Full-spectrum FM except for OB: residency interview question

[retroflex]

Current M3 planning to target FM programs that train you to go rural and do it all. Except after finishing up my OB rotation I know I don’t want to do OB.

When it comes time for residency interviews, should I just say that? It seems that many of the programs that give you good inpatient, procedural, and emergency med training also require a lot of OB. I wouldn’t want to put them off by saying I’m not interested in the OB part.

Obviously I would still work hard and fulfill my duties so that I didn’t cause more work for my future co-residents. Should I keep it vague and say I will potentially do OB in my career? Thanks.

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[cj_cregg]

You don't have to be planning to do OB in practice to benefit from robust OB training. Some of your patients will be pregnant or postpartum whether you deliver them or not, and you need to be able to recognize and manage obstetric emergencies, know what meds are safe to use in pregnancy and breastfeeding, etc. Also, family docs doing prenatal care but no deliveries is definitely a thing if that sounds more your speed. So you could just frame it as you're not sure you want to do deliveries in practice but you still want good full spectrum and obstetric training because XYZ.

 

[retroflex]

You don't have to be planning to do OB in practice to benefit from robust OB training. Some of your patients will be pregnant or postpartum whether you deliver them or not, and you need to be able to recognize and manage obstetric emergencies, know what meds are safe to use in pregnancy and breastfeeding, etc. Also, family docs doing prenatal care but no deliveries is definitely a thing if that sounds more your speed. So you could just frame it as you're not sure you want to do deliveries in practice but you still want good full spectrum and obstetric training because XYZ.

Very good point. I kind of had blinders on from being on L&D and forgot you can do pretty much everything but deliveries as FM if you so choose and find a place that is looking for those services. I enjoyed my time in clinic doing prenatal and postpartum appointments. And I hope to be able to take ED shifts in the (most likely) rural area I end up in, so your point about OB emergencies is on point as well.

 

[topraman]

Agree with CJ. Everything you learn as FM cross-trains. So train as if you're going to practice it all even if you don't end up doing you, you'll be better for it.

And similar to diagnostic reasoning, avoid premature closure. Clinical experiences in medical school and residency can be colored by the people you work with and the specific unit set up and culture as much as the subject area. We had people in my residency who started off thinking they just wanted to be outpatient docs who halfway through embraced new joys and ended up doing it all including surgical OB. It can go the other way as well.

Finally, I think for true FM philosophy one's scope is more than your own interests (though that's a part) - what we do should also be a function of what our community needs of us. Hard to know that ahead of time and that need can also change over the years but the fact that you can change with it and be there for them is the beauty of generalism.