Won't happen in the Eastern half of the country
Not in the
popular cities in the eastern half, no, but here on the mid-Atlantic coast I rotated with 2 FM+OB docs. Both did FM followed by 1 year OB fellowships (elsewhere). One has an FM academic appointment and has med+OB privileges in the big fat urban-ish academic hospital, and has a fairly stable relationship with the ObGyn faculty. The other doc is rural, and did her own job search, convincing a small hospital to hire her as their 2nd "half" OB. 0-2 babies/day with fairly flexible Q2-ish call, women's health clinic shared with the ObGyn 2-3 days/wk, FM clinic 2-3 days/wk. On rounds and in the OR with the rural doc I saw no particular differences in her operational/administrative ability to function vs. ObGyn attendings (I'm in no position to judge clinical ability). The rural doc makes in the $300k range. Based on a variety of factors I would speculate that the urban doc makes less.
In either case, the hospital has to be convinced, and the "competing" ObGyns have to be convinced, and nurturing those relationships obviously is the key to stability.
By contrast, the suburban areas in this mid-Atlantic coastal region are dense with ObGyn private practices, with no shortage of docs. There are no FM+OB docs in these wealthy, popular suburbs, as far as my interrogations have found.
Meanwhile,
west coast FM interview field report on OB: the 6 full spectrum, unopposed, "heavy OB" programs I went to
all say they have the highest OB numbers of any FM residency. Motivated residents get in the 200 vag, 100 c/s range over 3 years. Interested PGY3's tend to carry the "c-section pager", so they can max their procedure counts (sometimes with moonlighting pay). The PGY3's and the FM+OB fellows all advised interviewees to keep very good logs, as those logs are what get you hired in lieu of BC/BE (see
@cabinbuilder 's many comments on how logs are her locums job security, totally unrelated to OB). The OB fellowships at these programs
are competitive, mostly taking their own grads. Of these 6 programs, the 2 without an OB fellowship had higher OB counts, because there's no competition with fellows. I'd estimate that 1/3 of the current residents, and 1/2 of the interviewees, were more interested in OB than anything else; OB questions dominated the interview day discussion.
