What do you guys think about someone who is considering FM, but doesn't like OB. I have absolutely no intentions of practicing or even pretending to practice OB, but love FM. I want to take care of patients "cradle to the grave" but HATE OB. Most people tell me to just go med/peds then, but that is an extra year of training and I feel most programs neglect the outpatient setting. Most of the med/peds docs I talk to who practice outpatient only (what I will do most likely) say just go FM. How do I justify the wasted OB months? Those will be LONG months when I don't see their utility! Thoughts?

What do you guys think about someone who is considering FM, but doesn't like OB. I have absolutely no intentions of practicing or even pretending to practice OB, but love FM. I want to take care of patients "cradle to the grave" but HATE OB. Most people tell me to just go med/peds then, but that is an extra year of training and I feel most programs neglect the outpatient setting. Most of the med/peds docs I talk to who practice outpatient only (what I will do most likely) say just go FM. How do I justify the wasted OB months? Those will be LONG months when I don't see their utility! Thoughts?
So basically you have no problem once they are in the cradle....it's just that "wet Saint Bernard trying to come in through a cat door" stage that bothers you? I hate delivering babies and somehow I get cursed with delivering four of them in 10 years as an EMT. That's a record in my county.....one I'm not proud of.

So basically you have no problem once they are in the cradle....it's just that "wet Saint Bernard trying to come in through a cat door" stage that bothers you? I hate delivering babies and somehow I get cursed with delivering four of them in 10 years as an EMT. That's a record in my county.....one I'm not proud of.

:eek: That sucks! Congrads to you though, that's an accomplishment!

For a moment lets forget the fact that I just flat out don't like it (I don't like the call, the lifestyle, the feces...) and lets discuss practice likelyhood. The group I would like to join (yes, I have already been offered a job with them) doesn't do OB, OB costs too much for me to justify (malpractice) as evidenced by the mass exodus of OB docs and FM docs quiting OB, and I don't think I would feel comfortable with my expertice (besides routine deliveries).

:eek: That sucks! Congrads to you though, that's an accomplishment!

For a moment lets forget the fact that I just flat out don't like it (I don't like the call, the lifestyle, the feces...) and lets discuss practice likelyhood. The group I would like to join (yes, I have already been offered a job with them) doesn't do OB, OB costs too much for me to justify (malpractice) as evidenced by the mass exodus of OB docs and FM docs quiting OB, and I don't think I would feel comfortable with my expertice (besides routine deliveries).
I don't think I would feel comfortable either.....granted this is after three "routine" deliveries and one that was complicated one (breech....not sure what the term was but I described it on the radio as "ass first"). I'm dreading my OB rotations in med school and residency.

I have no desire to do OB either. However, as a FM resident you need to have 40 deliveries to graduate from your residency program. We do a month of OB in our 1st and 2nd year, and then have our own continuity OB patients. I can't wait to get my 40 deliveries and then be done with OB forever. I love all the other aspects of FM, so that's why I chose it. I don't know how it works in other residency programs, but I only have two months of OB rotations in three years, and I can handle that little amount of OB. So I would go FM if you plan on practicing more in the outpatient setting. You shouldn't have an extreme amount of OB in residency (depending on what area of the country you do residency in).

What do you guys think about someone who is considering FM, but doesn't like OB. I have absolutely no intentions of practicing or even pretending to practice OB, but love FM.

Join the club. I did as little OB as I possibly could in residency...just enough to fulfill the requirement. The med students loved me, because I gave away a ton of deliveries. ;)

I have no desire to do OB either. However, as a FM resident you need to have 40 deliveries to graduate from your residency program. We do a month of OB in our 1st and 2nd year, and then have our own continuity OB patients. I can't wait to get my 40 deliveries and then be done with OB forever. I love all the other aspects of FM, so that's why I chose it. I don't know how it works in other residency programs, but I only have two months of OB rotations in three years, and I can handle that little amount of OB. So I would go FM if you plan on practicing more in the outpatient setting. You shouldn't have an extreme amount of OB in residency (depending on what area of the country you do residency in).

I think I can handle two months (spread over three years!). But you're right, I like everything else about FM and want to practice outpatient medicine, so why would I let OB stop me!

Join the club. I did as little OB as I possibly could in residency...just enough to fulfill the requirement. The med students loved me, because I gave away a ton of deliveries. ;)

I just wanted to make sure that the feeling of dreading OB isn't weird for an FP. Everyone always talks about how much they like doing everything, even OB, and that just isn't me.

