OB intern wanting to switch - ideas?

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Hey all, I have a bit of a dilemma that I was hoping to get some insight/advice on:
I am currently an OB/GYN intern at a solid program and thinking of switching to Radiology or Psychiatry. I had a tough time deciding between these fields in the first place and would really like to do IR (diagnostic is fun as well but I think my goal is IR). I truly do love my field but the OB part I can do without. I realized I am someone that is more planned and the excitement of L&D wore off pretty fast. I like diagnosis more than management and prefer using fine technique. I do like the surgical aspect of my field but definitely prefer the finer surgeries in gyn than the rushed OB stuff. Urogyn? Yes, thought about it but don't think I'd be happy doing another 3 years of OB . . . .

Why do I like psychiatry? I think it's very rewarding personally. I love that you have extended time with patients and can make such a dramatic impact on someone's quality of life. I love reading psych literature and think I could definitely see myself happy in this field. The only CON I see with psych is - no procedures!
That all being said, ultimately I'm struggling with how to work all this out. Do I approach my PD first? How do I go about finding outside of the match spots? Should I just call every program I can think of? Should I just apply via ERAS next year? Should I continue my current residency(PGY2) until I find an open position even though I'm miserable? Would radiology accept my ob/gyn intern year as a prelim?
My stats aren't too impressive (step 1: 219, step 2: 211) so that's a factor as well (but I have alot of research, publications, solid grades from a good MS). My fiance is also a resident in my current city so that's a consideration as well. We would like to stay together if we could . . . . but ultimately we are okay with being on the same coast(east).

Ideas? Extrapolations? Random commentary?

I'm all ears.

Well, if it's just that you hate OB, why don't you finish your residency and then do a fellowship in a non obstetric field of Gyn (Uro-gyn, reproductive endocrinology, etc...)? Even if you applied to one of these other fields, you would likely have to start over, and the total time difference would be minimal. Reinventing the wheel and starting over is often more difficult than applying to the fellowship after the fact. I would have to say that unless you find the whole experience intolerable, the evil you know if often the preferred route.

Switch residency to something you'll be most happy doing! It's not that hard and more people do it than you think. I promise.

I think you have to start by letting your PD know you're thinking of switching. You need his/her blessing. And this will not be the first time they have heard of someone wanting to switch. I think if you are a hardworking resident with no major issues with your program, you'll get support. Maybe relucatant support... but that's good enough. (You WILL need a letter from your PD).

Then start asking around. I would start by calling the residency advisors in psych and radiology at your medical school. They may refer you to the PDs of those programs at your med school. Ask them what the process would be like to switch to their specialty. You almost certainly will need to complete an ERAS application... but may or may not need to go through the match.

Anyway, good luck!

Why don't you just finish your residency, and then, when you go into practice, just do gyn? You might even consider something like gynecological oncology, where you can diagnose a variety of benign and malignant tumors, if that's something that interests you. And the pace is definitely more planned and less rushed, unlike OB. It will be a major headache at this point to switch to radiology or psychiatry.

Plus, I'm confused. You said that your goal is to do IR, but you like diagnosis more than management. Wouldn't diagnostic radiology be more suitable than IR?

I would make sure you're not attracted to the "idea" of psychiatry vs the reality. Psych lit =/= practice.

Rads is still quite competitive. With USMLE scores well below the mean and funding issues, your chances of getting a spot are not great.

Still, you should follow your heart. Just make sure you know what you're getting into.

Originally Posted by aProgDirector

I would make sure you're not attracted to the "idea" of psychiatry vs the reality. Psych lit =/= practice.

Rads is still quite competitive. With USMLE scores well below the mean and funding issues, your chances of getting a spot are not great.

Still, you should follow your heart. Just make sure you know what you're getting into.

While I agree with you that rads is still quite competitive, there are a number of PGY-2 positions that are still open now so I don't think it's unrealistic for OP to get a spot if she has been a good resident and can get PD's blessings and a few good LOR's. For psych OP would have to start from scratch-intern year + 3 years of psych OR medicine year + 3 years of psych. Either way, it's 4 years. For rads, I guess it's still 4 years but she may be more well received since she comes from a more procedural specialty. Just my 2 cents!

Originally Posted by Mariposa75

Hey all, I have a bit of a dilemma that I was hoping to get some insight/advice on:
I am currently an OB/GYN intern at a solid program and thinking of switching to Radiology or Psychiatry. I had a tough time deciding between these fields in the first place and would really like to do IR (diagnostic is fun as well but I think my goal is IR). I truly do love my field but the OB part I can do without. I realized I am someone that is more planned and the excitement of L&D wore off pretty fast. I like diagnosis more than management and prefer using fine technique. I do like the surgical aspect of my field but definitely prefer the finer surgeries in gyn than the rushed OB stuff. Urogyn? Yes, thought about it but don't think I'd be happy doing another 3 years of OB . . . .

Why do I like psychiatry? I think it's very rewarding personally. I love that you have extended time with patients and can make such a dramatic impact on someone's quality of life. I love reading psych literature and think I could definitely see myself happy in this field. The only CON I see with psych is - no procedures!
That all being said, ultimately I'm struggling with how to work all this out. Do I approach my PD first? How do I go about finding outside of the match spots? Should I just call every program I can think of? Should I just apply via ERAS next year? Should I continue my current residency(PGY2) until I find an open position even though I'm miserable? Would radiology accept my ob/gyn intern year as a prelim?
My stats aren't too impressive (step 1: 219, step 2: 211) so that's a factor as well (but I have alot of research, publications, solid grades from a good MS). My fiance is also a resident in my current city so that's a consideration as well. We would like to stay together if we could . . . . but ultimately we are okay with being on the same coast(east).

