brian where we were from and what he did. Brian explained that we were moving to Philadelphia after the honeymoon and that he was starting residency. Without missing a beat, the man looks at me and says, “Ah, so you’re the trailing spouse?” His assumption is that our collective life revolved around Brian’s career. It didn’t occur to him to ask about my plans or wonder whether our geographical decisions related to me.

Male partners of female doctors and medical students

Those who date female medical students and doctors receive different treatment. In heterosexual couples, men dating doctors are not assumed to be financially dependent on the women they date. Instead, the comments tease the partner for having a woman earn more than they earn. I have spoken with men who date women in medical school and are working physicians. Some examples of comments they receive include, “Ooh! You got yourself a sugar momma!” and “Oh, SHE is going to be the breadwinner. How does that make you feel?” Do I need to spell out why these comments are problematic? A woman’s ability to earn large sums of money should not be met with comments about how uncomfortable their male partner should be. Once again, the comments are often not rooted. The men who date and marry female physicians are generally supportive and secure, not emasculated by their wife’s earning potential.

Even more fun, some respond to a man talking about his physician wife by assuming that the man means to say nurse. In one example, a man was met with, “Good for her. Nursing is such a great profession.” Medical schools in the United States have reached gender parity. These comments perpetuate the frustrating stereotype that women are nurses and men are doctors. The recent stories emerging about men and women both failing to believe female physicians are actually physicians are important. The casual assumptions that women in medicine are always nurses or the insistence that a man cannot possibly feel ok that his partner might just out-earn him contribute to the problem.

Comments about the looming demise of your partnership

When talking to female medical partners, a few told me that upon mentioning their spouses’ career in medicine, they received comments like “You know physicians’ marriages have the highest divorce rate, right?” and “Don’t be stupid. All doctors cheat on their wives.” Others I spoke with said they hear the same things. The rate of divorce among doctors is around 24 percent, while the national average hovers between 40 and 50 percent. I cannot speak to why people feel the need to say these hurtful comments. Is there a scenario when these comments are constructive and helpful?

These are only some of the wide variety of judgmental comments that get made to the significant others’ of doctors and medical students. We also endure comparisons between our careers and theirs, comments based on specialty choice, and references to raising children alone. We can do better for physician families and couples. The life we have chosen is unusual and often extremely difficult. It is time to start pointing out these comments when we hear them and find ways to discuss medicine in supportive ways.

Sarah Epstein is a master’s candidate in couples and family therapy who blogs at Dating a Med Student.

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