OB is actually pretty cool to me. I think it's pretty neat to bring a kid into this world, when all goes well, I mean. That's something the average Joe can't learn on the Internet. I actually wouldn't mind doing some international work delivering babies... avoiding all this madness we have here in the States.

It's the PEOPLE I don't like. I like the attendings, because they're at least normal... but I don't like OB/Gyn residents, I don't like the Charge Nurse, I don't like the L&D Nurses, I don't like the scrub tech. I just HATE how whenever it comes to pregnant women, people act like as if you just walked into another universe. I mean, it's like medicine doesn't apply anymore. Mag this, Mag that. Toothache? Mag it. Got a booger? Mag it. Ridiculous.

And, iatroB, the feces? Oh. No. Sir. You went into the WRONG profession if you think you're going to avoid feces. There is feces e-ver-y-where. In the ER, in the ICU, on the Floors, on the wall... on home visits, in the nursing homes, in L&D, in the NURSERY. Even the clinic in a plastic bag from a concerned mom so I can look at it. Hey, thanks. One call night, I got paged to "assess a patient" because he had pooped in the CT scanner. I mean, there's feces in RADIOLOGY. And then there's melena, there's Guiac cards, there's colonoscopies, there's stool O&Ps, fecal leukocytes. There is a whole 3 years devoted to Poop and people are banging down the doors to do it. I mean, even FPs are fighting like hell to stick a camera up there just to get a better LOOK at it.

Nuh-uh. Maybe you should have been an accountant. But as far as feces is concerned, you better get used to it.

When you say you hate OB... do you mean full scale OB like delivery and C-section... or like minor OB like period is irregular or pap smear things?

OB is actually pretty cool to me. I think it's pretty neat to bring a kid into this world, when all goes well, I mean. That's something the average Joe can't learn on the Internet. I actually wouldn't mind doing some international work delivering babies... avoiding all this madness we have here in the States.

It's the PEOPLE I don't like. I like the attendings, because they're at least normal... but I don't like OB/Gyn residents, I don't like the Charge Nurse, I don't like the L&D Nurses, I don't like the scrub tech.

And, iatroB, the feces? Oh. No. Sir. You went into the WRONG profession if you think you're going to avoid feces. There is feces e-ver-y-where. In the ER, in the ICU, on the floor, on the wall... on home visits, in the nursing homes, in L&D, in the NURSERY. One call night, I got paged to "assess a patient" because he had pooped in the CT scanner. I mean, there's feces in RADIOLOGY. And then there's melena, there's Guiac cards, there's colonoscopies, there's stool O&Ps, fecal leukocytes. There is a whole subspecialty devoted to Poop and people are banging down the doors to do it. I mean, even FPs are fighting like hell to stick a camera up there to get just to get a better LOOK at it.

Nuh-uh. Maybe you should have listened to Mama when she told you to be an accountant. But as far as feces is concerned, you better get used to it.

Great post! :laugh:

When you say you hate OB... do you mean full scale OB like delivery and C-section... or like minor OB like period is irregular or pap smear things?

I guess I consider the "minor OB" stuff as Gyn (I don't know what category they're in). That stuff doesn't bother me and I think an FP needs to be proficient at that (menstral cycle, paps, lower abdominal pain...). It is the OB portion that I don't like/don't think I'll use ("full scale" is what I'm referring too).

...but to care for families from cradle to grave, you have to know how to take care of pregnant ladies and post-partum moms. Are you going to dump them the second they get a postive HCG? True, you will refer them to an OB for their prenatal care and delivery (since you INSIST on not delivering them yourself ;) ), but they will still come to you with their URIs etc. during and just after their pregnancy.

You need to be aware of what's going on with the preggers, no matter how scary you think they (and their poop) are. That's the real reason why you apply perineal pressure with a surgical towel on the area, by the way. It's a poop shield, really.

Speaking of poo, I've had the distinct pleasure of watching a newborn pass meconium on several occasions this past week. Talk about a bizarre experience. Mec is some seriously funky...er....stuff.

When you say you hate OB... do you mean full scale OB like delivery and C-section... or like minor OB like period is irregular or pap smear things?

What's "minor OB?" You can't be a little bit pregnant. ;)

You mean gyn (http://forums.studentdoctor.net/attachment.php?attachmentid=6994&d=1159704246) (pronounced "guy-n", not "gin"). Gin is what I would be drinking a lot of if I had to do OB. :p

...

