OMG Loved OB/Gyn, what to do!

[Wednesday]

Hi all,

As many of my fellow 3rd years seem to be, I am in that stage where I’m trying to figure out what I want to do with my life. I had the strange experience of thinking I would absolutely hate ob/gyn and then really loving my rotation. In fact, it is the rotation I enjoyed the most. I love the variety of activities, the patient population and the subject matter. When I was doing peds (which I actually hated the most, also surprising to me) I enjoyed nursery so much because we got to talk about ob stuff!

I understand that this is not a horrible problem to have, some people don’t find anything they enjoy. My concern is that there are some aspects of the specialty that really make me feel nervous about going for it. My worries are pretty standard for ob/gyn: work hours (and I mean after residency) and stress. (I sort of feel that the malpractice thing will work itself out, so that is less concerning to me.) In addition, I did not LOVE being in the OR. I’m not sure if this has more to do with being a 3rd year and merely watching surgery (which is cool for about a week and then gets old) or if I actually don’t want to do it. The one thing that I did really want to do myself were the laproscopic procedures.

I guess my question is how have you guys come to the decision to pursue this field? Did you all know this is where you wanted to be before coming to med school? And how are you planning to balance your life after residency? I will have a baby soon (2 months!) so I feel like these “when I have kids” considerations are very real for me. I would like to actually see the child every once in a while. I worry that if I choose a specialty where I will be required to take overnight call in the hospital for the rest of my career I will regret it.

I get so many people saying, “don’t do it” but most of them are residents and attendings in different specialties. Just wanted to get some perspectives from those who have made the choice.

Thanks!

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[MedPuck]

Hey Wednesday,

I was in the same boat as you until about 3 weeks ago when I decided that I am going to pursue ob/gyn! OB/gyn was my first rotation this year and I have since missed that great feeling despite memories of a rigorous schedule. I have been trying to rationalize not going into ob/gyn for similar reasons that you have mentioned above. I have hovered through other 5-6 career interests this year, most in which I was interested for the wrong reason... primarily a better lifestyle.

I worked way too hard to earn a spot into medical school though I admit that I have had my moments, especially in 3rd year, where I have hit rock bottom. However, I did not put forth all of this effort to half-ass a career path which I will inevitably resent for not doing what I love, and in my case it is ob/gyn.

Just like you I have a baby on the way and I have a lot of responsibilities outside of medical school. Night-call and the 80 hr work-week really make residency more do-able, not to minimize the difficulty of ob residency programs. This will allow you to be a parent especially if you have support. Post-residency lifestyle varies but it can be better than many medical fields especially if you join a large practice which will dilute the call volume.

My vote is to go for it no matter what kind of comments come your way. Your passion is there, follow it. Good luck.

 

[Jules1231]

First, you have to do what you love. If you love ob/gyn then nothing else matters. You should try to do an ob/gyn surgery elective (like gyn-onc). Try to do it at a place that will actually let you do part of the procedure. Surgery is fairly boring to watch. When you do the procedure, you could be standing for hours and not realize it because it's so awesome. However, if while you're there you hate the surgery part it could be a mistake to go into the field. Even if you specialize in MFM you still have to do c-sxns and other procedures. Once you finish your residency there are so many options out there these days, you shouldn't let the hours scare you away either. You have the option to join a large practice and not work as much. Since you like laparoscopic surgery, you could consider Reproductive endocrinology. You usually have better hours in this field too. Hope this helps. Ob/gyn is the best specialty. I couldn't see myself doing anything else. Also, ignore everyone who makes fun of you for choosing the field. I get made fun of everyday. They're just jealous.

 

[neilc]

in my experience, it is pretty typical to have a late blooming interest in ob/gyn. in fact, i can only think of one person that i have known in all of the classes at my school that originally wanted to do ob/gyn. many others have decided on it after actually experiencing the rotation....

in my case, ob/gyn was on the short list of specialties i would NEVER do. my grandfather was even an ob/gyn, but i just was not interested. until i had to do it...then, i realized it was basically everything i enjoyed about medicine. primary care + surgery, relatively healthy patient population, etc...

there are concerns with each and every specialty. malpractice is an issue in many specialties. ob/gyn is not the only one with work hours issues. but, even the lifestyle specialties have some issues (i think boredom would play a role, and malpractice is a huge issue in gas, for example...)

you will spend the majority of your life working in your specialty. you can always tailor the day to day details of your practice by being selective in the patients you treat. you can make any specialty lifestyle friendly with some compromise. but, it is far more difficult to make a specialty that you really don't like enjoyable, even if you "only" spend 40-50 hours a week doing it...

good luck

 

[PsychStudent]

Jules, why do people make fun of you for doing ob/gyn? I guess I have a lot to learn about the culture of medicine.

