Have done an audition in both fields now, I like the FM residents a lot more, they seem to be more helpful, less aggressive, etc. I also don't love the L&d side of OB, but I enjoy procedures and like surgery also. I am torn now. I have catered my whole application to OB, I have great letters, great board scores, but I am feeling more and more like lifestyle and peer enjoyability are more important to me now than money and/or the fact that FM seems to be less respected. Have any of you been in this situation and jumped ship from OB to FM? I am seriously torn and need to figure something out before ERAS opens up for MD residencies.
Fm vs ob
- Thread starter jrlob91
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This should be a fairly straight forward decision, do you like the OR or do only see yourself doing clinic? OB you can do from either, though arguably OB/gyn will allow you to take care of higher risk pregnancies and do surgery. You can do surgical fellowships out of OB/gyn and never have to see the inside of L&D, but that's a gamble since those oncology, urogyn, and even MIGS (which is not boarded) are among the most competitive specialties. I personally strongly disliked OB (but liked reading about it) and knew I was going to do a surgical fellowship. You can have a very enjoyable career as an obgyn which is low risk and low stress, similarly you can have an extremely stressful career as an FM. And FM residency is no picnic if you go to a good program, many of them have 24 hour calls whereas for now at least OB/gyn is still mostly a night float system. When I was a resident the FM residents were some of the most harried in the hospital, caring for patients in the ICU, floor and L&D in the same night, what's more many of them chose to stay to care for delivering patients from their clinics after their shift was over. If your goal is to get good training both fm and OB/gyn will be hard (though at least FM is one less year) however what will make it less hard is of the work you do is enjoyable. As much as I disliked OB I still had some fun on L&D doing cesareans.
So again, this boils down to do you want to spend most of your career in clinic or the OR (keep in mind many FMs do lots of procedures they just happen to be more clinic based)
Hope that helps.
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Although this seems complicated, it really comes down to one thing. Do you want to deliver babies and/or do surgery? If the answer is yes, then stay away from FM. Many hospitals won't give you privileges to do c-sections so it may be a waste. Simple, want surgery? Do OBGYN
I think this is a somewhat common scenario as I know several people, myself included, who were trying to decide between OB and FM.
Anecdotally speaking, I met a handful of people who had switched from OB to FM, so that solidified in my mind that I was making the right choice.
While I was a med student, I thought that it wouldn't matter that I would be working an insane amount as an OB resident, as long as I loved what I was doing, but now that I am a FM resident I don't think that way of thinking is so simple.
Bottom line for me is that work life balance is so very important to me and FM provides that opportunity. In addition, FM provides very very wide options for careers. I don't plan to be the "typical" outpatient family doc and I have several mentors that have taken their careers outside of the box, so I look forward to that.
Overall I think for anyone to do Obgyn they really should be 100% committed to the career and lifestyle. I second guessed myself on wanting to be an Obgyn, went with FM and am 100% happy with my decision.
Anecdotally speaking, I met a handful of people who had switched from OB to FM, so that solidified in my mind that I was making the right choice.
While I was a med student, I thought that it wouldn't matter that I would be working an insane amount as an OB resident, as long as I loved what I was doing, but now that I am a FM resident I don't think that way of thinking is so simple.
Bottom line for me is that work life balance is so very important to me and FM provides that opportunity. In addition, FM provides very very wide options for careers. I don't plan to be the "typical" outpatient family doc and I have several mentors that have taken their careers outside of the box, so I look forward to that.
Overall I think for anyone to do Obgyn they really should be 100% committed to the career and lifestyle. I second guessed myself on wanting to be an Obgyn, went with FM and am 100% happy with my decision.
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going through this right now. it's purely the lifestyle and the type of people that are making me switch.
Thanks guys for your replies. Do you think it is a bad idea to apply and rank both? Also, do any of you that have switched think that FM is less intellectually stimulating, i.e. follow ups/med refills and things like that instead of managing high risk pregnancies/performing complicated surgeries?