Speaking of poo, I've had the distinct pleasure of watching a newborn pass meconium on several occasions this past week. Talk about a bizarre experience. Mec is some seriously funky...er....stuff.

A neonate pooping is CUTE!:love:

Her mother's poo, on the otherhand is :barf:

A neonate pooping is CUTE!:love:

Her mother's poo, on the otherhand is :barf:

you must surely be going into peds...:)

You mean gyn (http://forums.studentdoctor.net/attachment.php?attachmentid=6994&d=1159704246) (pronounced "guy-n"..)

...or "guy-in" for some who dislike male Ob/Gyns:rolleyes:

...or "guy-in" for some who dislike male Ob/Gyns:rolleyes:

How 'bout "groinocology?" ;)

...but to care for families from cradle to grave, you have to know how to take care of pregnant ladies and post-partum moms. Are you going to dump them the second they get a postive HCG? True, you will refer them to an OB for their prenatal care and delivery (since you INSIST on not delivering them yourself ;) ), but they will still come to you with their URIs etc. during and just after their pregnancy.

You need to be aware of what's going on with the preggers, no matter how scary you think they (and their poop) are. That's the real reason why you apply perineal pressure with a surgical towel on the area, by the way. It's a poop shield, really.

Speaking of poo, I've had the distinct pleasure of watching a newborn pass meconium on several occasions this past week. Talk about a bizarre experience. Mec is some seriously funky...er....stuff.

That's a good point, I never thought of it like that. You're right, I should learn how to take care of the medical issues of the pregnant ones.

How 'bout "groinocology?" ;)

Girl-friend: "No baby, "it" is something special...We sould save it until our wedding night."

Me: "But baby, I am a professional. I am a "groinocologist". Are you sure you want to wait?"

Girl-friend: Come down here NOW!

:cool:

you must surely be going into peds...:)

Well,...Pediatric Surgery:)

or...ahem, Ob/Gyn as a back-up.

you must surely be going into peds...:)
That or our white cell friend has partially lost his/her mind......

Girl-friend: "No baby, "it" is something special...We sould save it until our wedding night."

Me: "But baby, I am a professional. I am a "groinocologist". Are you sure you want to wait?"

Girl-friend: Come down here NOW!

:cool:
Stephen R__________, CRT, EMT-I, FACRG
(Fellow, American College of Recreational Gynecologists) :meanie:

Stephen R__________, CRT, EMT-I, FACRG
(Fellow, American College of Recreational Gynecologists) :meanie:

The one specialty where call ISNT a bad thing!

The one specialty where call ISNT a bad thing!
No kidding....now if I can just get my girlfriend to stop thinking like Leuko's girlfriend!

It says in the FM program requirements that one delivery can be "counted" for two residents if one is the supervising resident and the other is delivering. Not sure how many of the 40 you can do this for, because at least ten are supposed to be continuity patients, but it does give a ray of hope for those who aren't interested in OB (myself not included).

It says in the FM program requirements that one delivery can be "counted" for two residents if one is the supervising resident and the other is delivering. Not sure how many of the 40 you can do this for, because at least ten are supposed to be continuity patients, but it does give a ray of hope for those who aren't interested in OB (myself not included).

Hmm, interesting. Loopholes, I like loopholes.

Some of your continuities can be c-sections (even scheduled) as well. So that's even less OB if you think about it. Most of our residents scramble for the G3P2 with two prior sections. Can you say scheduled section?

[QUOTE= And, iatroB, the feces? Oh. No. Sir. You went into the WRONG profession if you think you're going to avoid feces. There is feces e-ver-y-where. In the ER, in the ICU, on the Floors, on the wall... on home visits, in the nursing homes, in L&D, in the NURSERY. Even the clinic in a plastic bag from a concerned mom so I can look at it. Hey, thanks. One call night, I got paged to "assess a patient" because he had pooped in the CT scanner. I mean, there's feces in RADIOLOGY. And then there's melena, there's Guiac cards, there's colonoscopies, there's stool O&Ps, fecal leukocytes. There is a whole 3 years devoted to Poop and people are banging down the doors to do it. I mean, even FPs are fighting like hell to stick a camera up there just to get a better LOOK at it.
Nuh-uh. Maybe you should have been an accountant. But as far as feces is concerned, you better get used to it.[/QUOTE]

This is soo darn funny. Oh My God, this **** is hilarious. Thanks for making me laugh. :laugh: :laugh: :laugh:

This is soo darn funny. Oh My God, this **** is hilarious.

