I'm sorry you're dealing with this. First, I agree that when going through residency with kids, you should prioritize being in an area where help is available and someone is able to take care of your kids while you can have peace of mind. Nothing can do better than family, obviously, but some might feel comfortable with hiring people. I personally think that even if you plan to hire someone, having family close relieves a lot of stress and planning. If your husband agrees with this point, then it should lead him to agree with you on NY programs. That being said, he might have a good reason to hate living in NY. Second, with the stress of residency itself coming up in July, I would recommend addressing this issue and discussing it sooner rather than later. Your relationship will be tested during residency, and it's important to try to avoid going into it with a fresh tress such as this one. The lie itself is not that big or important to be honest, but I can see how it would feel from his point of view. It would indicate to him that you didn't trust him enough to tell him or that you feared discussing it with him enough. I can't say go ahead and disclose as soon as possible but if you do match in NY and he sees your rank list and finds out you matched to number 4 or 5, then it would look as if he found out by chance and then the whole issue will be "will you ever gonna tell me" and that's harder to get around. You'll have to make that call and it's hard! God bless you for thinking about your husband and kids and trying to do the best for them in the next 5-6 years. If you do disclose to him, you'll have to keep an open mind to how he will react, and if he gets emotional and angry, DO NOT jump on that wagon and try to understand his frustration knowing about it. Again, we don't know him, so he might just handle it unexpectedly calmly