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People apply to 2 specialties every year, but I have no experience with that. I will say that people that let the "match decide" often end up being disappointed as they are left wondering what would have happened if their luck placed them in the other specialty. Also there's plenty of Nonstimulating visits in OB/gyn (for instance every prenatal visit after the first one, where all you're doing is checking fundal heights and blood pressures) unless you're doing mfm where a lot of it going through blood sugar logs and being in ultrasound all day long. Even where I trained (with a lot of pathology) most of what we saw in Mfm was the typical preeclampsia, diabetes and preterm birth which can get real routine after a while. Can't speak for other subspecialties but in urogyn (which I love) we do a lot of Med visits for OAB and post-op follow ups after the first postop visit aren't exactly the pinnacle of diagnosis. And unless you're going to a rural area or do a fellowship it is unlikely that a general obgyn will be doing a lot of complex surgeries as in many metropolitan areas specialty trained surgeons are doing the majority of anything beyond a D&C due to D&C. If anything FM will be more stimulating because of the variety. But in the end everything becomes routine because being on your toes all the time could get exhausting.
Thanks for your input, I really appreciate it!
No I don't think it's intellectually less stimulating at all. Actually, I think obgyn is less intellectually stimulating in general. We see much more variety on a daily basis. I would say the majority of my visits are something other than "routine" diabetes management for example. On the days the obgyns see routine prenatal care visits all day, I don't think that's very intellectually stimulating. I saw 4 Ob patients this morning and was glad it was only 4, ha.
If I did Obgyn my ultimate goal would've been to do urogyn as they have a generally nice lifestyle with a happy patient population and interesting surgeries. But I have no regrets about choosing fm as fellowships aren't guaranteed and I didn't want to go through 4 years of misery during residency.
The only reason I'd have a hard time ranking 2 specialities is because going on interviews is costly and time consuming. I really would want to maximize my options and chances in each speciality and for me personally that would mean going on at least 10 interviews in each specialty and doing 20 interviews seems too exhausting for me to want to deal with.
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I am in fam med and sincerely advocate that if you are considering obgyn at all, GO OBGYN.
The path of fam med is moving away from obgyn. You have to do a certain number of deliveries per year to keep your obgyn privileges and it's difficult to do that when you're in clinic 5 days a week and possibly taking call on weekends. Apart from FM physicians with strong desire to practice in a rural area, the majority of FM residents don't Intend to do deliveries outside of residency.
Most fam med residents tolerate OB because it's an important skill to know and it may be relevant one day if there are no other providers, but...tolerate is a good word.
Yes, there are FM docs who still do deliveries. Yes, there are FM docs who love OB. But every single person I've known who was torn between obgyn/FM or obgyn/peds, who "defaulted" into FM *HATES* being in FM. I don't want to see you be one of them!
Good luck w the match
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I disagree with this. The majority of the residents in my FM program intend to do FM w/ OB following residency. Many of us struggled between choosing FM vs OBGYN but ultimately chose FM because we love family medicine. It wasn't a backup. I think the main thing if you decide on FM, is make sure you go to a program with very strong OB training. I'm at a program where you can get delivery numbers that rival some OB programs and my program has strong c-section training as well. Of note- most of us intend to go into more rural areas. So make sure to be asking those questions on interviews (how many deliveries to expect, etc).
Good luck with your decision and the match!
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Great to hear your perspective as an FM/OB lover!
Two minor points- Sounds like you didn't "default" in FM- you chose it over OB ("it wasn't a backup") Which is great and probably why you enjoy it!
I just REALLY want to caution people who rank FM "just in case" that they aren't going to actually like practicing it. It's the "just in case-ers" who "default" into FM when they dont get an OB position who are understandably miserable, studying the 90% of FM that isn't OB.
Also, I maintain that the pie chart of FM residents who want to do OB and FM residents who want to practice rural medicine, is a circle. Like yourself. And the OB loving people at your program. 🙂