Yeah, that's some funny sh... er, stuff! :D

I just wanted to make sure that the feeling of dreading OB isn't weird for an FP. Everyone always talks about how much they like doing everything, even OB, and that just isn't me.
the vast majority of the fp docs I work with do gyn but no ob. the ones who like ob still do it( and make better money) but it is completely optional in most multispecialty groups, and even in large fp only groups.

I don't mind feces... I don't mind blood... it's evil people that kill me and coffee haters (a subdivision of evil people).

How 'bout "groinocology?" ;)

I love it--a new specialty for both male and female reproductive organs.

Yeah, that's some funny sh... er, stuff! :D

Kent, I think we should make lowbudget's poop post a sticky. :)

and after my midwife spent so much time convincing me they're used to women pooping in labor and i shouldn't feel embaressed. now i find out you people really do mind it and i should have felt embaressed after all! oh, those lying midwives! i want a re-do on my births...:meanie:

Yeah, they should be used to it.....seeing as they think castor oil speeds up the delivery process..... :rolleyes:

Hi, I'm new to SDN, but I have to say that the OP is in the majority of FP residents that I know. All of them hate OB. I wonder if it has more to do with the attitudes of OB nurses and residents, than the actual experience of delivering a baby.

I love OB, but hate the OB nurses and residents.

and after my midwife spent so much time convincing me they're used to women pooping in labor and i shouldn't feel embaressed. now i find out you people really do mind it and i should have felt embaressed after all! oh, those lying midwives! i want a re-do on my births...:meanie:

When you hear a resident say, "OH PLEASE FOR THE LOVE OF GOD!! DON'T PUSH!!!"

That means, if you get the baby out here in triage instead of the labor rooms....you will make us hate life.

Yeah, they should be used to it.....seeing as they think castor oil speeds up the delivery process..... :rolleyes:

LOL!!! It does induce labor though. My midwife was big on castor oil too, although I used other methods to try and induce labor.;) It works by making you POOP!!! The GI irritation in turn irritates the uterus and then voila, you are in labor and pooping everywhere!:D

OK, stupid questions here...I didn't realize that FM was able to do so much OB. I plan on specializing in (rural) FM, but I thought that you would just refer your patient to an OB/GYN for pregnancy. It is actually an option to do FM with OB? Do you do c-sections if you do? How does it affect your malpractice insurance? I would love to deliver babies, but I know I will hate any type of surgery. I might specialize in OB/GYN if it wasn't for the c-sections. I love pregnant women too. I am one of those people that likes to rub bellies!:D I have four kids of my own and want more someday. I think it would be awesome to help patients bring their children into the world.

I don't mind feces... I don't mind blood... it's evil people that kill me and coffee haters (a subdivision of evil people).

:thumbup: :D

and after my midwife spent so much time convincing me they're used to women pooping in labor and i shouldn't feel embaressed. now i find out you people really do mind it and i should have felt embaressed after all! oh, those lying midwives! i want a re-do on my births...:meanie:


LOL!!! I had four kids with midwives, and I can relate!:laugh: I think that people who actually specialize in OB/GYN don't mind the poop. I don't really see what the big deal is. What is wrong with a little poop? Then again, I have two children in diapers and so my daily life is filled with poop so I guess I have gotten used to it. Yet another reason why mothers make better doctors...;) :D

It is actually an option to do FM with OB?

Sure.

Do you do c-sections if you do?

You can, if you learn how.

How does it affect your malpractice insurance?

It goes up...a lot.

More info here: http://www.aafp.org/online/en/home/policy/policies/o/obstetrics.html

Sure.



You can, if you learn how.



It goes up...a lot.

More info here: http://www.aafp.org/online/en/home/policy/policies/o/obstetrics.html


Thanks! Very helpful.

...but to care for families from cradle to grave, you have to know how to take care of pregnant ladies and post-partum moms. Are you going to dump them the second they get a postive HCG? True, you will refer them to an OB for their prenatal care and delivery (since you INSIST on not delivering them yourself ;) ), but they will still come to you with their URIs etc. during and just after their pregnancy.

You need to be aware of what's going on with the preggers, no matter how scary you think they (and their poop) are.

Understanding the physiology of pregnancy and being comfortable managing the medical problems of pregnant women is something IM and FM trained physicians should be comfortable with whether they actually deliver babies during their post graduate training or not.