 

[Jules1231]

Jules, why do people make fun of you for doing ob/gyn? I guess I have a lot to learn about the culture of medicine.

A few examples:
During radiology-I was told I was crazy for wanting to work that hard and deal with the malpractice, etc.

One of my peers, jokingly asked me why I wanted to be a "broken cooter fixer", real mature, I know.

During surgery, the attendings tried to convence me to be a "real surgeon" and not a hack surgeon (as in hacking up ureters, etc)

Plus many other examples. About your culture of medicine statement, it's not like I don't kid fellow students about their career choices. (my favorite is-I can't belive you're going into ER--you want to be a highly paid triage nurse?). Most of the time, when I am being made fun of for my choice-i think the comments are mostly in good fun. Just be prepared to dish it back. Have a great day.


Disclamer: ER people don't get mad, I respect you guys, it's just a joke.

 

[NYC Girl]

Great questions - these were all issues that really prevented me from committing to OB/Gyn initially, and I REALLY went about purposefully finding out about the impact of hours and malpractice before I could really be certain.

First of all, I think OB/Gyn is one of the most incredible and fulfilling fields in medicine (a little biased...) - you can have the continuity of care of primary care, the fun of obstetrics (no patients are ever more appreciative and thankful!), as well as really exciting and extensive surgeries.

I personally came into med school absolutely convinced I'd never do a surgical field, but my surgery rotation was extremely hands on - and I LOVED IT! It is an ENTIRELY different thing retracting and trying to stay conscious while other people do things - compared to the excitement of getting the scalpel/bovie/suture in your own hands! It's incredibly engaging and thrilling. And gyn has some of the most diverse surgeries - from the enormous pelvic node dissections of onc, to slings and other assorted urogyn procedures, to laparoscopy in benign gyn and REI. If you do do a rotation with more hands-on surgery and still hate it, then perhaps gyn is not for you.

After speaking with practicing OB/Gyn's about the hours issue, you can really tailor your post-residency work hours. Plenty of folks, esp. women with children, will arrange part-time schedules, or group practices with shared call. My mentor said that when she was in private practice, she worked 40 hrs a week, INCLUDING CALL! During residency, because of the work hours limitations, OB/Gyn is now in the same boat as medicine, peds, etc.

Malpractice is definitely a reality, which is not limited to OB - neurosurgery, ortho, anesthesia all have terrible malpractice issues as well, as you never see anyone site malpractice as a reason not to go into these fields! As others have said, you can greatly decrease your malpractice issues by selectively practicing gyn or REI. And being purposeful about documenting your actions and thought processes, and COMMUNICATING CLEARLY with patients will just have to become part of your modus operandi

Oh, and the ribbing people in other fields thing happens for everyone - medicine makes fun of surgery, surgery makes fun of medicine, ER and OB/Gyn, everyone makes fun of psych Just kidding - but seriously, you'll never find a field that everyone reveres and respects entirely, so who cares? Do what you love, and if you're wise about choosing your practice arrangements, your lifestyle will be good.

 

[cll]

Dear Wednesday:

You sounded just like me. I never thought OB/GYN is a field for me until I did my rotation (back in December) and fall in love with the field. I am also nervous about the lifestyle and thus I spent the last three months digesting my interest in GYN. Most of my classmates have no interest of pursuing OB/GYN and the feedbacks I got back were also negative, until I started talking to people who are like me. They all have great energy and passion towards OB/GYN. I felt great talking about OB/GYN with them. The same reasons that attracted me into the field is the same reasons that attracted them. I felt more and more comfortable each day about my decision.

I have spent a lot of time talking about lifestyle management and malpractice with different attendings. They all told me that I can control my lifestyle. You can join a big practice, you can drop the OB part after a few years of practice (which is unfortunate but many of them do b/c they do not to put up with the malpractice and better lifestyle). You can always choose to practice OB/GYN in states that are not malignant to OB/GYNs. You can specialize. The point is there are many options. If malpractice gets so bad, this country will face OB/GYN shortage and the policy will have to change. Most of the attendings I talk to work between 50-60 hours per week, which is acceptable to me. So, good luck. I personaly think it is a great field and it will be great to work with people who share the same passion as you do Look for residency program that is not malignant and have night flows.