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Family Planning Fellowships

Discussion in 'Ob/Gyn' started by pjs, Aug 12, 2008.

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  1. pjs

    pjs

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    Does anyone have any information on family planning fellowships? I am aware of the fellowship programs that exist, but does anyone know --(1) how competitive it is to get a fellowship;(2) how many applicants there are in a typical year; and (3) any specifics about the different programs that anyone wants to share, would be appreciated. Thanks!
  2. fuzzyerin

    fuzzyerin Senior Member

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  3. pjs

    pjs

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    Thanks for posting the link to the website. I was really looking for personal insights into the different programs and experiences in applying. I would appreciate any info. people can give me.
  4. NKDA

    NKDA

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  5. Requiem4Souless

    Requiem4Souless

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    It's hard to find solid information on the fellowship without access to the fellowship site (they don't give access to medical students so I'll have to wait a couple of months myself). I've talked to a few of my school's family planning docs. I've been told that most people who apply get in somewhere. Generally, the people who don't are very limited in their geographical preferences.

    The programs are two years long and you generally get an MPH or MS degree while you're at it. There is salary support post-fellowship but I don't know how often that happens or what are the requirements.
  6. greenpistachio

    greenpistachio

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    I'm a third year med student. I love gynecology and I'm especially interested in Family planning: contraceptives, pregnancy terminations. Eventually I want to be in academic medicine, do research, teach students/residents.

    Here's my problem: I'm trying to decide between OB/GYN or family med. If I do OB/GYN, I'd do a FP fellowship too. If I do family, I will try to go to a program with abortion training.

    I'm hesitant about OB/GYN because
    1) I don't like OB... Delivering babies just doesn't give me a high like it seems others.
    2) The lifestyle of residency and attendings seems brutal compared to Family Med.

    There is no family planning fellowship at my med school and thus no faculty. I was turned off by my interactions with faculty because no one seemed to know a lot of performing terminations or how to advise a student about this.

    I'm looking for someone who is interested in a family planning fellowship, currently in one, or graduated from one for some perspective about it.
    -What is life like after finishing this fellowship ie do you see OB patients, take OB call?
    -Is it harder or easier to get an academic position after an FP fellowship?
    -Does doing terminations make it harder to get a job?

    You can also PM me.
  7. anonperson

    anonperson

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    If you do an OB GYN residency. Be prepared to spend around 50% of your time managing obstetric patients (not just delivering patients but medical and surgical problems of these patients) and labor/delivery. That is a fact of life in residency.

    The lifestyle after residency varies. Depends on if you're private practice, location, if you're full time etc.

    Many academic centers have faculty who specialize in family planning ie performing elective terminations. From what I have seen they still practice as generalists as OB is still the main source of business or they still cover residents as part of their coverage duties. This will vary from institution to institution.

    What exactly are your questions about terminations that couldn't be answered by your faculty? My program doesn't perform elective terminations but I've performed a decent amount of procedures due to fetal demises in the second trimester or lethal anomalies as far as 17 or 18 weeks. You should be getting this exposure in most residencies and probably develop a baseline comfort in residency. You can do a family planning fellowship to fine tune your skills but as a third year, if I had a patient with a 14 week demise, I would feel fairly comfortable performing the D+E in a safe manner.
  8. fluoropHore

    fluoropHore Birthin yer babies.

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    I have a related question. Do all residencies (or rotations) include terminations? I am interested in famplan as well, and I know it was an issue a few years ago... but is getting exposure (or more so, gaining a certain proficiency) in termination an issue for students in most hospitals? I guess in Catholic hospitals it would be. How does a medical student interested in fam plan get into it (I'm asking as a future DO student here) and do they HAVE to do a fellowship? It seems reading here, you don't.
  9. anonperson

    anonperson

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    Even if a residency doesn't offer elective terminations, you will still have training in D+Cs, D+Es, and medical management of abortions. There is a significant number of patients who will present with spontaneous abortions, IUFDs etc that need to be managed in essentially the same way as an elective termination.

    There are family planning fellowships out there.
  10. Pegsie

    Pegsie Junior Member

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    When I was interviewing for residencies awhile back, the general consensus was that you should be comfortable with the possibility of doing OB for the rest of your life. Gyn-only fellowships (Gyn Onc, REI, MIS) are, in general, fairly competitive, and so you can't count on necessarily getting one. In addition, if you start out as a generalist, it will be nearly impossible to not have OB responsibilities - most older partners who have put their time in are the ones giving up OB call, leaving more for the new hires. That being said, I know plenty of people who hated OB and got into fellowship. There is some buzz about having residency programs "fast-track" so that you can kind of start to specialize during residency. Cleveland Clinic is one such program.

    Yes, OB/GYN residency is no breeze; when you work, you work hard. But, sometimes my schedule would be more manageable than my friends' - during the latter half of my residency my shifts were no longer than 14 hrs, I always had 2 weekends off a month unless I agreed to a trade. Many of my friends were still doing 30 hours on call. Just choose your residency carefully.

    As far as a career post-family planning fellowship, the majority of FP faculty serve as generalists and take OB call. There are some places with a full FP division who don't serve as generalists but that tends to be the minority. You could also just go to a planned parenthood and never see an OB person again.

    FP fellowship gives lots of experience - research, MPH/MS - all of which can only help if you want an academic position.

    It's doubtful that having extra skill/expertise on a procedure will make it harder for you to get a job - assuming that you aren't going to look in an area or at an institution that is not supportive of family planning.
  11. fluoropHore

    fluoropHore Birthin yer babies.

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    So what do people usually do with fam Plan fellowships then? What are they necessary for?
  12. THP

    THP Senior Member

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    The vast majority of ob/gyns in the community do not want the reputation as someone who is willing to terminate a pregnancy. Anyone who has done a family planning fellowship is essentially advertising that they are willing to do it.

    I have never seen or done a D&E greater than 15 weeks. We typically induced these patients in the hospital during residency in the setting of IUFD, HELLP, etc. Not that I would ever do one, but I certainly would not feel comfortable from a skill set to do a 16 or 18 week D&E. I suppose you would get training on this during fellowship. How anyone can stomach that is beyond me.
  13. anonperson

    anonperson

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    There is more and more data out there indicating that D+E is safer and more effective for second trimester pregnancy termination. I feel that because of this, residents are getting more and more exposure as the procedure gets used more. Some of my older attendings have echoed this.

    Its a nice thing to offer patients during a difficult time.
  14. THP

    THP Senior Member

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    I agree, with the caveat being the surgeon is experienced in the procedure.

    Unless you have done a lot of these it is probably better for the patient to be induced. There can be pretty significant complications from a midtrimester D&E that doesn't go well. Plus, most patients want to be able to hold the baby afterwards and have a funeral, at least in my experience.

    Where I did residency we had 6 MFMs and only 2 felt comfortable doing mid trimester D&E and none of the generalists would do one beyond 16 weeks. No one in my current practice of 11 physicians does them. And our hospital is the tertiary referral center for a very large region.
  15. fluoropHore

    fluoropHore Birthin yer babies.

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    Can I ask another question? Is utilizing an externship (anywhere from 2 weeks to months- only requirement is viewing 50+ procedure) through Medical students for choice a kosher way of gaining experience to perform these if one cannot get a fellowship?
  16. Pegsie

    Pegsie Junior Member

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    Generally, just viewing won't be enough experience to perform a D&C. You will get plenty of experience doing D&Cs in residency, so fellowship won't be necessary for that. D&E experience will be variable depending on what program you go to.

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