nurse midwife who wants more

I am so glad I have found this site. I have made mention of this dream to several people and collegues but everyone seems to think I am crazy.

I am soon to be 39 and I know i am going to go to medical school. I don’t know how I don’t know when and I have no idea how i will ever do it but i know i will.

This is not a new idea but a very old one. I can remember being pregnant with my second child st just starting my first college classes, I was 21 years old and I knew I would someday be a doctor.

Let me give some history. I joined the Navy when I was 17 and was an electrician. Unplanned pregnancy, got married, decided to have children close together, had my second child at 21. We got out of the navy and I relized I needed a college education. The only higher education was a community college. I started and chose to major in nursing.

I graduated with an associate in Nursing in 1997. Decided I wanted a male child so with two girls at 9 and 7 we started again with newborn. By the time he was 5 yrs old I had worked asa a labor and delivery nurse for 5 years and felt unchallenged.

I had conterplated medical school then but was unable to figure out all the obsticles i would run into. The major one is that there is no medical school within a 100 miles. So instead I chose to a masters in nursing. I commuted to the University of Miami ( 168.5 miles) and majored in nurse midwifery.

I love being a midwife. I love the impact I have in women’s life. I love catching babies. But I love surgery and unfortunately I will never be able to do surgery as a CNM.

I hate being a “midlevel” provider. I hate being a “physician extender” I hate having to pass off patients because i don’t have the education to manage them.

I manage low risk, “problem” free patients but I that is not what I want to do for the next 20-25 years. I want to have complicated patients where I can maage them. If my labor patient needs a cesearean I want to do it.

Sometimes I do think it is crazy. I have a good job. I work with a wonderful physician who we co manage all the pregnant patients. But I still want more.

The changes are frightening. The decrease in reimbursement, the rising cost of malpractise insurance but regardless I want to be a doctor.

Unfortunately nursing didn’t require many science courses. I have many pre med classes to take. Seven to be precise. I need biology 1 and 2; chem 2; organic chem 1 and 2; and physics 1 and 2 nothing major. If i didn’t have to do all these pre med classes i wouldn’t even think twice about applying.

I am not in a hurry right now. My goal is to be ready to apply in 3 years. Start at 42 and I will be done at 50. This will give me 15 years to work hopefully before retirement.

I look foward to meeting some people here to share the experiences I am about to go through.



I understand your wish to have a wider scope of practice. Of course you can make it happen somehow, but here is the tough part. You will need to do a 4-year residency in Ob/Gyn if you really want to do C-sections and have all the skills you want, and to be assured of finding a position in an urban community.

Yes, you could do a 3-yr Family Medicine residency + a 1-2 year OB fellowship to get the C-section training, but even then many urban hospitals will not privilege you. In addition, you would have to do a lot of extra stuff in FM that you might not enjoy and has nothing to do with women’s health. If you and your family are OK with practicing in an extremely rural environment, then FM alone might be enough if you can get into a residency program where they will let you be primary on C/S (many will not).

OB/Gyn is a surgical specialty. The approach is very, very different from the midwifery model, as you know. There will be no more supporting your patients through labor; instead, as a resident, you will be the one rushing into the room to catch the baby at the last minute, then rushing away to go do something else. You will be following a model that emphasizes making things happen on a set schedule; AROM, cytotec, pit, etc. And you will have to follow that model even when your midwife’s instincts tell you not to do it.

Finally, taking the plunge to start a surgical practice at 50 is a big decision. People certainly do it, but the sheer physical challenges are not to be taken lightly. As one of my advisors said, starting to be a surgeon at 50 is entirely different from having been a surgeon for 20 years when you are 50.

good luck

Thank You so much for your imput. I am aware of how very different my practice style will have to change for several years. On the reverse side maybe just maybe my years of experience my make a positive impression but I am not holding my breath.

I have thought about the family medicine route but I do enjoy all the surgeries.

I am hoping to start at least one class in the spring and see where that takes me. My hardest part of taking classes is that I work with one doc and me. Therefore I do about 15 day on call a month. I am also in the office 4 full days a week. Unfortuantly obstetrics isn’t very predictable.

Sometimes I wonder if I would handle the hours of med school/residency… but then I realized I frequently do them already.


My experience has been that OB is a very hierarchical specialty, like most surgical specialties, and that as an intern/resident you are expected to follow procedures to a T, not to use your own judgement etc. to manage as you see fit.

I would really try to spend some time with OBs in your area and do some information interviewing to find out how this transition might be for you, and whether there might be other alternatives. Med school is just such a long and expensive route to take, with all kinds of extraneous crap that you don’t need and probably aren’t interested in.


There’s an excellent book by Dr. Marsden Wagner called “Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth”.

I wrote a review on Amazon about it which you can read here: /A2JD0X…

My hope is to create an “evidence based” practice utilizing as much of the midwifery model when possible. I’m hoping to become a MFM so I’m sure the majority of my deliveries will be either the typical stirrups & push or c-section route, but up until that becomes necessary, there are other options available.

I have 2 kids under 2, and my doctors were more like midwives until they needed to switch into high gear. I had c-sections with both (unlike my 2 older who I had naturally), and until the decision was actively made that I needed a c-section, my doctors visits and updates and such were all handled in the same manner as the midwife visits. Even with my boy (the 1st of the 2 younger ones), they let me labour in the hospital for hours before telling me they felt that a C was my best option – and still gave me another 2 hours to decide before telling me it was necessary. They hung out with me in the delivery room, played cards with me, etc. When we hit the ER though, it was all by the book – as it should be.

So, although there are certain ways some things “have to be done”, there is always a time and a place for everything. I know that when I look for residency/clerkship options, I’ll be looking for doctors that are more like my doctors, than the type of doctors I had years ago for my first kids.

Good luck!

Good luck with your journey!

I have had three CNM-assisted births (one at a FSBC, two at home) and I am a huge birth junkie. Everyone thinks it’s funny that I want to become a physician since my family and I barely see docs ourselves and have a very conservative approach to medical intervention.

I’m not interested in OB, but everyone assumes that I am since I am so into birth and babies! I tell them if I wanted to catch babies, I would be a CNM for sure!!!

Are you set on OB or are you interested in another surgical specialty (or general surgery)? I ask because I know that I could never reconcile my views on pregnancy and birth with the allopathic OB protocol (not that it’s wrong…it’s just so…different from what I know and what I have experienced).

Again, best of luck!