Ideas? Extrapolations? Random commentary?

I'm all ears.

If you are really unhappy doing OB, I don't think finishing residency is going to work. I am married to an OB/Gyn resident, so I know the schedule. You will be doing LOTS of OB in residency. I would NOT talk to your PD until you know what your plan is. You really have to decide which field you want to pursue. Radiology might be a reach with your stats (avg step 1 was 240 for US seniors and 235 for independents).

If she really hates OB then doing another 3 years of ob/gyn residency will be tough...though it could be done I'm sure.
I heard radiology is still competitive...she might get a spot but likely won't have much of a choice in where she goes...unless she can maybe see if there is a hospital in her current city that would give her an out of match spot in exchange for doing a year of research or something...but I'd think it will be tough.
Psych is not very competitive, but it's a very different field than ob/gyn. Very, very different. Remember you'll be giving up physically examining patients and there are no procedures. You'll have to convince people of your true interest in psych. Psych I think is a better option than rads if you want to make sure you can stay near your fiancee, which I now realize (now that I'm 30-something) is equally important as some job (which is what medicine ultimately is).

Also, make sure you aren't just burned out because being an intern kind of sucks.

I also agree with not talking to your PD unless/until you've definitely made your mind up.

You didn't mention internal medicine...that is another field that is pretty easy to get in to and leaves you the option to specialize later if you want. You can do things like critical care medicine or nephrology where there would be some procedures involved. There is a lot of diagnosis but also a lot of "treatment" of patients. Still, the hospitalist market has been pretty good the past few years and I think it will stay good for a while, so that might be an option and since there are so many IM spots, you could potentially stay at your same hospital and/or in same city, perhaps.

FP is another specialty where it is easy to get a spot in general, and that you'd be able to get credit for some of the months you have already done.

Originally Posted by Medstudentquest

While I agree with you that rads is still quite competitive, there are a number of PGY-2 positions that are still open now so I don't think it's unrealistic for OP to get a spot if she has been a good resident and can get PD's blessings and a few good LOR's. For psych OP would have to start from scratch-intern year + 3 years of psych OR medicine year + 3 years of psych. Either way, it's 4 years. For rads, I guess it's still 4 years but she may be more well received since she comes from a more procedural specialty. Just my 2 cents!

Actually, the ABPN (american board of psych and neuro who sets the guidelines of required rotations that residency programs follow-so their graduates can become board certified) accepts a completed PGY-1 year in any ACGME program as a PGY-1 year in psychiatry. So, technically, the OP can start as a PGY-2 psychiatry resident. You do have to make up the 2-months of neurology in your 2nd or 4th year. But you will only have to do 3 years of psychiatry if that is what you want to do. OP can PM me as I just made the switch from obgyn to psych. My situation is different from yours, but maybe I can share my story with you.

To all: It's so helpful to hear a variety of opinions on this matter and I am really grateful for that.

@ cerealbox, I love your story!
@ TopGun, IR requires minimal management and it's super cool Gyn onc is too sad for me
@ DragonFly, intern year sucks so bad but I think for ob/gyn - 2nd year just gets worse
@ PMPMD, I'm curious what specialty you are?

I am still figuring out what to do . . .I just finished up a month of SICU and really loved it. I don't know if it's the different pace, the different people or the actual variety of diseases - but I can now say for sure that going back to OB next month is going to make me miserable!

If you like the ICU you could consider switching to internal medicine and then consider critical care fellowship after that. Anesthesiologists also can do critical care.
Internal med tends to be easy to get into...you could almost definitely get a spot somewhere and maybe you could even get a spot at some place you know...you could cold call hospitals/residency programs and see if they may have an extra spot...or you could try to scramble (is that over already?). The only problem with medicine --> critical care is usually people do a pulm/critical care fellowship, which would be 3 years IM plus 3 years of fellowship...but I believe the critical care fellowship alone can be done, and might be only 1 year (? or two). Hospitalist and/or intensivist positions are decent lifestyle from what I have seen...you have to be able to deal with the stress of being in the inpatient setting with overall sicker patients, but there is no clinic BS and you never have to deal with outpatient phone calls or those types of issues...when those guys are off duty, they are really off.

Originally Posted by dragonfly99

If you like the ICU you could consider switching to internal medicine and then consider critical care fellowship after that. Anesthesiologists also can do critical care.
Internal med tends to be easy to get into...you could almost definitely get a spot somewhere and maybe you could even get a spot at some place you know...you could cold call hospitals/residency programs and see if they may have an extra spot...or you could try to scramble (is that over already?). The only problem with medicine --> critical care is usually people do a pulm/critical care fellowship, which would be 3 years IM plus 3 years of fellowship...but I believe the critical care fellowship alone can be done, and might be only 1 year (? or two). Hospitalist and/or intensivist positions are decent lifestyle from what I have seen...you have to be able to deal with the stress of being in the inpatient setting with overall sicker patients, but there is no clinic BS and you never have to deal with outpatient phone calls or those types of issues...when those guys are off duty, they are really off.

Anesthesia/CCM could be a 4 year path (3+1) for OP if they can get credit for intern year. The IM CCM only fellowship is 2 years I believe.