any thoughts on ob/gyn?

Hi everyone, I haven’t posted here in a long time because… well… I’m in medical school and have 3 kids. Am coming up for air and seeing the light at the end of first year, and was wondering if anyone here had any enlightening thoughts on ob/gyn especially for older residents. What do you think? Let me say also my basic personality: I am down to earth, like variety (get bored easily), and, shall we say, um, “blunt.” But one on one I am warm and caring. And I think the pelvis is awesome. Just such a cool place. So tell me why you hated your ob rotation, or loved it, or whatever.

Starmoon;


The best thing about med school is that you really don’t have to make up your mind for a while. You still have two more years to make up your mind, and I think you’ll be able to answer some of these questions after your OB rotation on 3rd year. Does your school offer shadowing opportunities for students? I know you are wicked busy with the school and kids. But if you really cannot wait, maybe somehow you can ‘produce’ a free afternoon so that you can shadow an OB doc and see how it works in real life!


Having said that, a couple of thoughts on OB/GYN from my perspective. From the very first day of my medical school, whenever I met somebody and they learnt I was in med school, they always asked what kind of a doctor I wanted to be. I always answered: “Not sure yet; but I know what I don’t want to be - OB/GYN!!!”. Right now I’m in my final week of ‘Women Health’ block and I’m getting ready for the final exam. Yesterday I learned how to do a pelvic exam on a standardized patient and… I totally love it! I’m not saying this is what I want to do, but I’ll seriously consider it during my 3rd year rotations. There were very few classes I enjoyed as much as this one so far.


I know it hasn’t really answered your question, but thought I’d share this experience with you.


Good luck with the remainder of M1 year.


Kasia

Hi Starmoon


I can’t really offer an opinion on ob/gyn as I’m not in med school yet, but I did want to ask you to post an update (when you come up for air in the summer) about your first year at Columbia. I’m quite interested in Columbia as a potential school.


Thanks and good luck with the rest of the year.


Lynda

Let me know what you find out because even though I’m not in med school yet, I definitely think it’s an area I’m interested in!!!


She got 3 replies and no answer

After years of no one going into OB/Gyn, 8 of my med school classmates, including our valedictorian, went into it. OB wasn’t my thing, but that is part of the beauty of medicine-- there is a niche for everyone. Even within OB itself, I thought there were several different personality types-- the gyn onc surgeons were very different from the docs up on L&D. I think it is a great specialty if you like a mix of longitudinal relationships in clinic as well as the technicality of doing surgery.

If you do go that route, do yourself a favor and go above and beyond what they provide you and purposefully educated yourself on lactation even if you need to do con ed to do so. I can not express how many OBGYNs and Peds I’ve run into with minimal knowledge on the subject only to deal with their patient’s mothers in tears thinking they have to wean over “xyz”, when they could have continued just fine.


So, don’t just focus on the uterus, since breasts can have just as important a role in early motherhood.

I’m actually really interested in perinatology or maternal-fetal medicine, specifically in fetal surgery which I realize is highly specialized and I’m no where close but completely fascinated.

Thanks Tara and Kasia. I was really looking for more perspectives from older medical students or residents who had been through it. I suppose the fact that there are very few of us older students going into it should tell me something.

fetal surgery is totally fascinating, but being I don’t have steady hands, I can not become a surgeon.

I disagree Starmoon - I would not extrapolate a lack presence of non-trads on OPM interested in, training in or practicing OB/Gyn as a reasonable sampling & therefore not really a legit platform to make inferences from. We’re pretty small, esp is you factor out the pre-med cadre. We’ve only a literal handful of attending-level docs and probably 3~4x that in residents…not too many considering how many pre-med, med student, residents & attendings there are in this country.


Furthermore, we do have many OPMers training in very competitive, demanding disciplines: neurosurgery, anesthesia, ER, critical care, surgery…


Don’t sell yourself short, esp since you’re barely even out of the starting gate.

As others have pointed out, there’s lots of different “flavors” of OB/GYN. OB/GYNs are surgeons and their training gives them plenty of exposure to that. OB/GYNs have a four-year residency. If they want to specialize further, they can do fellowships in reproductive endocrinology, maternal-fetal medicine, gynaecology-oncology, etc.


Family doctors do OB/GYN, including C-sections (sometimes); training in OB and office GYN is part of the three-year residency but a lot of family physicians do a fourth year of training in an OB fellowship in order to feel well-prepared to handle all OB situations.


OB is an extremely challenging business model because of the unpredictable nature of obstetrics. Sure, you could try and induce all your patients (note: I do not endorse this!!!) but somehow, Mother Nature often finds a way to circumvent human-made plans. So there’s a certain built-in chaos to the practice of an OB/GYN, who is dividing time amongst clinic, OR and L&D.


