June 30 is a date that those in the medical world know well; it’s the official end of the medical training calendar year. July 1 represents new beginnings: beginning of the academic year, an internship, a residency, or a fellowship. This year was our tenth and final passing through the medical new year. Looking back, I realize that we never would have predicted what we were going to learn and experience along the way.

My husband, Lee, used to be firefighter. He worked two 24-hour shifts/week, had a union job and was respected and admired by many, especially kids. During his paramedic training, several mentors encouraged him to pursue medical school. We agreed on a seven-year plan: he would attend medical school, become an ER doctor, and then run a fire department’s EMS response program. Over the next two years, Lee completed prerequisites, took the MCATs, and applied for medical school. In 2007, he was accepted and shortly thereafter resigned from the fire department. He was 30, I was 31, and our daughter was eight-months old. The three of us were quickly immersed in the new world of doctor-in-training and family/support system.

In his third year of medical school, Lee realized he was a surgeon at heart, so the seven-year plan turned into 10. He understood how his education affected many of our day-to-day activities and major family decisions; therefore, he treated school not as an extension of college but rather as a job. This paid off. He excelled academically, was inducted into the medical school honors society and matched into top residency and fellowship programs.

Our sacrifices over the years have been significant. Not just what it has cost us monetarily to quit our jobs and self-fund our moves every time he transitioned from job to school to residency to fellowship. I’m talking about what we sacrificed as a family. We lost time together. During medical school, he attended every lecture, organized study groups, completed a six-week away rotation and volunteered at underserved clinics. He took his education seriously and strove to become the best doctor he could be. That came with a price. He missed our kids’ school performances, family gatherings, his best friend’s wedding and even his grandfather’s funeral.

During residency, he worked 80 hours/week at the hospital; extra hours were logged charting and prepping at home. He was exhausted. He lost weight. He’d fall asleep during dinner and while our kids opened their birthday presents. A teacher once asked who he was when he picked up our son from preschool (our son had been going there for two years). When a friend of mine met Lee after hearing about him for several years, she commented, “I was starting to think you didn’t really exist.” I can’t imagine the pain this caused him. He’s an involved and attentive dad. We eat dinner together, he builds the kids bikes and we hike in the woods almost every weekend.

Looking back, I’m amazed at what we were able to accomplish when we had no other options. During his second year of medical school, I delivered our second child at 1:34 a.m. Lee took a psychiatry exam at 8 a.m. The professor asked if he wanted to postpone it, but Lee replied, “If I put this exam off, it’ll just push me into another one. I’ll take it now.” One of his classmates did the same thing when his wife delivered their fourth child. A few days after my son’s birth, I took my daughter to preschool. People were surprised to see me out, but as my mom noted, I needed to get used to it because she’d soon leave and I’d be doing it by myself.

I’ve sometimes wondered what our family life would’ve been like if we hadn’t chosen this path. For years, it felt like I barely saw Lee. I’ve chosen our housing, communities and schools by myself. For the most part, I do all the laundry, grocery shopping, and cooking. I like family dinner, so when Lee was on night float, we ate at 4:30. During this 5-week nocturnal schedule, we’d go on dates every weekend.

During his 24-hour shifts, we visited him at the hospital. I knew that to maintain the family life we envisioned, something had to give. I transitioned my career to home, consulting and working part-time as an editor, writer and nonprofit executive director. I don’t want pity; I consciously made these decisions. As an extrovert, it hasn’t always been easy. I’ve cried to family members and friends, who are scattered across the country in cities in which I lived for four-year stints.

This grueling schedule went on for years. It wears you down and beats you up. It takes a toll. For some, the cost is too much, and they don’t make it. We’ve seen medical friends get divorced, suspend a residency, change specialties and complete a second residency or quit medicine because they felt the relentless process wasn’t worth what they got in return. As a couple, we’ve struggled and have had to work to stay connected and communicate openly and honestly. We both recognize what we’ve each sacrificed and gained through the process.

It took over a decade for Lee to transform from a firefighter to an attending physician. This was not only his journey; it was our family’s journey. Our daughter has lived in four cities, and our son has lived in three. Each move meant leaving friends and starting new schools. We’ll be moving again this summer. People have understandably asked if we’re in the military.

Our medical journey has showed me that there are good people everywhere, I can maintain meaningful friendships from afar, we can set and accomplish goals, and that our family is the center of our world, no matter where we live. I’m proud of Lee — for his tenacity, his passion and love of his work and his ability to keep his head up when it was hard (because it’s been hard — physically, mentally and emotionally). As we begin our next medical phase, I recognize that I’m proud of us, too. We’ve had fun, gone on dates and continued to talk and love each other when we’ve been angry and exhausted. He’s the one with the degree, but it feels like we’ve accomplished this together.

Emily Loeb is a writer.

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