In this episode of Med Family, Eric and Karen continue their open discussion about life after an unexpected fellowship match outcome and what it means to pivot when carefully laid plans fall apart. Now in PGY-3 of internal medicine residency, Eric reflects on the professional uncertainty that follows a competitive match cycle. At the same time, Karen offers a perspective on supporting a medical career amid the demands of raising six children.

The episode begins with an update on family life, including their return to homeschool co-op, therapy schedules, and the flexibility homeschooling provides for a household shaped by residency hours. Karen shares the curricula and tools they use—ranging from math and reading programs to Khan Academy—highlighting the adaptability required when teaching children with diverse learning needs.

Eric then transitions into residency training, describing his current geriatrics rotation and how it contrasts with the ICU-heavy structure of their program. He reflects on the realities of long-term care medicine, end-of-life decision-making, and how these experiences have helped clarify his long-term career goals, even when those goals require reevaluation.

A central focus of the episode is fellowship strategy. Eric and Karen discuss the role of away rotations, the advantages of home programs, and the often underappreciated influence of institutional politics, GME funding, and professional connections. They explore how fellowship selection extends beyond board scores and CVs, emphasizing the weight of advocacy, mentorship, and personal reputation within small professional networks.

The episode closes with a realistic look at next steps: follow-up emails, outreach to mentors, exploring alternative and non-ACGME opportunities, and using lighter rotations to regroup and plan. Throughout, Eric and Karen maintain a reflective and transparent tone, offering listeners an honest account of medical training, resilience after disappointment, and the necessity of adapting when the path forward is no longer straightforward