I like the variety of family medicine but the chaos of working OB into the mix was a little more than I wanted to try and handle… so I chose not to pursue further OB training and I do not include OB in my practice. Well, I should say that OB care is not part of my practice. Since I see women who are pregnant for their other health needs, I do have to be knowledgeable about OB.


And I do lots of GYN, from well woman exams to teens with dysmenorrhea to post-menopausal issues… it is a BIG part of my practice as a female provider. I don’t do surgery and I haven’t done enough training in office procedures to feel competent at colposcopy (magnified cervical exams and biopsies for women who’ve had abnormal Pap smears) — I wish I could incorporate this into my work, because I always feel bad when I have to send a woman with an abnormal Pap on to another doctor for the follow-up.


I think your question is leaning toward the “lifestyle” question - do you want to do something that will require you to get up in the middle of the night, from now until forever? Well, no. I didn’t, truthfully. I will be honest and say that even just two years out from residency, I don’t know how the hell I got through it. I love sleeping in my own bed all night long, even if I do get the occasional wake-up page (very rare). But OB is by no means the only specialty where you’ll get woken up regularly. I am in awe of folks like Dave (critical care specialist) who drag themselves into the ICU, night after night, year after year. Or the surgeons who have to take their turn on Trauma Call for our tertiary care center (if they don’t, they risk losing their own privileges)… guys who’ve been in practice for twenty, thirty years are still shlepping down to work straight through the middle of the night.


As others have said, you will have the opportunity to try on all these different flavors when you get to third year. It can be pretty hard to predict what will attract you. I know that I thought I would NEVER like the highly varied nature of FM – I was internal medicine all the way, until I actually DID a month of each and discovered that in fact, I loooved FM (partly because there was an aspect of every single third-year rotation that appealed to me).


So breathe, enjoy the moment, don’t worry about the choice now!


Mary

Agree with Mary, the lifestyle and some of the personalites is what made say NO to ob/gyn. Of all my rotations the most stressed, rude, malignant folks were in ob/gyn. Now, I am not saying that this is true for all ob/gyn individuals but that was my take…the hours are unpredictable and many expectant moms need more TLC/hand holding than I was able to stomach. This is my story…

Yeah I have heard that before about the toxic personality/environment combo. Partly that’s why I posted. I guess I’ll just have to see. I do like the technical surgical aspect. And it’s been so many years that I have been woken up continually at night that I guess I just have forgotten what good sleep is like. (I have been blessed with three wonderful children who are unclear on the concept of “sleeping through,” for years on end.)


I’m also kind of curious about urogynecology, which I think can be a fellowship either out of ob/gyn or urology. It seems like it has a lot of the surgical and women’s health appeal, without some of the middle-of-the-night issues.


Another question for those further along than me: is there a hospitalist model of practice for ob/gyn as there is for IM and peds?

Well, I was going to leave the toxic stuff out but efex is certainly right, it seemed to me that almost every OB/GYN resident I encountered had a personality disorder. I don’t think you should pick your specialty based on the residency though… and more than once I encountered OB attendings who’d been malignant residents, but had become much more human after residency. Go figure.


I have not heard of a hospitalist model for OB/GYN. I will say that urology could definitely use more women in the field, and it’s a fun surgical specialty IMHO.


Mary

Starmoon, Sorry that it took me so long to post. I am in the middle of my Internal Med rotation as an M3 and feel more than just a little overwhelmed right now.


In answer to your original post, I have decided to go into OB/GYN residency. I tried keeping a very open mind as I went through my 3rd year clerkships, but nothing made my “eyes dance” (as Judy Colwell says) like that field. There is something about it that thrills my heart when I am working with women’s health. Originally, I was going to apply to both a Urology residency and OB/GYN, but in the end decided that my heart just wasn’t in Urology even though the “lifestyle” issue wanted me to pick that field. All I know is that the University of Nebraska’s OB/GYN clerkship was AWESOME!!! They have worked to make the program outstanding and I learned a great deal from some of the most talented attendings and great residents. That expeience, combined with my previous experience as an RN in Women’s Health, solidified my decision to pursue this field for the rest of my life.


Yes, you have to do what you really want to do. Weigh all the factors, but go with your heart. It will make you much happier with your career choice for the long haul! Enjoy your next 2-3 years in medical school and consider each and every field before making up your mind. Good luck–I wish you the best!



FWIW, one of my favorite and most inspirational professors was an OB/GYN. Also have had some family in the field, nice folks. So they’re not all distasteful